NR 661 Gastrointestinal Quiz
12 August 2024NR 661 Gastrointestinal Quiz
- Question: A patient has received a prescription for metronidazole for the treatment of C. difficile. What should be avoided in this patient?
- Correct Answer: Alcohol
- Question: A patient with gallbladder disease has classic symptoms. Which symptom below is NOT classic of gallbladder disease?
- Correct Answer: Pain that occurs when the stomach empties
- Question: Which of the following is NOT a risk factor for developing hepatitis B?
- Correct Answer: Consuming contaminated water
- Question: A 24-year-old female presents with pain and tenderness in the right lower abdominal quadrant. Her pelvic exam and urinalysis are within normal limits. Her WBC is elevated, and her urine pregnancy test is negative. What is part of the differential diagnosis?
- Correct Answer: Appendicitis
- Question: A patient has elevated liver enzymes. What is the likely etiology of the elevation?
- Correct Answer: Hepatitis
- Question: Choose the number on the image that most closely approximates the location of an indirect inguinal hernia.
- Correct Answer: 4
- Question: An 85-year-old adult has chronic constipation. What is the most likely cause of her constipation?
- Correct Answer: Medication-related
- Question: An 83-year-old patient is diagnosed with diverticulitis. Where is her pain typically located?
- Correct Answer: Left lower quadrant
- Question: A 19-year-old female presents with a temperature of 100.8°F and lower abdominal pain that began about 12 hours ago. She denies vaginal discharge. Which choice below is the least likely cause of her symptoms?
- Correct Answer: Renal stone
- Question: What is true regarding older adults who are overweight?
- Correct Answer: Mortality in older adults related to overweight states declines over time.
- Question: A patient has been diagnosed with hepatitis A. The most common reported risk factor is:
- Correct Answer: International travel
- Question: A 63-year-old male has been your patient for several years. He is a former smoker who takes simvastatin, ramipril, and an aspirin daily. His blood pressure and lipids are well controlled. He presents to your clinic with complaints of fatigue and “just not feeling well” for the last few days. His vital signs and exam are normal, but his liver enzymes are elevated. His hepatitis panel is negative for infectious hepatitis. What is the most likely cause of his elevated liver enzymes?
- Correct Answer: Daily grapefruit consumption for the past 10 days
- Question: An 84-year-old presents with a stated involuntary weight loss. He states that he’s lost about 6 pounds in the last 6 or 8 weeks. What statement below is NOT part of the assessment?
- Correct Answer: Evaluate his upper and lower extremity muscle mass.
- Question: The relationship between colon polyps and colon cancer is that polyps:
- Correct Answer: Have a slow progression to colon cancer.
- Question: In a patient with end-of-life physical pain, constipation commonly occurs. What is the most common cause of this?
- Correct Answer: Opioid use
- Question: A patient asks for advice about a medication that will produce rapid relief if he is having heartburn symptoms. What should the nurse practitioner recommend?
- Correct Answer: Calcium carbonate
- Question: The three most common causes of bacterial diarrhea in the US are Salmonella, Campylobacter, and:
- Correct Answer: Shigella
- Question: A 43-year-old female patient reports a possible exposure to hepatitis C about 4 months ago. Which statement is true about this patient?
- Correct Answer: The patient does not have hepatitis C but has immunity to hepatitis B.
- Question: A patient has the following laboratory values. What does this mean?
- Correct Answer: He has acute hepatitis B.
- Question: A patient has the following lab results. This means:
- Correct Answer: More data is needed.
- Question: A patient with diarrhea has a stool specimen positive for WBCs. What is a likely etiology?
- Correct Answer: A viral infection
- Question: Which is NOT an effective strategy for helping older adults gain weight?
- Correct Answer: Increase carbohydrate intake
- Question: A 70-year-old presents to the nurse practitioner’s office for a well exam today. What medication probably has no effect on screening for occult blood in the stool?
- Correct Answer: Acetaminophen
- Question: A patient presents with complaints of bright red stools over the past week. This symptom could be consistent with:
- Correct Answer: Cancer of the sigmoid colon
- Question: A patient has a positive hepatitis B surface antibody. This means he:
- Correct Answer: Is immune to hepatitis B
- Question: A patient with diarrhea is tested for C. difficile. How soon should the enzyme immunoassay (EIA) yield results?
- Correct Answer: About 24 hours
- Question: What choice below is most commonly associated with pancreatitis?
- Correct Answer: Gallstones and alcohol abuse
- Question: The most common cause of diarrhea in adults is:
- Correct Answer: Viral gastroenteritis
- Question: Which of the following would be usual in a patient with biliary colic?
- Correct Answer: Pain in the upper abdomen in response to eating fatty foods
- Question: Choose the number on the image that most closely approximates the location of a direct inguinal hernia.
- Correct Answer: 1
- Question: What medication listed below could be used to increase appetite in an anorexic patient?
- Correct Answer: Megestrol
- Question: Symptoms of uncomplicated reflux disease in older adults should be treated:
- Correct Answer: With empiric treatment
- Question: Which patient has the least worrisome symptoms associated with his diarrhea? One with:
- Correct Answer: Moderate amounts of watery diarrhea
- Question: A patient has had right upper quadrant pain that has lasted for the past 3 days, but the pain has become acute in the past 12 hours. He has a low-grade fever. Which lab test(s) will be elevated if he has pancreatitis?
- Correct Answer: Serum amylase
- Question: A 45-year-old patient has the following laboratory values. How should they be interpreted?
