Question 1

What symptom of liver failure would be marked by progressive Azotemia, elevated serum Creatinine levels and Oliguria?

Accepted Answer

Progressive azotemia, elevated serum Creatinine levels and oliguria are all signs and symptoms of Hepatorenal syndrome. Coma caused by the inability of the liver to convert ammonia to urea would be reflective of hepatic encephalopathy.

Question 2

A thirty seven year old male is being treated for shock related to acute Pancreatitis. The patient states that he has Paresthesia around his fingers and mouth. The nurse observes that the patient's wrists and foot are tremoring. When she applies the blood pressure cuff to the patient's arm, the entire hand and arm has spasms. What abnormality is the patient exhibiting signs and symptoms of?

Accepted Answer

The abnormality the patient is exhibiting signs of is Tetany, a condition that occurs when serum calcium falls to low levels. The patient with acute Pancreatitis is at risk for Tetany because of the electrolyte imbalance that occurs when the pancreas is not functioning as normal.

Question 3

What is the drug of choice for treating pain in the patient with acute Pancreatitis?

Accepted Answer

The drug of choice for treating pain in the patient with acute Pancreatitis is Meperidine. Morphine is not preferred because it can cause spasm of the sphincter of Oddi, which increases bile obstruction.

Question 4

Which of the following statements would reflect that the patient does not understand the long term effects of liver failure?

Accepted Answer

The statement that reflects that the patient does not understand the long term effects of liver failure is the statement, "If I stop drinking, my liver will get better." Damage to the liver is irreversible. It is important to monitor salt intake, get more rest and be aware of changes that will occur, such as jaundice, as the disease progresses.

Question 5

What nursing interventions would be the optimal choice to bring relief to the patient who has developed severe Ascites related to Hepatic failure?

Accepted Answer

The optimal way to relieve the Ascites related to Hepatic failure would be to keep the head of the bed elevated. Elevating the head of the bed reduces fluid pressure exerted on the diaphragm and helps to encourage lung expansion. Giving the patient small amounts of ice chips does not help to bring relief from Ascites.

Question 6

A 37 year old woman is admitted to the intensive care unit after experiencing an anterior spinal cord injury status post trauma. What kind of gastrointestinal problems would this patient be at risk for?

Accepted Answer

Patients who experience anterior spinal cord injuries are at risk for developing gastrointestinal ulcers and bleeding. The nurses should asses the abdomen for distention, look for signs and symptoms of bleeding and anticipate orders for appropriate medications.

Question 7

A nurse is assessing the patient for gastrointestinal related complications associated with being on a ventilator. Which of the following medications would assist in preventing peptic ulcer formation?

Accepted Answer

The medication that would assist in preventing peptic ulcer formation in the patient on a ventilator is Omeprazole. Total parenteral nutrition (TPN) is an intravenous nutrition. Dopamine and Verced are not used for gastrointestinal protection.

Question 8

A 33 year old female has been admitted with severe abdominal pain that has lasted greater than 3 days. She has had severe diarrhea and rectal bleeding for 48 hours. She is scheduled for an Endoscopy in one hour. What disease does this patient most likely have?

Accepted Answer

The patient with abdominal pain, diarrhea and rectal bleeding most likely has Ulcerative colitis, which is a form of inflammatory bowel disease (IBD). It causes swelling, ulcerations, and loss of function of the large intestine. Rectal bleeding does not occur in small bowel obstruction and gastroesophageal reflux disease.

Question 9

What is the main intervention that needs to occur if a patient develops a perforation of the gastro intestinal tract?

Accepted Answer

The main intervention that needs to occur if a patient develops a perforation of the gastrointestinal tract is surgical intervention. Perforation of the gastro intestinal wall results in peritonitis which can lead to sepsis, septic shock and death.

Question 10

Which of the following clinical manifestations are the most likely indicators of perforation of the gastrointestinal tract?

Accepted Answer

The most likely indicators that the gastrointestinal tract has perforated include severe abdominal pain, abdominal distention and the abdomen becoming stiff and rigid like a board. Fluid and electrolyte imbalances, hypotension and a paralytic ileus are also symptoms but are vaguer.

Question 11

The nurse has just inserted a Nasogastric tube on a patient who is experiencing a severe gastrointestinal bleed and has been continuously vomiting for 24 hours. She has Hemoglobin of 6.4. What nursing intervention would be most likely to prevent aspiration?

Accepted Answer

The nursing intervention that would be most likely to prevent aspiration would be to keep the head of the bed elevated at least 30 degrees. The other options do not help to prevent against aspiration.

Quiz 1: Adult