Exam 2 GI Full test

Test questions and answers from Exam 2

A patient with esophageal varices begins vomiting blood. What is the priority nursing action?

A. Insert a Foley Catheter 

B. maintain airway and prevent aspiration

C. Administer Oral fluids

D. Place the patient in supine position 

B. Maintain airway and prevent aspiration 

A patient with gastric ulcer would most likely describe their pain as:

A. Worse 30-60 minutes after meals

B. relieved by food or antacids 

C. Night pain relieved by snacks

D. Associated with weight gain 

A. Worse 30-60 minutes after meals

After a needle liver biopsy, which nursing action is priority?

A. Position on left side

B. Ambulate immediately

C. Position on right side for 2-4 hours

D. Encourage coughing exercises

C. Position on right side for 2-4 hours

A nurse caring for a patient post-cholecystectomy should notify the provider if the patient develops:

A. Mild incisional pain

B. Clear serous drainage from incision 

C. Abdominal distention unrelieved by analgesics 

D. Loss of appetite on day one 

C. Abdominal distention unrelieved by analgesics

A nurse is reviewing labs for a patient with suspected myocardial infarction. Which enzyme is most specific for cardiac muscle injury?

A. Myoglobin 

B. Troponin 

C. BNP

D. CK-MB

B. Troponin

A patient with Crohn’s disease is at greatest risk for:

A. Fistula formation 

B. Hepatic encephalopathy 

C. Gastric cancer

D. Fistula Formation 

A. or D. Fistula formation 

Which diagnostic test involves swallowing a capsule with sensors to capture small bowel images?

A. Colonoscopy

B. Capsule Endoscopy 

C. Barium Enema

D. MRCP 

B. Capsule Endoscopy

Which finding indicates severe pancreatitis?

A. Gray-blue discoloration around umbilicus 

B. Mild Jaundice

C. Flat abdomen with hypoactive sounds

D. Bradycardia 

A. Gray-blue discoloration around umbilicus 

A patient with ulcerative colitis flare should be placed on which diet?

A. High-fiber

B. Low-residue

C. High-fat 

D. High-protein 

B. Low-residue

Which patient statement indicates correct understanding of GERD management?

A. “I will stop my proton pump inhibitor when I feel better.”

B. “I should avoid lying flat after meals.”

C. “I can eat fried foods in moderation.”

D. “Sleeping flat will help digestion.”

B. "I should avoid lying flat after meals."

Which lab values would support the diagnosis of cholecystitis?

A. ALT 20 U/L

B. ALP 25 U/L

C. Amylase 40 U/L

D. Direct bilirubin 2.1 mg/dL

D. Direct bilirubin 2.1 mg/dL

A patient with appendicitis reports sudden relief of pain followed by rigid abdomen. The nurse suspects:

A. Constipation

B. Gastritis 

C. Perforation

D. Pain medication effect 

C. Perforation

A nurse teaching a patient with oral candidiasis about nystatin should include which instruction?

A. Swallow immediately

B. Rinse and spit after use

C. Swish thoroughly before swallowing

D. Take with a full meal 

C. Swish thoroughly before swallowing

Which medication increases risk for pulmonary edema by dilating vessels and shifting fluids?

A. Calcium Channel Blockers

B. Digoxin 

C. ACE inhibitors

D. Beta Blockers 

A. Calcium Channel Blockers

Which test involves contrast injection into bile ducts during endoscopy?

A. EGD

B. ERCP

C. MRCP

D. HIDA 

B. ERCP

Which lab finding is most consistent with peptic ulcer bleeding?

A. Elevated hematocrit 

B. Decreased hemoglobin

C. Increase potassium 

D. Elevated Platelets 

B. Decreased hemoglobin

A patient with liver cirrhosis has confusion, asterixis, and elevated ammonia. Which drug is most helpful?

A. Pantoprazole 

B. Lactulose

C. Sucralfate

D. Propranolol

B. Lactulose

A nurse suspects a DVT in a patient with calf pain and positive Homan’s sign. Which lab value supports this suspicion?

A. CRP

B. Troponin 

C. D-Dimer

D. BNP

C. D-Dimer

A patient is admitted with GI bleed. Which vital sign change is most concerning?

A. BP 140/88, HR 82

B. BP 118/72, HR 96

C. BP 90/60, HR 120

D. BP 130/84, HR 70

C. BP 90/60, HR 120

Which symptom is most associated with gastric ulcer rather than duodenal ulcer?

A. Pain relieved by food

B. Pain worsens after eating

C. Melena

D. Awakens at night with pain 

B. Pain worsens after eating

Which complication of cirrhosis is most life-threatening?

A. Ascites 

B. Jaundice

C. Esophageal varices 

D. Splenomegaly 

C. Esophageal varices

A nurse reviews telemetry and sees a heart rate of 45 bpm with regular rhythm. Which intervention should the nurse anticipate?

A. Atropine or pacemaker insertion 

B. Adenosine administration

C. Defibrillation

D. CPR immediately 

A. Atropine or pacemaker insertion

A nurse caring for a patient with hepatic encephalopathy recognizes which lab as most concerning?

A. Albumin 4.0 g/dL

B. PT 12 sec

C. INR 1.0

Ammonia 98 mcg/dL

D. Ammonia 98 mcg/dL

Which complication is associated with untreated pericarditis?

A. Aneurysm 

B. Pericardial effusion → tamponade

C. Stroke 

D. Myopathy

B. Pericardial effusion → tamponade

Which complication of ulcerative colitis is considered an emergency?

