Anemia, GI, & Endocrine

Which statement is INCORRECT about Histamine-receptor blockers? A. "H2 blockers block histamine which causes the chief cells to decrease the secretion of hydrochloric acid." B. "Ranitidine and Famotidine are two types of histamine-receptor blocker medications." C. "Antacids and H2 blockers should not be given together." D. All the statements are CORRECT.

A. "H2 blockers block histamine which causes the chief cells to decrease the secretion of hydrochloric acid."

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

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. Assess bowel sounds

A. Check the patient's blood glucose

A patient asks what type of testing is performed to assess for diverticulosis. As the nurse, you know that which test below is used to assess for diverticulosis? A. Colonoscopy B. Fleet Enema C. Bronchoscopy D. Cystoscopy

A. Colonoscopy

A patient arrives to the clinic for evaluation of epigastric pain. The patient describes the pain to be relieved by food intake. In addition, the patient reports awaking in the middle of the night with a gnawing pain in the stomach. Based on the patient's description this appears to be what type of peptic ulcer? A. Duodenal B. Gastric C. Esophageal D. Refractory

A. Duodenal

The results of a client's most recent blood work and physical assessment are suggestive of immune thrombocytopenic purpura (ITP). This client should undergo testing for which of the following potential causes? Select all that apply. A. Hepatitis B. Acute kidney injury C. HIV D. Malignant melanoma E. Cholecystitis

A. Hepatitis C. HIV

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

A. Hyperpigmentation of the skin

A nurse is caring for a client with severe anemia. The client is tachycardic and reports dizziness and exertional dyspnea. What signs and symptoms might develop if this client goes into heart failure? A. Peripheral edema B. Nausea/vomiting C. Migraine D. Fever

A. Peripheral edema

Select all the medications a physician may order to treat a H. Pylori infection that is causing a peptic ulcer? A. Proton-Pump Inhibitors B. Antacids C. Anticholinergics D. 5-Aminosalicylates E. Antibiotics F. H2 Blockers G. Bismuth Subsalicylates

A. Proton-Pump Inhibitors E. Antibiotics F. H2 Blockers G. Bismuth Subsalicylates

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

A. The patient reports their last bowel movement the day before surgery.

Which bowel disease starts in the rectum and migrates in a continuous fashion throughout the colon? A. Ulcerative Colitis B. Crohn's Disease

A. Ulcerative Colitis

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."

B. "I will take this medication as needed when symptoms present."

You're educating a group of patients at an outpatient clinic about peptic ulcer formation. Which statement is correct about how peptic ulcers form? A. "An increase in gastric acid is the sole cause of peptic ulcer formation." B. "Peptic ulcers can form when acid penetrates unprotected stomach mucosa. This causes histamine to be released which signals to the parietal cells to release more hydrochloric acid which erodes the stomach lining further." C. "Peptic ulcers form when acid penetrates unprotected stomach mucosa. This causes pepsin to be released which signals to the parietal cells to release more pepsinogen which erodes the stomach lining further." D. "The release of prostaglandins cause the stomach lining to breakdown which allows ulcers to form."

B. "Peptic ulcers can form when acid penetrates unprotected stomach mucosa. This causes histamine to be released which signals to the parietal cells to release more hydrochloric acid which erodes the stomach lining further."

(Select all) the patients who are at MOST risk for iron-deficiency anemia: A. A 55 year old male who reports taking Ferrous Sulfate regularly. B. A 25 year old female who was recently diagnosed with Celiac Disease. C. A 35 year old female who is 36 weeks pregnant that reports craving ice. D. A 67 year old female with a Hemoglobin level of 14.

B. A 25 year old female who was recently diagnosed with Celiac Disease. C. A 35 year old female who is 36 weeks pregnant that reports craving ice.

Which patient is MOST likely to develop Diabetic Ketoacidosis? A. A 25 year old female newly diagnosed with Cushing's Disease taking glucocorticoids. B. A 36 year old male with diabetes mellitus who has been unable to eat the past 2 days due to a gastrointestinal illness and has not been taking insulin C. A 35 year old female newly diagnosed with Type 2 diabetes. D. None of the options are correct.

B. A 36 year old male with diabetes mellitus who has been unable to eat the past 2 days due to a gastrointestinal illness and has not been taking insulin

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. Cushing Syndrome B. Addisonian Crisis C. Thyroid crisis D. Hashimoto thyroiditis

B. Addisonian Crisis

Which of the following is NOT a typical finding in HHS? A. Dehydration B. Blood pH <7.35 C. Mental status changes D. Osmotic diuresis

B. Blood pH <7.35

A patient has developed a duodenal ulcer. As the nurse, you know that which of the following plays a role in peptic ulcer formation. Select ALL that apply: A. Spicy foods B. Helicobacter pylori C. NSAIDs D. Milk E. Corticosteroids

