Med-Surg Exam I and GI ATI QUESTIONS \| \| \| \| \| \| \|
WITH ANSWERS \|
A nurse is caring for a hospitalized client with acute pancreatitis.
\| \| \| \| \| \| \| \| \| \| \|
After treatment begins, the nurse anticipates that which serum
\| \| \| \| \| \| \| \| \|
laboratory value will return to normal within 72 hr? \| \| \| \| \| \| \| \|
A aldolase
\|
B amylase
\|
C lipase
\|
D lactose dehydrogenase - CORRECT ANSWERS ✔✔B, Amylase
\| \| \| \| \| \| \|
Rationale: Pancreatitis is the most common reason for marked
\| \| \| \| \| \| \| \| \|
elevations in serum amylase. Serum amylase begins to increase
\| \| \| \| \| \| \| \| \|
about 3 to 6 hr following onset of acute pancreatitis. The
\| \| \| \| \| \| \| \| \| \| \|
amylase level peaks in 20 to 30 hr and returns to normal in 2 to
\| \| \| \| \| \| \| \| \| \| \| \| \| \| \|
3 days.
\|
A client is receiving a tube feeding via a continuous enteral pump
\| \| \| \| \| \| \| \| \| \| \|
at 75 mL/hr. When the nurse assesses the client at 0800, which
\| \| \| \| \| \| \| \| \| \| \| \| \|
of the following nursing observations requires intervention?
\| \| \| \| \| \|
A A pitcher of water and plastic cup are sitting on the client's
\| \| \| \| \| \| \| \| \| \| \| \| \|
over-bed table within reach. \| \| \|
B The disposable feeding bag is from the previous day at 1000
\| \| \| \| \| \| \| \| \| \| \| \|
and contains 200 mL of feeding.
\| \| \| \| \|
,C The client is lying on the right side with a visible dependent
\| \| \| \| \| \| \| \| \| \| \| \| \|
loop in the feeding tube.\| \| \| \|
D, The head of the bed is elevated 20º. - CORRECT ANSWERS
\| \| \| \| \| \| \| \| \| \| \| \|
✔✔D, The head of the bed is elevated 20º.
\| \| \| \| \| \| \| \|
Rationale:The head of the bed should be elevated at least 30º \| \| \| \| \| \| \| \| \| \| \|
(semi-Fowler's position) while the tube feeding is administered. \| \| \| \| \| \| \| \|
This position uses gravity to help the feeding go down and
\| \| \| \| \| \| \| \| \| \| \|
lessens the possibility of regurgitation. \| \| \| \|
A nurse is caring for a client with severe gastroesophageal reflux
\| \| \| \| \| \| \| \| \| \| \|
disease (GERD) who is to undergo a esophagoscopy. While
\| \| \| \| \| \| \| \| \|
teaching the client about the procedure, the nurse should state,
\| \| \| \| \| \| \| \| \|
\|
AThe procedure is needed to measure the presence of acid in
\| \| \| \| \| \| \| \| \| \| \|
the esophagus." \|
"B Esophagoscopy is useful in determining how well the lower
\| \| \| \| \| \| \| \| \| \|
part of your esophagus works."
\| \| \| \|
"C You should discuss this procedure with your provider."
\| \| \| \| \| \| \| \|
"D An esophagoscopy procedure helps to determine if you have
\| \| \| \| \| \| \| \| \| \|
cancer." - CORRECT ANSWERS ✔✔B, Esophagoscopy is useful in
\| \| \| \| \| \| \| \| \|
determining how well the lower part of your esophagus works." \| \| \| \| \| \| \| \| \|
Rationale: Esophagoscopy is useful in determining the \| \| \| \| \| \| \|
incompetence of the lower esophageal sphincter and the extent \| \| \| \| \| \| \| \| \|
of inflammation, potential scarring, and strictures.
