Pathophysiology Test 3 - NCLEX style questions (GI, Renal, Diabetes, Endocrine, Liver )

Which of the following patients is at most risk for Type 2 diabetes? A 6 year old girl recovering from a viral infection with a family history of diabetes. A 28 year old male with a BMI of 49. A 76 year old female with a history of cardiac disease. None of the options provided.

A 28 year old male with a BMI of 49. Remember Type 2 diabetes risk factors are related to lifestyle....being obese is a risk factor (BMI >30 in males is considered obese). So, the 28 year old male with a BMI of 49 is most at risk for Type 2.

1. A patient reports frequent heartburn twice a week for the past 4 months. What other symptoms reported by the patient may indicate the patient has GERD? SELECT-ALL-THAT-APPLY: A. Bitter taste in mouth B. Dry cough C. Melena D. Difficulty swallowing E. Smooth, red tongue F. Murphy's Sign

A. Bitter taste in mouth B. Dry cough D. Difficulty swallowing The answers are A, B, D. These are signs and symptoms seen with GERD. Melena is seen with gastrointestinal bleeding as in peptic ulcer disease. Smooth, red tongue is seen with vitamin B12 deficiency, and Murphy's Signs is seen with cholecystitis.

10. A patient with Crohn's Disease is taking corticosteroids. The patient is complaining of extreme thirst, polyuria, and blurred vision. What is your next nursing action? A. Check the patient's blood glucose B. Give the patient a food containing sugar (ex: orange juice) C. Administer oxygen via nasal cannula D. D. Assess bowel sounds

A. Check the patient's blood glucose The answer is A. A side effect of corticosteroids is hyperglycemia. Extreme thirst, polyuria, and blurred vision are classic signs and symptoms of hyperglycemia. Therefore, the nurse should check the patient's blood glucose to confirm the hyperglycemia.

5. Select ALL of the following that are complications associated with Crohn's Disease: A. Cobble-stone appearance of GI lining B. Lead-pipe sign C. Toxic megacolon D. Fistula E. Abscess F. Anal Fissure

A. Cobble-stone appearance of GI lining D. Fistula E. Abscess F. Anal Fissure The answers are A, D, E, and F. These are all complications found with Crohn's Disease. Lead-pipe sign and toxic megacolon are complications associated with ulcerative colitis.

6. You're collecting a patient's medication history that has GERD. Which medication below is NOT typically used to treat GERD? A. Colesevelam "Welchol" B. Omeprazole "Prilosec" C. Metoclopramide "Reglan" D. Ranitidine HCL "Zantac"

A. Colesevelam "Welchol" The answer is A. Options B is a proton-pump Inhibitors (PPIs) and it decreases stomach acid and helps the esophagus heal. Option C is a type of prokinetic drug and prevents delayed gastric emptying by improving pressure in lower esophageal sphincter and it improves peristalsis of the GI tract. Option D is a histamine receptor blocker and it blocks histamine. When histamine is released it causes the parietal cells to release HCL but this response will be blocked so gastric acid secretion will be decreased. Option A is a drug used in gallbladder disease.

8. A patient is receiving treatment for Crohn's Disease. Which food found on the patient's food tray should the patient avoid? A. Fresh Salad B. White rice C. Baked chicken D. Cooked skinless apples

A. Fresh Salad The answer is A. Patients who are experiencing flare-ups of Crohn's Disease should avoid high fiber foods, foods that are hard to digest, spicy foods, dairy products etc. Therefore, the patient should avoid a fresh salad. This contain vegetables which are high in fiber and hard to digest. The gut needs to rest. It is best for the patient to consume low fiber and high protein foods. White rice and fruits/vegetables that are cooked/skinless are low in fiber. Baked chicken is a good source of protein for the patient.

4. During a home health visit, you are helping a patient develop a list of foods they should avoid due to GERD. Which items in the patient's pantry should be avoided? SELECT-ALL-THAT-APPLY: A. Hot and Spicy Pork Rinds B. Peppermint Patties C. Green Beans D. Tomato Soup E. Chocolate Fondue F. Almonds G. Oranges

A. Hot and Spicy Pork Rinds B. Peppermint Patties D. Tomato Soup E. Chocolate Fondue G. Oranges The answers are A, B, D, E, G. Patients with GERD should avoid foods that relax the lower esophageal sphincter such as greasy/fatty foods (Hot and Spicy Pork Rinds), peppermint (peppermint patties), acidic or citrus foods/juice (tomato soup and oranges), chocolate (chocolate fondue), along with coffee and soft drinks

2. Your patient, who is presenting with signs and symptoms of GERD, is scheduled to have a test that assesses the function of the esophagus' ability to squeeze food down into the stomach and the closer of the lower esophageal sphincter. The patient asks you, "What is the name of the test I'm having later today?" You tell the patient the name of the test is: A. Lower Esophageal Gastrointestinal Series B. Transesophageal echocardiogram C. Esophageal manometry D. Esophageal pH monitoring

C. Esophageal manometry The answer is C. An esophageal manometry assesses the function of the esophagus' ability to squeeze the food down and how the lower esophageal sphincter closes.

2. A patient with Crohn's Disease is MOST likely to have the disease is what part of the GI tract? A. Rectum B. Duodenum of the small intestine C. Terminal Ileum D. Descending colon

C. Terminal Ileum The answer is C. Crohn's disease is MOST likely to affect the terminal ileum. However, it may affect any area of the GI tract.

8. Which of the following does NOT play a role in the development of GERD? A. Pregnancy B. Hiatal hernia C. Usage of antihistamines or calcium channel blockers D. All the above play a role in GERD

D. All the above play a role in GERD The answer is D. All the options above play a role in the development of GERD. These options can weaken the lower esophageal sphincter and cause it to not close properly.

4. A physician is explaining to a patient that the patient has a type of Crohn's Disease that is found in both the ileum and colon. As the nurse, you know this type of Crohn's Disease is called? A. Gastroduodenal Crohn's Disease B. Granulomatous Colitis C. Ileitis D. Ileocolitis

D. Ileocolitis The answer is D. This patient has ileocolitis which affects parts of the colon and ileum. Gastroduodenal Crohns affects the stomach and duodenum which is the first part of the small intestine. Granulomatous colitis affects only the colon. Ileitis affects the ileum.

