Gastrointestinal Conditions - NCLEX-PN
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Which of the following is not a response normally seen in liver disease?
Which of the following is not a response normally seen in liver disease?
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The liver generally responds to injury in the following ways: inflammation, necrosis or apoptosis, degeneration leading to accumulation of intracellular deposits, fibrosis, and regeneration. Some of these, such as inflammation and mild degeneration, are reversible. Other changes, such as severe degeneration and fibrosis, may be permanent.
The liver generally responds to injury in the following ways: inflammation, necrosis or apoptosis, degeneration leading to accumulation of intracellular deposits, fibrosis, and regeneration. Some of these, such as inflammation and mild degeneration, are reversible. Other changes, such as severe degeneration and fibrosis, may be permanent.
Overdose of which of the following over-the-counter medications is one of the leading causes of liver failure in the United States?
Overdose of which of the following over-the-counter medications is one of the leading causes of liver failure in the United States?
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Acetaminophen causes more liver failure in the United States than viral hepatitis, making it one of the most common causes of liver-related emergency room visits. It causes approximately 78,000 emergency room visits and 150 deaths due to liver failure each year. None of the other medications listed are associated with liver failure.
Acetaminophen causes more liver failure in the United States than viral hepatitis, making it one of the most common causes of liver-related emergency room visits. It causes approximately 78,000 emergency room visits and 150 deaths due to liver failure each year. None of the other medications listed are associated with liver failure.
The majority of hepatic infections are with which of the following type of microbe?
The majority of hepatic infections are with which of the following type of microbe?
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The majority of liver infections are viral in nature. Hepatitis A, hepatitis B, and hepatitis C are the most frequent agents of infection, with hepatitis C being the leading cause of liver transplants. Bacterial infections in the liver most commonly take the form of an abscess. Fungal hepatitis and prion infection of the liver are not generally seen.
The majority of liver infections are viral in nature. Hepatitis A, hepatitis B, and hepatitis C are the most frequent agents of infection, with hepatitis C being the leading cause of liver transplants. Bacterial infections in the liver most commonly take the form of an abscess. Fungal hepatitis and prion infection of the liver are not generally seen.
Which of the following viruses can cause hepatitis?
Which of the following viruses can cause hepatitis?
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There are multiple viruses that can cause hepatitis other than hepatitis A, B, or C. Among these are Epstein-Barr virus, cytomegalovirus, and yellow fever.
There are multiple viruses that can cause hepatitis other than hepatitis A, B, or C. Among these are Epstein-Barr virus, cytomegalovirus, and yellow fever.
What tissue of the gastrointestinal tract is affected in Celiac disease?
What tissue of the gastrointestinal tract is affected in Celiac disease?
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While individuals with Celiac disease can certainly have gastritis, fistulas, and ulceration due to inflammation, the primary effect of Celiac disease is villous atrophy in the small intestine. Villi become blunted, leading to loss of ability to absorb nutrients, including minerals and fat-soluble vitamins.
While individuals with Celiac disease can certainly have gastritis, fistulas, and ulceration due to inflammation, the primary effect of Celiac disease is villous atrophy in the small intestine. Villi become blunted, leading to loss of ability to absorb nutrients, including minerals and fat-soluble vitamins.
What part of the bowel is most often affected by Crohn's disease?
What part of the bowel is most often affected by Crohn's disease?
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While Crohn's disease can affect any part of the alimentary canal, the small intestine, particularly the terminal ileum, is the most common site of serosal inflammation.
While Crohn's disease can affect any part of the alimentary canal, the small intestine, particularly the terminal ileum, is the most common site of serosal inflammation.
What is the characteristic mucosal alteration seen in ulcerative colitis?
What is the characteristic mucosal alteration seen in ulcerative colitis?
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The characteristic histological alteration seen in ulcerative colitis is the crypt abscess, in which inflammation causes loss of goblet cells due to neutrophilic exudate in glandular lumens. Granulomas, thickened mucosa, and skip lesions are all seen in Crohn's disease.
The characteristic histological alteration seen in ulcerative colitis is the crypt abscess, in which inflammation causes loss of goblet cells due to neutrophilic exudate in glandular lumens. Granulomas, thickened mucosa, and skip lesions are all seen in Crohn's disease.
