CCRN Gastrointestinal and Renal Care 2

Question 1

A patient with acute pancreatitis develops a positive Cullen sign. What does this finding indicate?

Accepted Answer

Periumbilical ecchymosis from retroperitoneal hemorrhage

Answer

Right upper quadrant rebound tenderness

Answer

Hyperactive bowel sounds

Answer

Jaundice of the sclera

Question 2

Which serum value is the most specific marker for acute pancreatitis?

Accepted Answer

Lipase

Answer

Amylase

Answer

Alkaline phosphatase

Answer

Bilirubin

Question 3

A patient with cirrhosis has worsening confusion and asterixis. Which intervention is most appropriate?

Accepted Answer

Administer lactulose

Answer

Restrict all protein permanently

Answer

Give a proton pump inhibitor

Answer

Increase sodium intake

Question 4

Which electrolyte abnormality is most common in a patient with prolonged nasogastric suction?

Accepted Answer

Metabolic alkalosis with hypokalemia

Answer

Metabolic acidosis with hyperkalemia

Answer

Respiratory acidosis

Answer

Hyperchloremia

Question 5

A patient with an upper GI bleed has melena. What does melena indicate?

Accepted Answer

Digested blood from an upper GI source

Answer

Bright red bleeding from the rectum

Answer

Fresh lower GI bleeding

Answer

Biliary obstruction

Question 6

Which finding is the earliest sign of acute kidney injury in a critically ill patient?

Accepted Answer

Rising serum creatinine and decreased urine output

Answer

Hypotension

Answer

Peripheral edema

Answer

Hyperglycemia

Question 7

A patient receiving continuous renal replacement therapy (CRRT) suddenly becomes hypotensive. What is the priority action?

Accepted Answer

Assess fluid removal rate and circuit

Answer

Increase the dialysate flow

Answer

Administer a diuretic

Answer

Stop all IV fluids