\| \| \| \| \|
, A nurse is caring for a client who is diagnosed with fulminant
\| \| \| \| \| \| \| \| \| \| \| \|
hepatic failure. Which of the following procedures should the
\| \| \| \| \| \| \| \| \|
nurse expect the client to be prepared for?
\| \| \| \| \| \| \|
\|
A Portacaval anastomosis
\| \|
B Right liver lobectomy
\| \| \|
C Liver transplant
\| \|
D Transjugular intrahepatic portosystemic shunt - CORRECT
\| \| \| \| \| \| \|
ANSWERS ✔✔C, Liver Transplant \| \| \|
Rationale: Fulminant hepatic failure, most often caused by viral
\| \| \| \| \| \| \| \| \|
hepatitis, is characterized by the development of hepatic
\| \| \| \| \| \| \| \|
encephalopathy within weeks of the onset of disease in a client \| \| \| \| \| \| \| \| \| \| \|
without prior evidence of hepatic dysfunction. Mortality remains
\| \| \| \| \| \| \| \|
high, even with treatment modalities such as blood or plasma
\| \| \| \| \| \| \| \| \| \|
exchanges, charcoal hemoperfusion, and corticosteroids.
\| \| \| \| \|
Consequently, liver transplantation has become the treatment of \| \| \| \| \| \| \| \|
choice for these clients.
\| \| \|
A nurse is caring for a client who is scheduled to have an
\| \| \| \| \| \| \| \| \| \| \| \| \|
esophagogastroduodenoscopy (EGD). The nurse should \| \| \| \| \|
recognize that this procedure is used to do which of the
\| \| \| \| \| \| \| \| \| \| \|
following?
\|
A Visualize colon polyps.
\| \| \|
B Sclérose esophageal varices.
\| \| \|
C Evaluate the ileum.
\| \| \|
D Determine the presence of free air in the abdomen. -
\| \| \| \| \| \| \| \| \| \| \|
CORRECT ANSWERS ✔✔B, Sclérose esophageal varices.
\| \| \| \| \|
WITH ANSWERS \|
A nurse is caring for a hospitalized client with acute pancreatitis.
\| \| \| \| \| \| \| \| \| \| \|
After treatment begins, the nurse anticipates that which serum
\| \| \| \| \| \| \| \| \|
laboratory value will return to normal within 72 hr? \| \| \| \| \| \| \| \|
A aldolase
\|
B amylase
\|
C lipase
\|
D lactose dehydrogenase - CORRECT ANSWERS ✔✔B, Amylase
\| \| \| \| \| \| \|
Rationale: Pancreatitis is the most common reason for marked
\| \| \| \| \| \| \| \| \|
elevations in serum amylase. Serum amylase begins to increase
\| \| \| \| \| \| \| \| \|
about 3 to 6 hr following onset of acute pancreatitis. The
\| \| \| \| \| \| \| \| \| \| \|
amylase level peaks in 20 to 30 hr and returns to normal in 2 to
\| \| \| \| \| \| \| \| \| \| \| \| \| \| \|
3 days.
\|
A client is receiving a tube feeding via a continuous enteral pump
\| \| \| \| \| \| \| \| \| \| \|
at 75 mL/hr. When the nurse assesses the client at 0800, which
\| \| \| \| \| \| \| \| \| \| \| \| \|
of the following nursing observations requires intervention?
\| \| \| \| \| \|
A A pitcher of water and plastic cup are sitting on the client's
\| \| \| \| \| \| \| \| \| \| \| \| \|
over-bed table within reach. \| \| \|
B The disposable feeding bag is from the previous day at 1000
\| \| \| \| \| \| \| \| \| \| \| \|
and contains 200 mL of feeding.
\| \| \| \| \|
,C The client is lying on the right side with a visible dependent
\| \| \| \| \| \| \| \| \| \| \| \| \|
loop in the feeding tube.\| \| \| \|
D, The head of the bed is elevated 20º. - CORRECT ANSWERS
\| \| \| \| \| \| \| \| \| \| \| \|
✔✔D, The head of the bed is elevated 20º.