8. A patient with ulcerative colitis is scheduled for ileoanal anastomosis (J-Pouch) surgery. You know that this procedure: A. Removes the colon and rectum which allows a pouch to be created that will attach to the ileum. This will allow stool to pass from the small intestine to the anus. B. Removes the colon and rectum and creates a permanent ileostomy. C. Removes the colon and creates a temporary colostomy. D. Removes the rectum which allows a pouch to be created from the colon. This will allow stool to pass from the colon to the anus.

The answer is A. A J-pouch surgery (ileoanal anastomosis) removes the colon and rectum which allows a pouch to be created that will attach to the ileum. This will allow stool to pass from the small intestine to the anus.

3. A patient with late-stage cirrhosis develops portal hypertension. Which of the following options below are complications that can develop from this condition? Select all that apply: A. Increase albumin levels B. Ascites C. Splenomegaly D. Fluid volume deficient E. Esophageal varices

The answer are B, C, and E. Portal Hypertension is where the portal vein becomes narrow due to scar tissue in the liver, which is restricting the flow of blood to the liver. Therefore, pressure becomes increased in the portal vein and affects the organs connected via the vein to the liver. The patient may experience ascites, enlarged spleen "splenomegaly", and esophageal varices etc.

8. A patient with Cushing's syndrome will be undergoing an adrenalectomy. Which of the following will be included in the patient's discharge teaching after the procedure? A. Glucocorticoid replacement therapy B. Avoiding avocadoes and pears C. Declomycin therapy D. Signs and symptoms of Grave's Disease

The answer is A

7. In Cushing's Disease and Syndrome there are: A. Increased cortisol production B. Low potassium and glucose levels C. Increased production of aldosterone and cortisol D. Decreased production of cortisol and aldosterone

The answer is A.

9. Which of the following is not a typical sign and symptom of Cushing's Syndrome? A. Hyperpigmentation of the skin B. Hirsutism C. Purplish striae D. Moon Face

The answer is A.

11. The physician orders a patient with pancreatitis to take a pancreatic enzyme. What assessment finding demonstrates the pancreatic enzymes are working properly? A. Abdominal girth is decreased B. Skin turgor is less than 2 seconds C. Blood glucose is 250 D. Stools appear formed and solid

The answer is D. Pancreatic enzymes help the body break down carbs, proteins, and fats because the body is not sufficiently producing digestive enzymes anymore. Hence, the stool will not appear as oily or greasy (decrease in steatorrhea) but appear solid and formed.

1. True or False: Ulcerative colitis is a type of inflammatory bowel disease that causes inflammation and ulcer formation in the inner lining of the small intestine, specifically the terminal ileum. True False

The answer is FALSE: Ulcerative colitis is a type of inflammatory bowel disease that causes inflammation and ulcer formation in the inner lining of the LARGE (not small) intestine. The inflammation tends to start in the rectum and spreads throughout the colon. The small intestine is usually not involved.

8. True or False: Most patients with chronic diverticulitis require surgery at some point, such as a bowel resection. If the healthy bowel cannot be reconnected right away, a permanent colostomy will be created until it can be reconnected. True False

The answer is False. Most patients with chronic diverticulitis require surgery at some point, such as a bowel resection. If the healthy bowel cannot be reconnected right away, a TEMPORARY (NOT permanent) colostomy will be created until it can be reconnected

3. A patient with Addison's Disease is being discharged home on Prednisone. Which of the following statements by the patient warrants you to re-educate the patient? A. "I will notify the doctor if I become sick or experience extra stress." B. "I will take this medication as needed when symptoms present." C. "I will take this medication at the same time every day." D. "My daughter has bought me a Medic-Alert bracelet." .

The answer is option B

10. You're providing diet teaching to a patient with ulcerative colitis about what types of foods to avoid during a "flare-up". Which foods below should the patient avoid? SELECT-ALL-THAT-APPLY: A. Ice cream B. White Rice C. Fresh apples and pears D. Popcorn E. Cooked carrots

The answers are A, C, and D. Patients experiencing a flare-up with ulcerative colitis should avoid dairy products (ice cream), food that are high in fiber (fresh apples or pears) (cooked fruits without the skin would be okay), and foods that are hard to digest (popcorn). Instead, patients should consume foods low in fiber (low residue) like cooked vegetables (carrots), bland foods (white rice) etc.

The _____ ______ secrete insulin which are located in the _______. Alpha cells, liver Alpha cells, pancreas Beta cells, liver Beta cells, pancreas

Beta cells, pancreas

Which of the following symptoms do NOT present in hyperglycemia? Extreme thirst Hunger Blood glucose <60 mg/dL Glycosuria

Blood glucose <60 mg/dL

3. After dinner time, during hourly rounding, a patient awakes to report they feel like "food is coming up" in the back of their throat and that there is a bitter taste in their mouth. What nursing intervention will you perform next? A. Perform deep suctioning B. Assist the patient into the Semi-Fowler's position C. Keep the patient NPO D. Instruct the patient to avoid milk products

B. Assist the patient into the Semi-Fowler's position The answer is B. The patient is experiencing regurgitation. The clues in this scenario are the patient signs and symptoms along with the time of day (after dinner time...the patient just ate a meal and is sleeping..we can assume they are lying down). If a patient has reflux disease, the lower esophageal sphincter is weak and after a meal when a person lies down to sleep the food can regurgitate into the throat which will cause the patient to feel like "food in coming up" in the back of the throat and bitter taste in the mouth. Placing the patient in semi-fowler's position will help alleviate this.

3. You're providing teaching to a patient who has been newly diagnosed with Crohn's Disease. Which statement by the patient's spouse requires re-education? A. "Crohn's Disease can be scattered throughout the GI tract in patches with some areas appearing healthy while others are diseased." B. "There is no cure for Crohn's Disease." C. "Strictures are a common complication with Crohn's Disease." D. "Crohn's Disease can cause the haustra of the large intestine to lose its form."

D. "Crohn's Disease can cause the haustra of the large intestine to lose its form." The answer is D. All the statements are true except option D. ULCERATIVE COLITIS can cause the haustra of the large intestine to lose its form. This is not common with Crohn's Disease.

5. After providing education to a patient with GERD. You ask the patient to list 4 things they can do to prevent or alleviate signs and symptoms of GERD. Which statement is INCORRECT? A. "It is best to try to consume small meals throughout the day than eat 3 large ones." B. "I'm disappointed that I will have to limit my intake of peppermint and spearmint because I love eating those types of hard candies." C. "It is important I avoid eating right before bedtime." D. "I will try to lie down after eating a meal to help decrease pressure on the lower esophageal sphincter."