Which of the following describes a calcium carbonate preparation?
Which of the following describes a calcium carbonate preparation?
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Calcium carbonate preparation is rapid-acting, releasing carbon dioxide in the stomach, causing belching and flatulence. Calcium carbonate is an antacid which reacts quicly with HCl to form CaCL2 and carbon dioxide.
Calcium carbonate preparation is rapid-acting, releasing carbon dioxide in the stomach, causing belching and flatulence. Calcium carbonate is an antacid which reacts quicly with HCl to form CaCL2 and carbon dioxide.
Which of the following does the nurse not recognize as a medication regimen for treating Helicobacter Pylori infections?
Which of the following does the nurse not recognize as a medication regimen for treating Helicobacter Pylori infections?
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Multiple therapies are required to treat Helicobacter Pylori infections. Colestipol is a bile acid sequestrant used to lower blood cholesterol, which is not used to treat Helicobacter Pylori infections ( a bacterium that colonizes the human stomach).
Multiple therapies are required to treat Helicobacter Pylori infections. Colestipol is a bile acid sequestrant used to lower blood cholesterol, which is not used to treat Helicobacter Pylori infections ( a bacterium that colonizes the human stomach).
Frequent projectile, non-bilious vomiting starting 2-3 weeks after birth is indicative of what condition?
Frequent projectile, non-bilious vomiting starting 2-3 weeks after birth is indicative of what condition?
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In congenital hypertrophic pyloric stenosis, the smooth muscle of the pylorus becomes thickened, decreasing the lumen size of the pylorus. This prevents food from passing out of the stomach and into the small intestine, resulting in vomiting which is often projectile and tends to be non-bilious. Intussusception may show vomiting, but the more obvious sign is bloody "currant jelly" stools. Infant gastroesophageal reflux disease (GERD) may result in frequent spitting up, but projectile vomiting is rare. Diverticulitis is generally a condition of the elderly and tends to present as abdominal pain with alterations in bowel function and mild fever.
In congenital hypertrophic pyloric stenosis, the smooth muscle of the pylorus becomes thickened, decreasing the lumen size of the pylorus. This prevents food from passing out of the stomach and into the small intestine, resulting in vomiting which is often projectile and tends to be non-bilious. Intussusception may show vomiting, but the more obvious sign is bloody "currant jelly" stools. Infant gastroesophageal reflux disease (GERD) may result in frequent spitting up, but projectile vomiting is rare. Diverticulitis is generally a condition of the elderly and tends to present as abdominal pain with alterations in bowel function and mild fever.
A female client with advanced cirrhosis of the liver has noticed that her abdomen has become greatly distended and she is concerned about her body image. The client asks the nurse "What is causing my stomach to look so big?"
The nurse responds based on her knowledge of liver disease and possible signs and symptoms. She tells the client which of the following explanations for her distended abdomen?
A female client with advanced cirrhosis of the liver has noticed that her abdomen has become greatly distended and she is concerned about her body image. The client asks the nurse "What is causing my stomach to look so big?"
The nurse responds based on her knowledge of liver disease and possible signs and symptoms. She tells the client which of the following explanations for her distended abdomen?
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Portal hypertension causes proteins to move from the bloodstream into the lymphatics which cannot handle the excess and they leak into to abdominal cavity. The proteins causes an osmotic pressure pulling fluid into the space leading to ascites. Hypoalbuminemia will lead to decreased colloid oncotic pressure as well, also contributing to ascites.
Portal hypertension causes proteins to move from the bloodstream into the lymphatics which cannot handle the excess and they leak into to abdominal cavity. The proteins causes an osmotic pressure pulling fluid into the space leading to ascites. Hypoalbuminemia will lead to decreased colloid oncotic pressure as well, also contributing to ascites.
What foods must be avoided in Celiac disease?
What foods must be avoided in Celiac disease?
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Celiac disease is an autoimmune condition that is triggered by ingestion of gluten, a protein found in wheat, barley, and rye. A wheat-free diet is not sufficient for a patient with Celiac disease, as many other products contain elements of barley or rye and thus also contain gluten.
Oat, while often avoided by individuals with Celiac disease due to cross-contamination during processing, does not contain gluten. Whole dairy products are also generally gluten-free and considered safe for patients with Celiac disease.