A. Toxic megacolon 

B. GERD 

C. Barrett’s esophagus 

D. Irritable bowel syndrome 

A. Toxic megacolon

A patient with H. pylori infection should be taught:

A.  “I will take a combination of antibiotics and a PPI.”

B. “I can stop antibiotics when I feel better.”

C. “Antacids cure the infection.”

D. “Corticosteroids are the treatment of choice.”

A. "I will take a combination of antibiotics and a PPI."

Which lab is most specific for diagnosing pancreatitis?

A. Potassium

B. Bilirubin

C. ALT

D. Lipase 

D. Lipase 

Which complication after gastrectomy indicates dumping syndrome?

A. Constipation

B. Sweating, diarrhea, dizziness after meals

C. Severe nocturnal pain

D. Bloating relieved by lying flat 

B. Sweating, diarrhea, dizziness after meals

A patient with cirrhosis reports severe shortness of breath and tense ascites. Which intervention provides relief?

A. Lactulose 

B. Paracentesis

C. Proton pump inhibitor 

D. Endoscopic band ligation

B. Paracentesis

Which symptom is most specific for pernicious anemia?

A. Pallor 

B. Fatigue

C. Beefy red tongue

D. Pica 

C. Beefy red tongue

Which diet teaching is correct for a patient post-cholecystectomy?

A.  “I can resume a high-fat diet.”

B. “I need extra dairy for healing.”

C. “I must remain on liquids only.”

D. “I should avoid gas-forming and fatty foods.”

D. "I should avoid gas-forming and fatty foods."

A nurse recognizes that small bowel obstruction is most likely when:

A. Hypoactive bowel sounds

B. Hyperactive, high-pitched bowel sounds

C. Regular formed stool

D. Slow return of flatus 

B. Hyperactive, high-pitched bowel sounds

Which medication replaces digestive enzymes in chronic pancreatitis?

A. Pancrelipase

B. Famotidine

C. Lactulose

D. Pantoprazole 

A. Pancrelipase

Which teaching is most important for a patient with thrombocytopenia?

A. Avoid sharp foods and NSAIDs

B. Increased potassium intake

C. Avoid sodium

D. Report fever above 99

A. Avoid sharp foods and NSAIDs

Which diagnostic test requires NPO and bowel prep with laxatives?

A. Capsule endoscopy

B. Colonoscopy

C. MRCP

D. HIDA scan

B. Colonoscopy

Which complication is most associated with Crohn’s disease but not ulcerative colitis?

A. Fistula Formation 

B. Rectal bleeding

C. Continuous colonic involvement

D. Toxic megacolon 

A. Fistula Formation

Which lab finding suggests cholelithiasis?

A. Bilirubin 0.8 mg/dL

B. Amylase 45 U/L 

C. ALT 20 U/L

D. ALP 140 U/L 

D. ALP 140 U/L

Which finding is an early warning sign of cancer?

A. Fatigue after work 

B. Dry skin

C. Sore that does not heal

D. Mild headache 

C. Sore that does not heal

A patient with perforated ulcer presents with rigid abdomen, hypotension, and tachycardia. What is the priority?

A. Start clear liquids 

B. Prepare for emergency surgery

C. Administer sucralfate 

D. Insert Foley catheter 

B. Prepare for emergency surgery

Which patient finding is most consistent with irritable bowel syndrome (IBS)?

A. Bloody stools

B. Weight loss and fever

C. Cramping pain relieved by defecation

D. Rigid abdomen 

C. Cramping pain relieved by defecation

Which medication class is first-line for GERD management?

A. Proton Pump Inhibitors

B. Corticosteroids

C. Antiemetics

D. Antibiotics 

A. Proton Pump Inhibitors 

Which complication of cirrhosis results from impaired bile excretion and high bilirubin?

A. Splenomegaly

B. Jaundice and pruritus

C. Varices

D. Ascites 

B. Jaundice and pruritus

Which test best detects H. pylori?

A. Urea breath test 

B. Liver biopsy

C. Colonoscopy 

D. ERCP 

A. Urea breath test

Which oncologic emergency occurs when chemotherapy causes rapid destruction of tumor cells, leading to electrolyte imbalance?

A. Hypercalcemia

B. Neutropenia

C. Tumor lysis syndrome

D. Spinal cord compression 

C. Tumor lysis syndrome

Which nursing intervention is priority for upper GI bleed?

A. Apply oxygen 

B. Start IV fluids

C. Prepare for endoscopy 

D. All of the above 

D. All of the above

Which cancer commonly presents with painless lumps in lymph nodes and Reed-Sternberg cells?

A. Hodgkin’s lymphoma 

B. Non-Hodgkins

C. Leukemia

D. Multiple myeloma 

A. Hodgkin’s lymphoma

Which vital sign pattern indicates severe dehydration from GI fluid loss?

A. BP 160/90, HR 70

B. BP 88/48, HR 128

C. 140/84, HR 80

D. 120/72, HR 68

B. BP 88/48, HR 128

Which drug is prescribed to prevent bleeding recurrence in esophageal varices?

A. Propranolol

B. Sucralfate

C. Pantoprazole

D. Loperamide

A. Propranolol

Which teaching is essential for a patient prescribed sucralfate?

A. Take on empty stomach

B. Take with meals 

C. Take with milk

D. Take at same time as antacids 

A. Take on empty stomach

Which lab finding is expected in cirrhosis?

A. Increase albumin

B. Decrease bilirubin

C. Increase bilirubin 

D. Increase AST/ALT 

C. Increased bilirubin or D. Increased AST/ALT (both correct)