D. "I will try to lie down after eating a meal to help decrease pressure on the lower esophageal sphincter." The answer is D. This statement is incorrect. The patient should have said I will AVOID lying down after eating a meal to help decrease pressure on the lower esophageal sphincter. It is important a patient does not immediately lie down after eating but wait for about 1 hour.

7. A patient experiencing a flare-up with Crohn's Disease is ordered complete bowel rest by the physician. You are administering TPN (total parental nutrition) per physician order. When developing the patient's nursing plan of care, which nursing diagnosis is MOST important to include in the care plan? A. Risk for allergy response B. Risk for unstable blood glucose level C. Risk for imbalance nutrition: more than body requirements D. Risk for imbalanced nutrition: less than body requirements

D. Risk for imbalanced nutrition: less than body requirements The answer is D. Patients with Crohn's Disease are at risk for undernourishment due to how the disease process effects the body (small intestine is inflamed which is the area of the gut that absorbs most of the nutrients from food). With severe cases of Crohn's Disease, the physician may order complete bowel rest (where the patient will be nothing by mouth (NPO) and nothing will enter the GI system....so the patient is at even more risk for imbalance nutrition. Physicians may prescribe an IV solution (total parental nutrition) which will be given through a central line that contains nutrients (so it enters the bloodstream...bypassing the gut). However, there is still a risk for imbalanced nutrition (less than body requirements) for the patient. The nurse must monitor the patient's nutrition status very closely such as daily weights, hydration status, electrolytes, skin, etc.

A 36 year old male is newly diagnosed with Type 2 diabetes. Which of the following treatments do you expect the patient to be started on initially? Diet and exercise regime Metformin BID by mouth Regular insulin subcutaneous None, monitoring at this time is sufficient enough

Diet and exercise regime

A patient with diabetes has a morning glucose of 50. The patient is sweaty, cold, and clammy. Which of the following nursing interventions is MOST important? Recheck the glucose level Give the patient ½ cup (4 oz) of fruit juice Call the doctor Keep the patient nothing by mouth

Give the patient ½ cup (4 oz) of fruit juice

Which of the following statements are true regarding Type 2 diabetes treatment? Insulin and oral diabetic medications are administered routinely in the treatment of Type 2 diabetes. Insulin may be needed during times of surgery or illness. Insulin is never taken by the Type 2 diabetic. Oral medications are the first line of treatment for newly diagnosed Type 2 diabetics

Insulin may be needed during times of surgery or illness.

A Type 2 diabetic may have all the following signs or symptoms EXCEPT: Blurry vision Ketones present in the urine Glycosuria Poor wound healing

Ketones present in the urine

A patient who has diabetes is nothing by mouth as prep for surgery. The patient states they feel like their blood sugar is low. You check the glucose and find it to be 52. The next nursing intervention would be to: Notify the doctor for further orders regarding the blood sugar Continue to monitor the glucose Give the patient 3 graham crackers to eat None, this is a normal blood glucose reading

Notify the doctor for further orders regarding the blood sugar This question requires critical thinking because the patient is NPO for surgery and can NOT eat but is experiencing hypoglycemia. Normally, you could give the patient juice or graham crackers to consume without a doctor's order. However with this question you would have to call the doctor for further orders.....he/she will probably order IV D50 to increase the blood sugar

What statement or statements are INCORRECT regarding Diabetic Ketoacidosis? DKA occurs mainly in Type 1 diabetics. Ketones are present in the urine in DKA. Cheyne-stokes breathing can present in DKA. Severe hypoglycemia is a hallmark sign in DKA. Options 3 & 4

Options 3 & 4

7. Your patient is 4 days post-opt from an appendectomy. Which assessment finding requires further evaluation? A. The patient reports their last bowel movement was the day before surgery. B. The patient reports incisional pain. C. The patient coughs and deep breathes while splinting the abdominal incision. D. Options A and C

The answer is A. If the patient has not had a bowel movement 2-3 days after surgery it requires further evaluation such as listening to bowel sounds and asking the patient if they are passing gas. If the patient has no bowel sounds or does NOT report passing gas, the doctor should be notified. Options B and C are normal findings

8. A patient is recovering after having an appendectomy. The patient is 48 hours post-opt from surgery and is tolerating full liquids. The physician orders for the patient to try solid foods. What types of foods should the patient incorporate in their diet? A. Foods high in fiber B. Foods low in fiber C. Foods high in carbohydrates D. Foods low in protein

The answer is A. It is best for the patient to follow a diet high in fiber to prevent straining during bowel movements.

4. A patient is admitted to the ER. The patient is unconscious on arrival. However, the patient's family is with the patient and reports that before the patient became unconscious she was complaining of severe pain in the abdomen, legs, and back, and has been experiencing worsening confusion. In addition, they also report the patient has not been taking any medications. The patient was recently discharged from the hospital for treatment of low cortisol and aldosterone levels. On assessment, you note the patient's blood pressure is 70/45. What disorder is this patient most likely experiencing? A. Addisonian Crisis B. Cushing Syndrome C. Thyroid crisis D. Hashimoto thyroiditis .

The answer is A. Note the patient is experiencing the signs and symptoms of Addisonian Crisis. The red flag in this scenario are the patient's symptoms, recent hospitalization diagnosis, and that she is not taking any medications. Remember that patients who have Addision's disease are at risk for Addisonian Crisis, especially if they are not taking their prescribed hormone therapy replacement

5. A patient is admitted with hepatic encephalopathy secondary to cirrhosis. Which meal option selection below should be avoided with this patient? A. Beef tips and broccoli rabe B. Pasta noodles and bread C. Cucumber sandwich with a side of grapes D. Fresh salad with chopped water chestnuts

The answer is A. Patients who are experiencing hepatic encephalopathy are having issues with toxin build up in the body, specifically ammonia. Remember that ammonia is the byproduct of protein breakdown, and normally the liver can take the ammonia from the protein breakdown and turn it into urea (but if the cirrhosis is severe enough this can't happen). Therefore, the patient should consume foods LOW in protein until the encephalopathy subsides. Option A is very high in protein while the others are low in protein. Remember meats, legumes, eggs, broccoli rabe, certain grains etc. are high in protein.