Celiac disease is an autoimmune condition that is triggered by ingestion of gluten, a protein found in wheat, barley, and rye. A wheat-free diet is not sufficient for a patient with Celiac disease, as many other products contain elements of barley or rye and thus also contain gluten.
Oat, while often avoided by individuals with Celiac disease due to cross-contamination during processing, does not contain gluten. Whole dairy products are also generally gluten-free and considered safe for patients with Celiac disease.
Samantha is a registered nurse working in the intensive care unit with a patient recently diagnosed with _Clostridium difficil_e. She violates Clostridium difficile contact precautions by .
Samantha is a registered nurse working in the intensive care unit with a patient recently diagnosed with _Clostridium difficil_e. She violates Clostridium difficile contact precautions by .
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Clostridium difficile (C. diff) is an infection caused by Clostridium difficile bacteria and requires contact precautions. Contact precautions state that nurses must wear gloves and a gown while caring for the patient. Nurses must also preform adequate hand hygiene before and after the use of gloves. Additionally, because C. diff infections are caused by spores, alcohol gel alone may not be sufficient to eliminate the bacteria. Current practice is the use of soap and water to cleanse hands. Afterwards, nurses may utilize alcohol-based hand gel. It is acceptable to place a C. diff patient in a semi-private room with another C. diff patient if private rooms are unavailable.
Clostridium difficile (C. diff) is an infection caused by Clostridium difficile bacteria and requires contact precautions. Contact precautions state that nurses must wear gloves and a gown while caring for the patient. Nurses must also preform adequate hand hygiene before and after the use of gloves. Additionally, because C. diff infections are caused by spores, alcohol gel alone may not be sufficient to eliminate the bacteria. Current practice is the use of soap and water to cleanse hands. Afterwards, nurses may utilize alcohol-based hand gel. It is acceptable to place a C. diff patient in a semi-private room with another C. diff patient if private rooms are unavailable.
Carrie is caring for an 85-year-old woman in a long-term care facility. Her patient has been taking antibiotics for the past two weeks to treat a severe case of cellulitis. Carrie notices that her patient has developed a fever, has refused her last two meal trays, and is complaining of abdominal pain. Which of the following samples should Carrie seek permission to obtain?
Carrie is caring for an 85-year-old woman in a long-term care facility. Her patient has been taking antibiotics for the past two weeks to treat a severe case of cellulitis. Carrie notices that her patient has developed a fever, has refused her last two meal trays, and is complaining of abdominal pain. Which of the following samples should Carrie seek permission to obtain?
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It is possible that this patient is suffering from a Clostridium difficile infection caused by bacteria. The presence of an underlying condition, increasing age, and antibiotic use are all risk factors for contracting Clostridium difficile. A stool sample is commonly used to test for the bacteria. Until the results are available, Carrie should place the patient under proper C. difficile contact precautions.
It is possible that this patient is suffering from a Clostridium difficile infection caused by bacteria. The presence of an underlying condition, increasing age, and antibiotic use are all risk factors for contracting Clostridium difficile. A stool sample is commonly used to test for the bacteria. Until the results are available, Carrie should place the patient under proper C. difficile contact precautions.
Which of the following bacterial species is responsible for the development of peptic ulcers?
Which of the following bacterial species is responsible for the development of peptic ulcers?
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Helicobacter pylori or H. pylori is the bacterial cause of peptic ulcers. Staphylococcus aureus is a bacteria that frequently causes skin infections along with other conditions such as toxic shock syndrome. Streptococcus faecalis is responsible for many urinary tract infections and contracting Viridans streptococci may result in endocarditis. Treponema pallidum bacteria cause syphilis.
Helicobacter pylori or H. pylori is the bacterial cause of peptic ulcers. Staphylococcus aureus is a bacteria that frequently causes skin infections along with other conditions such as toxic shock syndrome. Streptococcus faecalis is responsible for many urinary tract infections and contracting Viridans streptococci may result in endocarditis. Treponema pallidum bacteria cause syphilis.
Which of the following refers to bleeding from partial-thickness tears in the mucosa at the junction of the stomach and esophagus?
Which of the following refers to bleeding from partial-thickness tears in the mucosa at the junction of the stomach and esophagus?