B. Helicobacter pylori C. NSAIDs E. Corticosteroids

A patient is admitted with Diabetic Ketoacidosis. The physician orders intravenous fluids of 0.9% Normal Saline and 10 units of intravenous regular insulin IV bolus and then to start an insulin drip per protocol. The patient's labs are the following: pH 7.25, Glucose 455, potassium 2.5. Which of the following is the most appropriate nursing intervention to perform next? A. Start the IV fluids and administer the insulin bolus and drip as ordered B. Hold the insulin and notify the doctor of the potassium level of 2.5 C. Hold IV fluids and administer insulin as ordered D. Recheck the glucose level

B. Hold the insulin and notify the doctor of the potassium level of 2.5

Which of the following is not a sign or symptom of Diabetic Ketoacidosis? A. Positive Ketones in the urine B. Oliguria C. Polydipsia D. Abdominal Pain

B. Oliguria

A physician prescribes a Proton-Pump Inhibitor to a patient with a gastric ulcer. Which medication is considered a PPI? A. Famotidine B. Pantoprazole C. Magnesium Hydroxide D. Metronidazole

B. Pantoprazole

Select ALL the signs and symptoms that can present in pernicious anemia: A. Erythema B. Paresthesia of hands and feet C. Racing thoughts D. Extreme hunger E. Depression F. Unsteady gait G. Shortness of breath with activity

B. Paresthesia of hands and feet F. Unsteady gait G. Shortness of breath with activity

A client's blood work reveals a platelet level of 17,000/mm3. When inspecting the client's integumentary system, what finding would be most consistent with this platelet level? A. Dermatitis B. Petechiae C. Urticaria D. Alopecia

B. Petechiae

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

B. Pituitary gland

A patient arrives to the ER and is unable to give you a health history due to altered mental status. The family reports the patient has gained over 10 lbs in 1 week and says it is mainly "water" weight. In addition, they report the patient hasn't been able to urinate or eat within the past week as well and was recently diagnosed with small cell lung cancer. On assessment, you note the patient's HR is 115 and BP 180/92. Patient sodium level is 90. Which of the following conditions do you suspect the patient is most likely presenting with? A. Diabetes Insipidus B. SIADH C. Addison's Disease D. Fluid Volume Deficient

B. SIADH

You are providing education to a patient about how to take their prescribed PO iron supplement. Which statement by the patient requires you to re-educate the patient on how to take this supplement?* A. "I will take this medication on an empty stomach." B. "I will wait and take my calcium supplements 2 hours after I take my iron supplement." C. " I will avoid taking this medication with orange juice." D. " This medication can cause constipation. So I will drink plenty of fluids and take a stool softer as needed."

C. " I will avoid taking this medication with orange juice."

Which of the following patients is MOST LIKELY experiencing Hyperglycemic Hyperosmolar Syndrome based on their symptoms? A. A 72 year old with a health history of diabetes who has a blood glucose of 300 mg/dL and is complaining of thirst and frequent urination. B. A 66 year old with type I diabetes that has ketones present in their urine. C. A 69 year old admitted with pneumonia health history of diabetes that reports missing several doses of Metformin and has a blood glucose of 800 mg/dL. D. A 26 year old that is presenting with polyuria, polydipsia, abdominal pain, and vomiting.

C. A 69 year old admitted with pneumonia health history of diabetes that reports missing several doses of Metformin and has a blood glucose of 800 mg/dL.

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.

C. Diverticulitis, if not treated, can lead to abscess formation and peritonitis.

A patient with chronic peptic ulcer disease underwent a gastric resection 1 month ago and is reporting nausea, bloating, and diarrhea 30 minutes after eating. What condition is this patient most likely experiencing? A. Gastroparesis B. Fascia dehiscence C. Dumping Syndrome D. Somogyi effect

C. Dumping Syndrome

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 fistula C. Peritonitis D. Hemorrhage

C. Peritonitis

Which of the following signs and symptoms is NOT expected with Diabetes Insipidus? A. Polyuria B. Polydipsia C. Polyphagia D. Extreme thirst

C. Polyphagia

A nurse is admitting a client with immune thrombocytopenic purpura to the unit. In completing the admission assessment, the nurse must be alert for what medications that potentially alter platelet function? Select all that apply. A. Antihypertensives B. Penicillins C. Sulfa-containing medications D. Aspirin-based drugs E. Protamine

C. Sulfa-containing medications D. Aspirin-based drugs

The anti-diuretic hormone is __________ in Diabetes Insipidus and _________ in SIADH A. high, low B. absent, absent C. low, high D. low, low

C. low, high

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."

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."

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

D. All the above play a role in GERD

A patient with SIADH is undergoing IV treatment of a hypertonic IV solution of 3% saline and IV Lasix. Which of the following nursing findings requires intervention? A. Sodium level of 136. B. Patient reports urinating more frequently. C. Potassium level of 5.0. D. Assessment finding of crackles throughout the lung fields

D. Assessment finding of crackles throughout the lung fields

A patient diagnosed with ulcerative colitis 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. Fistula B. Stricture C. Bowel obstruction D. Toxic megacolon

D. Toxic megacolon