8. While assisting a patient with chronic pancreatitis to the bathroom, you note the patient's stool to be oily/greasy in appearance. In your documentation you note this as: A. Steatorrhea B. Melena C. Currant D. Hematochezia

The answer is A. Steatorrhea is an oily/greasy appearance of the stool which can occur in chronic pancreatitis. This occurs due to the inability of the pancreas to produce digestive enzymes which help break down fats. Fats are not being broken down; therefore, it is being excreted into the stool. Melena is used to describe tarry/black stool, hematochezia is used to describe red stools, and currant are jelly type stools

5. In the scenario above, what medication do you expect the patient to be started on? A. IV Solu-Cortef B. PO Prednisone C. PO Declomycin D. IV Insulin

The answer is A. The patient needs cortisol immediately because they are experiencing Addisonian Crisis. IV Solu-Cortef is the best option because it is intravenous and a glucocorticoid. The patient is unconscious and can not take oral medications, therefore Prednisone is not the best option and all the other options are incorrect

3. A 65 year old male patient has a glomerular filtration rate of 55 mL/min. The patient has a history of uncontrolled hypertension and coronary artery disease. You're assessing the new medication orders received for this patient. Which medication ordered by the physician will help treat the patient's hypertension along with providing a protective mechanism to the kidneys? A. Lisinopril B. Metoprolol C. Amlodipine D. Verapamil .

The answer is A. There are two types of drugs that can be used to treat hypertension and protect the kidneys in patients with CKD. These drugs include angiotensin converting enzyme inhibitors (ACE inhibitors) and angiotensin receptor blockers (ARBs). The only drug listed here that is correct is Lisinopril. This drug is known as an ACE inhibitor. Metoprolol is a BETA BLOCKER. Amlodipine and Verapamil are calcium channel blockers

11. The physician orders Lactulose 30 mL by mouth per day for a patient with cirrhosis. What findings below demonstrates the medication is working effectively? Select all that apply: A. Decrease albumin levels B. Decrease in Fetor Hepaticus C. Patient is stuporous. D. Decreased ammonia blood level E. Presence of asterixis

The answer is B and D. A patient with cirrhosis may experience a complication called hepatic encephalopathy. This will cause the patient to become confused (they may enter into a coma), have pungent, musty smelling breath (fetor hepaticus), asterixis (involuntary flapping of the hands) etc. This is due to the buildup of ammonia in the blood, which affects the brain. Lactulose can be prescribed to help decrease the ammonia levels. Therefore, if the medication is working properly to decrease the level of ammonia the patient would have improving mental status (NOT stuporous), decreased ammonia blood level, decreasing or absence of asterixis, and decreased ammonia blood level.

10. In Cushing's disease, the _______ is secreting too much ACTH (Adrenocorticotropic hormone) which is causing an increase in cortisol production. A. Adrenal cortex B. Pituitary gland C. Thyroid gland D. Hypothalamus

The answer is B.

10. While providing mouth care to a patient with late-stage cirrhosis, you note a pungent, sweet, musty smell to the breath. This is known as: A. Metallic Hepatico B. Fetor Hepaticus C. Hepaticoacidosis D. Asterixis

The answer is B.

3. You're assessing morning lab values on a female patient who is recovering from a myocardial infraction. Which lab value below requires you to notify the physician? A. Potassium level 4.2 mEq/L B. Creatinine clearance 35 mL/min C. BUN 20 mg/dL D. Blood pH 7.40

The answer is B. A normal creatinine clearance level in a female should be 85-125 mL/min (95-140 mL/min males). A creatinine clearance level indicates the amount of blood the kidneys can make per minute that contain no amounts of creatinine in it. Remember creatinine is a waste product of muscle breakdown. Therefore, the kidneys should be able to remove excessive amounts of it from the bloodstream. A patient who has experienced a myocardial infraction is at risk for pre-renal acute injury due to decreased cardiac output to the kidneys from a damaged heart muscle (the heart isn't able to pump as efficiently because of ischemia). All the other labs values are normal.

10. A patient who received treatment for pancreatitis is being discharged home. You're providing diet teaching to the patient. Which statement by the patient requires immediate re-education about the diet restrictions? A. "It will be hard but I will eat a diet low in fat and avoid greasy foods." B. "It is very important I limit my alcohol intake to no more than 2-3 glasses of wine a week." C. "I will concentrate on eating complex carbohydrates rather than refined carbohydrates." D. "I will purchase foods that are high in protein."

The answer is B. A patient with pancreatitis should AVOID any amount of alcohol because of its effects on the pancreas. Remember alcohol is a cause of both acute and chronic pancreatitis. All the other options are correct.

1. ______________ is solely filtered from the bloodstream via the glomerulus and is NOT reabsorbed back into the bloodstream but is excreted through the urine. A. Urea B. Creatinine C. Potassium D. Magnesium

The answer is B. Creatinine is a waste product from muscle breakdown and is removed from the bloodstream via the glomerulus of the nephron. It is the only substance that is solely filtered out of the blood but NOT reabsorbed back into the system. It is excreted out through the urine. This is why a creatinine clearance test is used as an indicator for determining renal function and for calculating the glomerular filtration rate

2. A patient with CKD has a low erythropoietin (EPO) level. The patient is at risk for? A. Hypercalcemia B. Anemia C. Blood clots D. Hyperkalemia

The answer is B. EPO (erythropoietin) helps create red blood cells in the bone marrow. The kidneys produce EPO and when the kidneys are damaged in CKD they can decrease in the production of EPO. Therefore, the patient is at risk for anemia

6. Your patient with acute pancreatitis is scheduled for a test that will use a scope to assess the pancreas, bile ducts, and gallbladder. The patient asks you, "What is the name of the test I'm going for later today?" You tell the patient it is called: A. MRCP B. ERCP C. CT scan of the abdomen D. EGD

The answer is B. ERCP (Endoscopic Retrograde Cholangio-Pancreatography) is used to diagnosis and sometimes treat the causes of pancreatitis. It will assess the pancreas, bile ducts, and gallbladder. In addition, the doctor may be able to remove gallstones, dilate the blocked ducts with a stent or balloon, drain presenting cysts etc.

2. The liver receives it blood supply from two sources. One of these sources is called the _________________, which is a vessel network that delivers blood _____________ in nutrients but ________ in oxygen. A. hepatic artery, low, high B. hepatic portal vein, high, low C. hepatic lobule, high, low D. hepatic vein, low, high

The answer is B. Majority of the blood flow to the liver comes from the hepatic portal vein. This vessel network delivers blood HIGH in nutrients (lipids, proteins, carbs etc.) from organs that aid in the digestion of food, but the blood is POOR in oxygen. The organs connected to the hepatic portal vein are: small/large intestine, pancreas, spleen, stomach. Rich oxygenated blood comes from the hepatic artery to the liver.