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Mallory–Weiss syndrome refers to bleeding from partial-thickness tears in the mucosa at the junction of the stomach and esophagus, often from trauma such as violent retching or coughing. This is compared to Boerhaave's syndrome, which is a full-thickness tear of the esophageal wall. Esophagitis is most commonly caused by gastroesophageal reflux disease (GERD) and does not present with bleeding. Barrett's esophagus refers to a type of metaplasia in the lower esophagus which is thought to be caused by chronic GERD.
Mallory–Weiss syndrome refers to bleeding from partial-thickness tears in the mucosa at the junction of the stomach and esophagus, often from trauma such as violent retching or coughing. This is compared to Boerhaave's syndrome, which is a full-thickness tear of the esophageal wall. Esophagitis is most commonly caused by gastroesophageal reflux disease (GERD) and does not present with bleeding. Barrett's esophagus refers to a type of metaplasia in the lower esophagus which is thought to be caused by chronic GERD.
A 35-year-old client is being discharged post hemorrhoidectomy surgery. The nurse is explaining in detail all discharge instructions to be followed for a successful postoperative period.
The client will need to adhere to which of the following instructions?
A 35-year-old client is being discharged post hemorrhoidectomy surgery. The nurse is explaining in detail all discharge instructions to be followed for a successful postoperative period.
The client will need to adhere to which of the following instructions?
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To prevent pain during a bowel movement post operatively, pain medication is often indicated to help make it more tolerable. Pain medications will need to be given post op and may contribute to constipation, but oral stool softeners and and a high fiber diet can help to avoid the constipation. Rectal suppositories and daily enemas are not needed. Bowel movements should not be delayed nor avoided in the post operative period.
To prevent pain during a bowel movement post operatively, pain medication is often indicated to help make it more tolerable. Pain medications will need to be given post op and may contribute to constipation, but oral stool softeners and and a high fiber diet can help to avoid the constipation. Rectal suppositories and daily enemas are not needed. Bowel movements should not be delayed nor avoided in the post operative period.
A client is being treated on the medical-surgical unit for pneumonia and has recently developed severe diarrhea. Upon cultures performed it has been determined the client is now carrying Clostridium Difficile (C-diff), and will need to be on special precautions to prevent the spread of this disease.
All of the following are consistent with the appropriate precautions when dealing with those infected with C. difficile except .
A client is being treated on the medical-surgical unit for pneumonia and has recently developed severe diarrhea. Upon cultures performed it has been determined the client is now carrying Clostridium Difficile (C-diff), and will need to be on special precautions to prevent the spread of this disease.
All of the following are consistent with the appropriate precautions when dealing with those infected with C. difficile except .
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This client is to be on contact precautions, the wearing of a mask is consistent with airborne precautions which is not necessary for C-diff. All other choices are appropriate for contact precautions.
This client is to be on contact precautions, the wearing of a mask is consistent with airborne precautions which is not necessary for C-diff. All other choices are appropriate for contact precautions.
The nurse is caring for a 25-year old-patient diagnosed with a poorly functioning lower esophageal sphincter. The nurse may advise the patient to do which of the following?
The nurse is caring for a 25-year old-patient diagnosed with a poorly functioning lower esophageal sphincter. The nurse may advise the patient to do which of the following?
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Several foods can cause relaxation or irritation of the lower-esophageal sphincter. Alcohol, carbonated beverages, and chocolate are a few examples. Advise the patient to remain upright after meals, to utilize antacids when appropriate, and to practice a balanced diet.
Several foods can cause relaxation or irritation of the lower-esophageal sphincter. Alcohol, carbonated beverages, and chocolate are a few examples. Advise the patient to remain upright after meals, to utilize antacids when appropriate, and to practice a balanced diet.
Which of the following GERD medications works by neutralizing stomach acid?
Which of the following GERD medications works by neutralizing stomach acid?
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Magnesium hydroxide is a strong base. It works by neutralizing the acid in the stomach, forming water and magnesium chloride. All other listed medications work to prevent the stomach from over-producing acid, rather than neutralizing the existing acid in the stomach.
Magnesium hydroxide is a strong base. It works by neutralizing the acid in the stomach, forming water and magnesium chloride. All other listed medications work to prevent the stomach from over-producing acid, rather than neutralizing the existing acid in the stomach.