Complex Disease III - GI (Worksheet 1, 2, 3, and Hepatitis)

d. Warfarin

Which of the following medications should be stopped before obtaining a FOBT?

a. Atorvastatin

b. Norvasc

c. Digoxin

d. Warfarin

a. Left side

How do you position a patient for EGD or Colonoscopy?

a. Left side

b. Right side

c. Prone

d. Semi-Fowler

a. Chocolate

c. Spicy foods

d. Pregnancy

e. Coffee

What are common risk factors to develop GERD? Select all that apply

a. Chocolate

b. Certain medications such as Calcium Carbonate

c. Spicy foods

d. Pregnancy

e. Coffee

a. Prolonged use of Solu-Medrol

b. Helicopacter pylori

c. Patients that are in critical condition

d. Excess alcohol and smoking

What are common risk factors that contribute to the development of peptic ulcer disease? Select all that apply

a. Prolonged use of Solu-Medrol

b. Helicopacter pylori

c. Patients that are in critical condition

d. Excess alcohol and smoking

e. Frequent use of Famotidine

a. True

True or False: Patients with duodenal ulcer experience pain relief with eating

a. True

b. False

a. Rebound tenderness

b. Tachycardia

c. Rigid-board like abdomen

d. Diminished bowel sounds

e. Hypotension

Which of the following manifestations may the nurse assess as a complication of peptic ulcer disease that perforated? Select all that apply

a. Rebound tenderness

b. Tachycardia

c. Rigid-board like abdomen

d. Diminished bowel sounds

e. Hypotension

d. The stomach lining is unable to produce the intrinsinc factor leading to Vit B12 deficiency

Why is the patient with gastritis at risk to develop pernicious anemia?

a. The H/H is expected to be low

b. The patient has a folic acid deficiency

c. The patient likely has not consumed enough iron and is therefore anemic

d. The stomach lining is unable to produce the intrinsinc factor leading to Vit B12 deficiency

e. The patient will be pale and fatigued

b. False

True or false: Vagotomy is a procedure in which the top part of the stomach is folded and sewn around the lower esophageal sphincter to help with the malfunctioning LES.

a. True

b. False

b. False

Following bariatric surgery, the patient will be on strict bedrest to ensure adequate healing

a. True

b. False

b. “I can continue to have milk with my oatmeal"

A patient is S/P bariatric surgery and is being discharged. Further education is required if the patient states:

a. "should not eat too much fresh fruit"

b. “I can continue to have milk with my oatmeal"

b. The stomach fails to produce hydrochloric acid (HCL) in gastric secretions leading to an increased risk of gastric cancer

What is Achlorhydria?

a. Fear of open or crowded spaces

b. The stomach fails to produce hydrochloric acid (HCL) in gastric secretions leading to an increased risk of gastric cancer

c. It describes an absence of chloride often leading to hyponatremia requiring fluid replacement

d. It is a fear of spiders. Cancer patients often experience this phenomenon

a. True

True or false: Patients after surgeries should get out of bed to reduce the risk of atelectasis?

a. True

b. False

c. Right lower abdomen

Where would you find Mc Burney's Point?

a. Left lower abdomen

b. Umbilical area

c. Right lower abdomen

d. Right upper abdomen

a. True

True of False: Irritable Bowel Syndrome may present with alternating constipation and diarrhea

a. True

b. False

b. Monitor the patient for signs and symptoms of dehydration and electrolyte imbalance

You are caring for a patient with Inflammatory bowel disease (IBD). Your patient is experiencing an acute exacerbation of the disease-Which of the following nursing action is most important?

a. Administer antidiarrheal medication frequently to stop the diarrhea

b. Monitor the patient for signs and symptoms of dehydration and electrolyte imbalance

c. Teach the patient about surgcial options for IBD treatment

d. Encourage consumption of high-fiber foods to promote bowel regularity

a. The large intestine becomes significantly distended and inflamed

b. Toxic megacolon is a common complication of Inflammatory Bowel Disease (IBD)

c. Systemic toxicity occurs presenting with hypotension and tachycardia

d. Corticosteroids are given to reduce the inflammation in cases related to IBD

e. It is a serious and life-threatening condition

Which of the following is associated with Toxic mega colon?