9. A patient with acute pancreatitis is reporting excessive thirst, excessive voiding, and blurred vision. As the nurse, it is priority you? A. Reassure the patient this is normal with pancreatitis B. Check the patient's blood glucose C. Assist the patient with drinking a simple sugar drink like orange juice D. Provide a dark and calm environment

The answer is B. Patients with acute pancreatitis are at risk for hyperglycemia (the signs and symptoms the patient are reporting are classic symptoms of hyperglycemia). Remember the endocrine function of the pancreas (which is to release insulin/glucagon etc. is insufficient) so the nurse must monitor the patient's blood glucose levels even if the patient is not diabetic.

5. A patient is experiencing an acute episode of diverticulitis. The patient is having abdominal pain, temperature 102.6 'F, and elevated WBCs. As the nurse, you know it is important to: A. Encourage intake of high-fiber foods B. Monitor the patient for peritonitis C. Apply a heating pad to the patient's abdomen to help alleviate pain D. Encourage intake of full liquids

The answer is B. The patient experiencing an episode of acute diverticulitis is at risk for abscess due to the presenting infection in the affected pouch/pouches which can lead to peritonitis if the abscess ruptures. Therefore, the nurse should monitor the patient for signs and symptoms of peritonitis which include: increased HR, RR, abdominal tenderness/bloating, and high fever.

5. A patient with Stage 5 CKD is experiencing extreme pruritus and has several areas of crystallized white deposits on the skin. As the nurse, you know this is due to excessive amounts of what substance found in the blood? A. Calcium B. Urea C. Phosphate D. Erythropoietin

The answer is B. This patient is experiencing uremic frost that occurs in severe chronic kidney disease. This is due to high amounts of urea in the blood being secreted via the sweat glands onto the skin, which will appear as white deposits on the skin. The patient will experience itching with this as well.

6. You're providing education to a group of nursing students about the care of a patient with appendicitis. Which statement by a nursing student requires re-education about your teaching? A. "After an appendectomy the patient may have a nasogastric tube to remove stomach fluids and swallowed air." B. "Non-pharmacological techniques for a patient with appendicitis include application of heat to the abdomen and the side-lying position." C. "The nurse should monitor the patient for signs and symptoms of peritonitis which includes increased heart rate, respirations, temperature, abdominal distention, and intense abdominal pain." D. "It is normal for some patients to have shoulder pain after a laparoscopic appendectomy."

The answer is B. This statement by the nursing student requires re-education because heat should NEVER be applied to abdomen if appendicitis is suspected or known. Heat application can increase the risk of appendix perforation. Ice application is recommended, if warranted. However, the side-lying position can help relieve the patient's pain and is recommended. All the other options are correct.

1. Most patients with diverticulosis are most likely to have diverticula located in the? A. Transverse colon B. Sigmoid Colon C. Rectum D. Ascending Colon

The answer is B: sigmoid colon. Diverticulosis can occur throughout the GI tract, however, it tends to be most common in the sigmoid colon.

6. A patient with Addison's Disease should consume which of the following diets? A. High fat and fiber B. Low potassium and high protein C. High protein, carbs, and adequate sodium D. Low carbs, high protein, and increased sodium

The answer is C

1. Inside the pancreas are special cells that secrete digestive enzymes and hormones. The cells that secrete digestive enzymes are known as ______________ cells. A. Islet of Langerhans B. Protease C. Acinar D. Amylase .

The answer is C. Acinar cells secrete digestive enzymes such as amylase, protease, and lipase

6. During your morning assessment of a patient with cirrhosis, you note the patient is disoriented to person and place. In addition while assessing the upper extremities, the patient's hands demonstrate a flapping motion. What lab result would explain these abnormal assessment findings? A. Decreased magnesium level B. Increased calcium level C. Increased ammonia level D. Increased creatinine level

The answer is C. Based on the assessment findings and the fact the patient has cirrhosis, the patient is experiencing hepatic encephalopathy. This is due to the buildup of toxins in the blood, specifically ammonia. The flapping motion of the hands is called "asterixis". Therefore, an increased ammonia level would confirm these abnormal assessment findings

9. A patient is scheduled for appendectomy at noon. While performing your morning assessment, you note that the patient has a fever of 103.8 'F and rates abdominal pain 9 on 1-10. In addition, the abdomen is distended and the patient states, "I was feeling better last night but it seems the pain has become worst." The patient is having tachycardia and tachypnea. Based on the scenario, what do you suspect the patient is experiencing? A. Pulmonary embolism B. Colon Fistulae C. Peritonitis D. Hemorrhage .

The answer is C. Based on the patient's presenting symptoms, the patient is most likely experiencing peritonitis because the appendix has ruptured. The key clues in this scenario are the classic signs and symptoms of peritonitis (tachycardia, tachypnea, high temperature, and abdominal pain/distension) along with the patient's statement that they were feeling better last night (hence probably the time the appendix ruptured) which periodically relieved the pain at the appendix but allowed for the contents of the appendix to leak into the peritoneal cavity....hence causing peritonitis

6. In regards to question 5, this patient signs and symptoms are starting to subside. Which of the following food items would be best for the patient to consume? A. Oatmeal and bran B. Orange juice and eggs C. Chicken broth and Jello D. Salad with chicken .

The answer is C. During the recovery phase of diverticulitis, once the symptoms start subsiding, the patient should start out with clear liquids like broth, jello, ice etc. and then low-fiber foods until healed. After the patient has fully recovered, they should consume a high-fiber diet and stay hydrated

5. An 18 year old patient is admitted with appendicitis. Which statement by the patient requires immediate nursing intervention? A. "The pain hurts so much it is making me nauseous." B. "I have no appetite." C. "The pain seems to be gone now." D. "If I position myself on my right side, it makes the pain less intense."

The answer is C. It is important that the nurse monitors the patient's pain level. If the patient reports that the pain has suddenly decreased or is gone, this is a warning sign that the appendix may have perforated (ruptured). If the appendix has ruptured, the sudden decrease in pain will be followed by more pain due to peritonitis (which is life- threatening). Therefore, the nurse should notify the doctor immediately.