- Correct Answer: The patient has hepatitis.
- Question: A patient has the following laboratory value. What is the clinical interpretation?
- Correct Answer: He has immunity to hepatitis A.
- Question: Many older adults have cachexia. What characterizes this?
- Correct Answer: Illness and loss of muscle mass
- Question: The relationship between duodenal ulcer disease and H. pylori infection is:
- Correct Answer: Very likely.
- Question: What medication used to treat patients who have GERD provides the fastest relief of heartburn symptoms?
- Correct Answer: Calcium carbonate
- Question: A patient has hepatitis B. He probably has a predominance of:
- Correct Answer: Lymphocytes.
- Question: What should the nurse practitioner recommend to any elder taking medications?
- Correct Answer: Keep a list of all your medications with you.
- Question: What is the most common nutrition syndrome in older adults?
- Correct Answer: Undernutrition
- Question: Which set of symptoms is most likely in a patient infected with C. difficile?
- Correct Answer: Diarrhea, abdominal pain, nausea, or vomiting
- Question: The two tests that can indicate current infection with hepatitis B are:
- Correct Answer: Presence of hepatitis B surface antigen and IgM.
- Question: What is the recommendation for daily multivitamin supplementation in older adults?
- Correct Answer: It has no proven benefit.
- Question: A 40-year-old patient has the following laboratory values. How should they be interpreted?
- Correct Answer: The patient had hepatitis.
- Question: A patient is 86 years old and functions independently. He has hypertension, hyperlipidemia, BPH, and flare-ups of gout. His last colonoscopy was at age 76 years. What should he be advised about having a colonoscopy?
- Correct Answer: It is not advised in this patient at this time.
- Question: Which choice contains three medications that should have liver function tests measured prior to initiation of the medications?
- Correct Answer: Terbinafine, atorvastatin, simvastatin
- Question: Mrs. Lovely, an 84-year-old, complains of fecal incontinence. A likely cause is:
- Correct Answer: Constipation.
- Question: A mother of a 4-week-old infant visits your office. She states that her baby is vomiting after feeding and then cries as if he is hungry again. What should the nurse practitioner assess?
- Correct Answer: His abdomen for an olive-shaped mass.
- Question: A 37-year-old has routine blood work performed during an annual exam. On exam, he has a tender, enlarged liver. How should the nurse practitioner proceed?
- Correct Answer: Order a hepatitis panel.
- Question: A mother presents with her 1-month-old infant. She reports that he cries inconsolably every evening after his first evening feeding. She asks for help. What should be done?
- Correct Answer: Provide education, parental reassurance, and encouragement.
- Question: A 14-year-old male patient has an acute, painless groin swelling. Which tool would yield the most information to identify the etiology of the swelling?
- Correct Answer: Ultrasound of the scrotum.
- Question: A 7-year-old male presents with encopresis. The NP might expect:
- Correct Answer: Constipation.
- Question: A patient has the following lab values. This indicates that he:
- Correct Answer: Is immune to hepatitis B.
- Question: What would be age-appropriate anticipatory guidance for the parent of a 9-month-old infant?
- Correct Answer: Discuss weaning from a bottle.
- Question: Which of the following is an appropriate initial intervention for gastroesophageal reflux disease (GERD) in an 8-week-old?
- Correct Answer: Small, frequent thickened feedings.
- Question: Hirschsprung’s disease is characterized by:
- Correct Answer: Failure to pass meconium in the first 48 hours of life.
- Question: A fecal occult blood test (FOBT) obtained during a rectal examination:
- Correct Answer: Is inadequate to screen for colorectal cancer.
- Question: A 20-year-old female patient presents with tenderness at McBurney’s point. Appendicitis is considered. What laboratory test should be done initially to determine the etiology of this patient’s abdominal pain?
- Correct Answer: Serum pregnancy test.
- Question: What medication may be used to treat GERD if a patient has tried over-the-counter ranitidine without benefit?
- Correct Answer: Pantoprazole.
- Question: A 3-day-old full-term infant has a bilirubin level of 16 mg/dL. How should this be managed?
- Correct Answer: Order phototherapy for the infant.
- Question: A 42-year-old patient was diagnosed with ulcerative colitis many years ago. What part of his routine health screenings should be stressed by the nurse practitioner?
- Correct Answer: He should have a colonoscopy every 1-5 years.
- Question: A 3-day-old infant weighed 8 pounds at birth. Today he weighs 7.5 pounds. How should this be managed?
- Correct Answer: Continue feeding every 2-4 hours.
- Question: The initial step in the management of encopresis is:
- Correct Answer: Client and family education.
- Question: Children with an inguinal hernia:
- Correct Answer: Have a history of an intermittent bulge in the groin.
- Question: A 35-year-old patient has the following laboratory values. How should they be interpreted?
- Correct Answer: The patient should consider Hepatitis B immunization.
- Question: What is the simplest screen for nutritional adequacy in elderly patients?
- Correct Answer: Measure their weight.
- Question: A patient is in the clinic with a 36-hour history of diarrhea and moderate dehydration. Interventions should include:
- Correct Answer: Oral rehydration with an electrolyte replenishment solution.
- Question: A 6-week-old male infant is brought to the nurse practitioner because of vomiting. The mother describes vomiting after feeding and feeling a “knot” in his abdomen especially after he vomits. The child appears adequately nourished. What is the likely etiology?
- Correct Answer: Pyloric stenosis.