a. The large intestine becomes significantly distended and inflamed

b. Toxic megacolon is a common complication of Inflammatory Bowel Disease (IBD)

c. Systemic toxicity occurs presenting with hypotension and tachycardia

d. Corticosteroids are given to reduce the inflammation in cases related to IBD

e. It is a serious and life-threatening condition

a. Encourage high fiber diet

b. Encourage the patient to increase fluid intake

d. Administer a prescribed stool softener such as Ducosate Sodium (Colace)

e. Encourage the patient to engage in light physical activity such as walking

You are caring for an elderly patient who reports constipation for the past several days. Which of the following interventions are helpful to relieve constipation? Select all that apply.

a. Encourage high fiber diet

b. Encourage the patient to increase fluid intake

c. Administer loperamide as ordered

d. Administer a prescribed stool softener such as Ducosate Sodium (Colace)

e. Encourage the patient to engage in light physical activity such as walking

a. "This is normal for a new stoma. It should shrink and become less red over time."

You are caring for a patient S/P colostomy placement 2 days ago. The patient expresses concern that the stoma is red and slightly swollen. Which of the following is your most appropriate response?

a. "This is normal for a new stoma. It should shrink and become less red over time."

b. "Apply cold compress until the swelling goes down."

c. "This is a concerning finding as it indicates a sign of an acute infection."

d. "You should not eat anything until the redness goes down."

c. "I should contact my health care provider if I notice redness, drainage, or swelling from my incision site"

A 65-year-old patient is S/P colon cancer surgery. The nurse is providing discharge instructions. Which of the following statements indicates effective learning?

a. "It is normal to have a small amount of blood in my stool during the initial 2 months post-surgical"

b. "I should avoid all physical activity for the next 3 months"

c. "I should contact my health care provider if I notice redness, drainage, or swelling from my incision site"

c. Insert a nasogastric (NG) tube for decompression

A patient with intestinal obstruction has been admitted to your unit. The patient complains of severe abdominal pain, bloating, and vomiting for the past 24 h. Which of the following intervention should the nurse implement first?

a. Encourage the patient to ambulate to relieve gas

b. Prepare the patient for immediate surgery

c. Insert a nasogastric (NG) tube for decompression

d. Administer analgesics as prescribed

d. Maintain the patient on NPO status

A 65-year-old female is admitted with acute diverticulitis to your unit. Which of the following nursing actions is most appropriate during the acute phase of diverticulitis?

a. Encourage fruit and vegetable to compensate for nutrient and vitamin loss

b. Provide small, frequent meals

c. Encourage high-fiber diet

d. Maintain the patient on NPO status

c. Hep A

Which of the following hepatitis is NOT associated with cirrhosis of the liver?

a. Hep B

b. Hep C

c. Hep A

d, Hep D

b. Obesity

A patient has developed NAFLD (non alcoholic fatty liver disease). Which of the following factors is associated with this type of liver cirrhosis?

a. Smoking

b. Obesity

c. Alcohol

a. Tea-colored urine

b. Clay-colored stool

f. Jaundice

Which of the following are associated findings in patients with impaired bilirubin metabolism? Select all that apply

a. Tea-colored urine

b. Clay-colored stool

c. Ascites

d. Edema

e. Bruising

f. Jaundice

b. Vit K deficiency

Which of the following deficiency would result in patients experiencing Ecchymosis?

a. Folic acid deficiency

b. Vit K deficiency

c. Vit B1 deficiency

d. Thiamine deficiency

e. Vit B12 deficiency

a. Lactulose

Which of the following medication is used to treat hepatic encephalopathy and will lower the ammonia level?

a. Lactulose

b. Albumin

c. IV fluid (isotonic)

b. Senkstaken Blakemore drain are used to stop bleeding esophageal varices

d. Scissors should be placed at the bedside in case of dislocation of the drain

e. The Senkstaken Blakemore drain has 3 lumen: 2 to compress varices and 1 for gastric aspiration