4. Which patient below is NOT at risk for developing chronic kidney disease? A. A 58 year old female with uncontrolled hypertension. B. A 69 year old male with diabetes mellitus. C. A 45 year old female with polycystic ovarian disease. D. A 78 year old female with an intrarenal injury.

The answer is C. Options A, B, and D are all at risk for developing CKD. However, option C is not at risk for CKD.

5. Which patient below is at MOST risk for CHRONIC pancreatitis? A. A 25 year old female with a family history of gallstones. B. A 35 year old male who reports social drinking of alcohol. C. A 15 year old female with cystic fibrosis. D. A 66 year old female with stomach cancer.

The answer is C. Patients in options A and B are at slight risk for ACUTE pancreatitis not chronic. Remember the main causes of ACUTE pancreatitis are gallstones and alcohol consumption. In option C, the patient with cystic fibrosis is at MAJOR risk for CHRONIC pancreatitis because they are lacking the protein CFTR which plays a role in the movement of chloride ions to help balance salt and water in the epithelial cells that line the ducts of the pancreas. There is a decreased production of bicarbonate secretion by the epithelial cells. Therefore, this leads to thick mucus in the pancreatic ducts that can lead to blockage of the pancreatic ducts which can cause the digestive enzymes to activate and damage the pancreas. Overtime, the pancreas will experience fibrosis of the pancreas' tissue and will no longer produce digestive enzyme to help with food digestion.

4. A 55 year old male patient is admitted with a massive GI bleed. The patient is at risk for what type of acute kidney injury? A. Post-renal B. Intra-renal C. Pre-renal D. Intrinsic renal

The answer is C. Pre-renal injury is due to decreased perfusion to the kidneys secondary to a cause (massive GI bleeding...patient is losing blood volume). This leads to a major decrease in kidney function because the kidneys are deprived of nutrients to function and the amount of blood it can filter. Pre-renal injury can eventually lead to intrarenal damage where the nephrons become damaged

13. Which of the following is NOT a role of the liver? A. Removing hormones from the body B. Producing bile C. Absorbing water D. Producing albumin .

The answer is C. The liver does not absorb water. The intestines are responsible for this function

7. You're providing discharge teaching to a patient who was hospitalized with diverticulitis. Which statement by the patient requires you to re-educate the patient? A. "It is important I consume a diet high in fiber and keep hydrated to keep my stool soft." B. "The physician prescribed me to take Psyllium every day which will help prevent constipation." C. "I will be sure to always cook and skin my fruits and vegetables rather than eating them fresh." D. "I will notify my physician if I develop abdominal pain and fever."

The answer is C. The patient should consume fresh fruits and vegetables because they contain the most fiber. Fruits and vegetables that have been skinned or cooked have low amounts of fiber in them. The patient needs to follow a high-fiber diet..not low-fiber. A low fiber diet is only followed when the patient has experienced an episode of diverticulitis and is not fully healed from the inflammation.

3. A 23 year old patient is admitted with suspected appendicitis. The patient states he is having pain around the umbilicus that extends into the lower part of his abdomen. In addition, he says that the pain is worst on the right lower quadrant. The patient points to his abdomen at a location which is about a one-third distance between the anterior superior iliac spine and umbilicus. This area is known as what? A. Rovsing's Point B. Hamman's Point C. McBurney's Point D. Murphy's Point

The answer is C. This is known as McBurney's Point and is a classic sign and symptom in patients with appendicitis.

1. A 55 year old male patient is diagnosed with chronic kidney disease. The patient's recent GFR was 25 mL/min. What stage of chronic kidney disease is this known as? A. Stage 1 B. Stage 3 C. Stage 4 D. Stage 5

The answer is C. This is known as Stage 4 of CKD because the GFR (glomerular filtration rate) for this stage is 15-29 mL/min (patient's GFR is 25 mL/min). The other stage's criteria are as follows: Stage 1: Kidney damage with normal renal function GFR >90 ml/min but with proteinuria (3 months or more); Stage 2: Kidney damage with mild loss of renal function GFR 60-89 ml/min with proteinuria (3 months or more); Stage 3: Mild-to-severe loss of renal function GFR 30-59 mL/min; Stage 4: Severe loss renal function GFR 15-29 mL/min; Stage 5: End stage renal disease GRF less 15 mL/min

4. A patient asks what type of testing is performed to assess for diverticulosis. As the nurse, you know that which of the following is NOT used to assess for diverticulosis? A. Colonoscopy B. Barium enema C. Bronchoscopy D. CT scan with contrast of the abdomen

The answer is C. This is the only option that can NOT assess for diverticulosis. A bronchoscopy assesses the lungs.

2. You're providing nursing education to a group of nursing students about diverticulosis versus diverticulitis. Which statement by the nursing students demonstrate they understand the education provided? A. "Most patients with diverticulitis are asymptomatic." B. "Diverticulosis tends to occur in young women with a family history of diverticulosis." C. "Diverticulitis, if not treated, can lead to abscess formation and peritonitis." D. "Patients with diverticulosis should at all times avoid eating seeds and nuts."

The answer is C. This statement is the only true statement. Option A is wrong because patients with diverticulOSIS (not diverticulitis) are usually asymptomatic. Patients with diverticulitis will have symptoms of cramping like abdominal pain which is mainly felt in the left lower quadrant, blood in stool, constipation, fever. Option B is wrong because diverticulosis tends to occur in middle to older-aged adults not young. Option D is wrong because research now shows that consuming seeds or nuts does not cause diverticulitis as it was once thought.

2. Addison's Disease is: A. Increased secretion of cortisol B. Increased secretion of aldosterone and cortisol C. Decreased secretion of cortisol D. Decreased secretion of aldosterone and cortisol

The answer is D

8. A 45 year old male has cirrhosis. The patient reports concern about the development of enlarged breast tissue. You explain to the patient that this is happening because? A. The liver cells are removing too much estrogen from the body which causes the testicles to produce excessive amounts of estrogen, and this leads to gynecomastia. B. The liver is producing too much estrogen due to the damage to the liver cells, which causes the level to increase in the body, and this leads to gynecomastia. C. The liver cells are failing to recycle estrogen into testosterone, which leads to gynecomastia. D. The liver cells are failing to remove the hormone estrogen properly from the body, which causes the level to increase in the body, and this leads to gynecomastia.

The answer is D.