\| \| \| \| \| \| \| \|
Rationale:The head of the bed should be elevated at least 30º \| \| \| \| \| \| \| \| \| \| \|
(semi-Fowler's position) while the tube feeding is administered. \| \| \| \| \| \| \| \|
This position uses gravity to help the feeding go down and
\| \| \| \| \| \| \| \| \| \| \|
lessens the possibility of regurgitation. \| \| \| \|
A nurse is caring for a client with severe gastroesophageal reflux
\| \| \| \| \| \| \| \| \| \| \|
disease (GERD) who is to undergo a esophagoscopy. While
\| \| \| \| \| \| \| \| \|
teaching the client about the procedure, the nurse should state,
\| \| \| \| \| \| \| \| \|
\|
AThe procedure is needed to measure the presence of acid in
\| \| \| \| \| \| \| \| \| \| \|
the esophagus." \|
"B Esophagoscopy is useful in determining how well the lower
\| \| \| \| \| \| \| \| \| \|
part of your esophagus works."
\| \| \| \|
"C You should discuss this procedure with your provider."
\| \| \| \| \| \| \| \|
"D An esophagoscopy procedure helps to determine if you have
\| \| \| \| \| \| \| \| \| \|
cancer." - CORRECT ANSWERS ✔✔B, Esophagoscopy is useful in
\| \| \| \| \| \| \| \| \|
determining how well the lower part of your esophagus works." \| \| \| \| \| \| \| \| \|
Rationale: Esophagoscopy is useful in determining the \| \| \| \| \| \| \|
incompetence of the lower esophageal sphincter and the extent \| \| \| \| \| \| \| \| \|
of inflammation, potential scarring, and strictures.
\| \| \| \| \|
, A nurse is caring for a client who is diagnosed with fulminant
\| \| \| \| \| \| \| \| \| \| \| \|
hepatic failure. Which of the following procedures should the
\| \| \| \| \| \| \| \| \|
nurse expect the client to be prepared for?
\| \| \| \| \| \| \|
\|
A Portacaval anastomosis
\| \|
B Right liver lobectomy
\| \| \|
C Liver transplant
\| \|
D Transjugular intrahepatic portosystemic shunt - CORRECT
\| \| \| \| \| \| \|
ANSWERS ✔✔C, Liver Transplant \| \| \|
Rationale: Fulminant hepatic failure, most often caused by viral
\| \| \| \| \| \| \| \| \|
hepatitis, is characterized by the development of hepatic
\| \| \| \| \| \| \| \|
encephalopathy within weeks of the onset of disease in a client \| \| \| \| \| \| \| \| \| \| \|
without prior evidence of hepatic dysfunction. Mortality remains
\| \| \| \| \| \| \| \|
high, even with treatment modalities such as blood or plasma
\| \| \| \| \| \| \| \| \| \|
exchanges, charcoal hemoperfusion, and corticosteroids.
\| \| \| \| \|
Consequently, liver transplantation has become the treatment of \| \| \| \| \| \| \| \|
choice for these clients.
\| \| \|
A nurse is caring for a client who is scheduled to have an
\| \| \| \| \| \| \| \| \| \| \| \| \|
esophagogastroduodenoscopy (EGD). The nurse should \| \| \| \| \|
recognize that this procedure is used to do which of the
\| \| \| \| \| \| \| \| \| \| \|
following?
\|
A Visualize colon polyps.
\| \| \|
B Sclérose esophageal varices.
\| \| \|
C Evaluate the ileum.
\| \| \|
D Determine the presence of free air in the abdomen. -
\| \| \| \| \| \| \| \| \| \| \|
CORRECT ANSWERS ✔✔B, Sclérose esophageal varices.
\| \| \| \| \|