Which of the following statements are correct? Select all that apply

a. Senkstaken Blakemore drains are very helpful in reducing ascites and making the patient more comfortable

b. Senkstaken Blakemore drain are used to stop bleeding esophageal varices

c. The lumen are filled with sterile 0.9% NS to hold the drain in place

d. Scissors should be placed at the bedside in case of dislocation of the drain

e. The Senkstaken Blakemore drain has 3 lumen: 2 to compress varices and 1 for gastric aspiration

b. Nitroglycerin is a powerful vasoconstrictor helping to stabilize systemic effects

Which of the following statement is NOT correct?

a. Octreotide is helpul in decreasing esophageal bleeding by reducing portal pressure

b. Nitroglycerin is a powerful vasoconstrictor helping to stabilize systemic effects

c. Propranolol is a non-cardioselective beta blocker used to decreased the portal vein pressure

b. Replace albumin after paracentesis

c. Measure abdominal girth daily

d. Weigh patient daily

e. Administer diuretics as prescribed

f. Prepare patient for paracentesis as needed

Which of the following nursing actions do you expect to include in the assessment and treatment of ascites? Select all that apply

a. Advise the patient on a high sodium diet to decrease ascites

b. Replace albumin after paracentesis

c. Measure abdominal girth daily

d. Weigh patient daily

e. Administer diuretics as prescribed

f. Prepare patient for paracentesis as needed

c. TIPS will reduce the pressure in the portal vein by connecting the portal veing with the hepatic vein, bypassing the liver

Which statement regarding TIPS is correct?

a. TIPS is a surgical procedure in which part of the liver will be removed to decrease portal hypertension

b. TIPS will drain ascites out of the abdominal cavity

c. TIPS will reduce the pressure in the portal vein by connecting the portal veing with the hepatic vein, bypassing the liver

a. Flumazenil

Which of the following medications can be helpful to improve hepatic encephalopathy patients' LOC due to their increased benzodiazepine receptors?

a. Flumazenil

b. Diazepam

c. Narcan

a. Thiamine

Wernicke's Encephalopathy occurs as a result of a deficiency in?

a. Thiamine

b. Coagulation factors

c. Vit B12

d. Vit K

a. Asterixis

b. Lethargy

c. Irritability

d. Memory difficulties

Which of the following S/S could you assess in a patient with hepatic encephalopathy? Select all that apply.

a. Asterixis

b. Lethargy

c. Irritability

d. Memory difficulties

c. "Hep B is primarily transmitted through exposure to infected blood, sexual contact, or from mother to baby during childbirth."

A nurse is providing education to a group of students about the different types of viral hepatitis and their modes of transmission. Which statement made by a student indicates a correct understanding of how Hep B is transmitted?

a. "Hep B is transmitted through the fecal-oral route, like contaminated water and food"

b. "Hep B requires contact precautions"

c. "Hep B is primarily transmitted through exposure to infected blood, sexual contact, or from mother to baby during childbirth."

d. "There is no vaccine for Hep B"

b. Positive EIA test

A nurse is caring for a client who has a new diagnosis of hepatitis C. Which of the following laboratory findings should the nurse expect?

a. Alanine aminotransferase (ALT) 15 IU/L

b. Positive EIA test

c. Presence of immunoglobulin G antibodies (IgG)

d. Aspartate aminotransferase (AST) 35 units/L

a. To minimize the movement of the liver to reduce the risk of complications such as hemorrhage

Why are patients asked to hold their breath during the liver biopsy?

a. To minimize the movement of the liver to reduce the risk of complications such as hemorrhage

b. To reduce the amount of ammonia that usually rises after stimulation of the liver

c. To decrease the risk of hepatosplenomegaly

b. Limit physical activity

c. Avoid alcohol

d. Eat small frequent meals

A nurse is teaching a client who has hepatitis B about home care. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

a. Wear a mask when in public places

b. Limit physical activity

c. Avoid alcohol

d. Eat small frequent meals

e. Take acetaminophen for comfort