12. ________ reside in the liver and help remove bacteria, debris, and old red blood cells. A. Hepatocytes B. Langerhan cells C. Enterocytes D. Kupffer cells

The answer is D. Kupffer cells perform this function and are one of the two types of cells found in the liver lobules (the functional units of the liver). These cells play a role in helping the hepatocytes turn parts of the old red blood cells into bilirubin.

2. A patient is admitted with ulcerative colitis. In the physician's notes, it is stated that the patient's barium enema results showed the patient has colitis that starts in the rectum and extends into the sigmoid and descending colon. As the nurse, you know that this is what type of ulcerative colitis? A. Right-sided colitis B. Proctosigmoiditis C. Ulcerative procotitis D. Left-sided colitis

The answer is D. Left-sided colitis (distal colitis) starts in the rectum and goes to the sigmoid and descending colon. Ulcerative proctitis affects the rectum only. Proctosigmoiditis affects the rectum and sigmoid colon. Right-sided colitis is NOT a type of ulcerative colitis.

4. You're caring for a 45 year old patient who is admitted with suspected acute pancreatitis. The patient reports having extreme mid-epigastric pain that radiates to the back. The patient states the pain started last night after eating fast food. As the nurse, you know the two most common causes of acute pancreatitis are: A. High cholesterol and alcohol abuse B. History of diabetes and smoking C. Pancreatic cancer and obesity D. Gallstones and alcohol abuse

The answer is D. Main causes of acute pancreatitis are gallstones and alcohol consumption. Heavy, long-term alcohol abuse is the main cause of CHRONIC pancreatitis.

4. A patient diagnosed with pancolitis is experiencing extreme abdominal distension, pain 10 on 1-10 scale in the abdomen, temperature of 103.6 'F, HR 120, and profuse diarrhea. What complication due you suspect the pain is experiencing? A. Fistulae B. Stricture C. Bowel obstruction D. Toxic megacolon

The answer is D. Pancolitis affects all the colon and is a very severe form of ulcerative colon. The patient is at risk for toxic megacolon. In toxic megacolon, the large intestine dilates due to the overwhelming inflammation. The large intestine is unable to function properly and becomes paralyzed. Typical signs and symptoms of toxic megacolon include: abdominal distention, fever, diarrhea, abdominal pain, dehydration, and tachycardia.

10. The kidneys are responsible for performing all the following functions EXCEPT? A. Activating Vitamin D B. Secreting Renin C. Secreting Erythropoietin D. Maintaining cortisol production

The answer is D. The adrenal glands are responsible for maintaining cortisol production not the kidneys.

12. During a home health visit, you are assessing how a patient takes the prescribed pancreatic enzyme. The patient is unable to swallow the capsule whole, so they open the capsule and mix the beads inside the capsule with food/drink. Which food or drink is safe for the patient to mix the beads with? A. Pudding B. Ice cream C. Milk D. Applesauce

The answer is D. The patient should mix the medications with acidic foods like applesauce. It is very important the patient does NOT use alkaline foods for mixing (like dairy products, pudding etc.) because they can damaged the enzyme.

7. A patient is admitted to the ER with the following signs and symptoms: very painful mid-epigastric pain felt in the back, elevated glucose, fever, and vomiting. During the head-to-toe assessment, you notice bluish discoloration around the belly button. As the nurse, you know this is called? A. Grey-Turner's Sign B. McBurney's Sign C. Homan's Sign D. Cullen's Sign

The answer is D. This is known as Cullen's Sign. It represents retroperitoneal bleeding from the leakage of digestive enzymes from the inflamed pancreas into the surrounding tissues which is causing bleeding and it is leaking down to umbilicus tissue. Remember the C in Cullen for "circle" and the belly button forms a circle. The patient can also have Grey-Turner's Sign which is a bluish discoloration at the flanks (side of the abdomen). Remember this by TURNER ("turn her" over on her side) which is where the bluish discoloration will be.

1. Which condition is NOT a known cause of cirrhosis? A. Obesity B. Alcohol consumption C. Blockage of the bile duct D. Hepatitis C E. All are known causes of cirrhosis

The answer is E. All of these conditions can cause cirrhosis.

9. True or False: NSAIDs are used as first-line treatment for pain relief with patients with ulcerative colitis. True False .

The answer is FALSE. NSAIDs should be avoided in patients with ulcerative colitis because they can cause a "flare-up" in the condition. Tylenol should be used instead or a similar medication that isn't an NSAID

8. True or False: All patients with acute renal injury will progress through the oliguric stage of AKI but not all patients will progress through the diuresis stage. True False

The answer is FALSE. Some patients will skip the oliguric stage of AKI and progress to the diuresis stage.

1. True or False: A patient with Crohn's Disease can experience inflammation in the large intestine that affects mainly the mucosa (inner layer) of the bowel. True False

The answer is FALSE: A patient with Crohn's Disease can experience inflammation throughout the GI Tract (mainly in the terminal ileum and beginning of the colon) from the mouth to anus (not just the large intestine) and it affects the WHOLE bowel lining (not just the mucosa layer).

1. True or False: The appendix is found on the left lower side of the abdomen and is connected to the cecum of the large intestine. True False

The answer is FALSE: The appendix is found on the RIGHT (not left) lower side of the abdomen and is connected to the cecum of the large intestine.

1. Which of the following patients are at risk for developing Cushing's Syndrome? A. A patient with a tumor on the pituitary gland, which is causing too much ACTH to be secreted. B. A patient taking glucocorticoids for several weeks. C. A patient with a tuberculosis infection. D. A patient who is post-opt from an adrenalectomy.

The answer is option B. A patient taking glucocorticoids for several weeks. Remember that CUSHING'S DISEASE is caused by the pituitary gland producing too much ACTH which in turn increases cortisol. Cushing's SYNDROME is caused by medication therapy of glucocorticoids. An adrenalectomy is a treatment for Cushing's Disease (so this is not the answer in this case) and TB is a risk factor for developing ADDISON'S Disease

3. A patient with a history of diverticulosis is admitted with abdominal pain. The physician suspects diverticulitis. What other findings would correlate with diverticulitis? SELECT-ALL-THAT-APPLY: A. Abdominal pain that is mainly present in the upper right quadrant B. Unrelenting cramping type pain C. Pain found at McBurney's Point D. Blood in stool E. Fever F. Reports of constipation G. Abdominal bloating H. Positive Cullen's Sign

The answers are : B, D, E, F, and G. These are typical signs and symptoms found with diverticulitis. Option C is found in appendicitis and Option H is found in acute pancreatitis. Option A is wrong because abdominal pain is typically found in the left lower quadrant not upper right

. A patient with acute renal injury has a GFR (glomerular filtration rate) of 40 mL/min. Which signs and symptoms below may this patient present with? Select all that apply: A. Hypervolemia B. Hypokalemia C. Increased BUN level D. Decreased Creatinine level .

The answers are A and C. The glomerular filtration rate indicates how well the glomerulus is filtering the blood. A normal GFR tends to be 90 mL/min or higher. A GFR of 40 mL/min indicates that the kidney's ability to filter the blood is decreased. Therefore, the kidneys will be unable to remove waste and excessive water from the blood...hence hypervolemia and an increased BUN level will present in this patient. The patient will experience HYPERkalemia (not hypo) because the kidneys are unable to remove potassium from the blood. In addition, an INCREASED creatinine level (not decreased) will present because the kidneys cannot remove excessive waste products, such as creatinine

4. Your patient with cirrhosis has severe splenomegaly. As the nurse you will make it priority to monitor the patient for signs and symptoms of? Select all that apply: A. Thrombocytopenia B. Vision changes C. Increased PT/INR D. Leukopenia

The answers are A, C, and D. A patient with an enlarged spleen (splenomegaly) due to cirrhosis can experience thrombocytopenia (low platelet count), increased PT/INR (means it takes the patient a long time to stop bleeding), and leukopenia (low white blood cells). The spleen stores platelets and WBCs. An enlarged spleen can develop due to portal hypertension, which causes the platelets and WBCs to become stuck inside the spleen due to the increased pressure in the hepatic vein (hence lowering the count and the body's access to these important cells for survival)

3. Select-ALL-that-apply: In the pancreas, the acinar cells release: A. Amylase B. Somatostatin C. Lipase D. Protease

The answers are A, C, and D. Acinar cells secrete digestive enzymes into the pancreatic ducts. These enzymes are: Amylase: breaks down carbs to glucose, Protease: breaks down proteins to amino acids, Lipase: breaks down fats

9. You're providing an in-service to new nurse graduates about esophageal varices in patients with cirrhosis. You ask the graduates to list activities that should be avoided by a patient with this condition. Which activities listed are correct: Select all that apply A. Excessive coughing B. Sleeping on the back C. Drinking juice D. Alcohol consumption E. Straining during a bowel movement F. Vomiting

The answers are A, D, E, and F. Esophageal varices are dilated vessels that are connected from the throat to the stomach. They can become enlarged due to portal hypertension in cirrhosis and can rupture (this is a medical emergency). The patient should avoid activities that could rupture these vessels, such as excessive cough, vomiting, drinking alcohol, and constipation (straining increases thoracic pressure.)

7. You are receiving shift report on a patient with cirrhosis. The nurse tells you the patient's bilirubin levels are very high. Based on this, what assessment findings may you expect to find during your head-to-toe assessment? Select all that apply: A. Frothy light-colored urine B. Dark brown urine C. Yellowing of the sclera D. Dark brown stool E. Jaundice of the skin F. Bluish mucous membranes

The answers are B, C, and E. High bilirubin levels are because the hepatocytes are no longer able to properly conjugate the bilirubin because they are damaged. This causes bilirubin to leak into the blood and urine (rather than entering the bile and being excreted in the stool). Therefore, the bilirubin stays in the blood and will enter the urine. This will cause the patient to experience yellowing of the skin, sclera of the eyes, and mucous membranes ("jaundice") and have dark brown urine. The stools would be CLAY-COLORED not dark brown (remember bilirubin normally gives stool it brown color but it will be absent).

3. You're educating a group of outpatients about signs and symptoms of ulcerative colitis. Which of the following are NOT typical signs and symptoms of ulcerative colitis? SELECT-ALL-THAT-APPLY: A. Rectal Bleeding B. Abdominal mass C. Bloody diarrhea D. Fistulae E. Extreme Hungry F. Anemia

The answers are B, D, and E. Rectal bleeding, bloody diarrhea, and anemia are present in ulcerative colitis. However, an abdominal mass or fistulae tends to be present with Crohn's Disease. Loss of appetite rather than extreme hungry presents in ulcerative colitis.

2. Select all the following options that are NOT causes of appendicitis: A. Fecalith B. Routine usage of NSAIDs C. Infection due to Helicobacter pylori D. Lymph node enlargement due to viral or bacterial infection E. Diet low in fiber

The answers are: B, C, and E. These options are NOT causes of appendicitis. Routine usage of NSAIDS and infection due H. pylori are causes of peptic ulcers. While a diet low in fiber is thought to be the cause of diverticulosis. Fecalith and lymph node enlargement due to viral or bacterial infection (such as mononucleosis etc.) can cause appendicitis.

4. Thinking back to the scenario in question 3, what other signs and symptoms are associated with appendicitis. SELECT-ALL-THAT-APPLY: A. Increased red blood Cells B. Patient has the desire to be positioned in the prone position to relieve pain C. Umbilical pain that extends in the right lower quadrant D. Abdominal rebound tenderness E. Abdominal Flaccidity

The answers are: C and D. These are classic signs and symptoms found in patients with appendicitis. Option A is wrong because the patient may have increased WHITE blood cells (not red). Option B is wrong because the patient may have the desire to be in the fetal position (side-lying with the knees bent) to relieve the pain. The prone position would increase the pain. Option E is wrong because the patient would have abdominal RIGIDITY (not flaccidity)

5. Select all the patients below that are at risk for acute intra-renal injury? A. A 45 year old male with a renal calculus. B. A 65 year old male with benign prostatic hyperplasia. C. A 25 year old female receiving chemotherapy. D. A 36 year old female with renal artery stenosis. E. A 6 year old male with acute glomerulonephritis. F. An 87 year old male who is taking an aminoglycoside medication for an infection.

The answers are: C, E, and F. These patients are at risk for an intra-renal injury, which is where there is damage to the nephrons of kidney. The patients in options A and B are at risk for POST-RENAL injury because there is an obstruction that can cause back flow of urine into the kidney, which can lead to decreased function of the kidney. The patient in option D is at risk for PRE-RENAL injury because there is an issue with perfusion to the kidney.

Type 1 diabetics typically have the following clinical characteristics: Thin, young with ketones present in the urine Overweight, young with no ketones present in the urine Thin, older adult with glycosuria Overweight, adult-aged with ketones present in the urine

Thin, young with ketones present in the urine