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

Cullen sign is periumbilical bruising indicating retroperitoneal bleeding seen in severe hemorrhagic pancreatitis.

Question 2

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

Accepted Answer

Lipase

Answer

Lipase is more specific and stays elevated longer than amylase in acute pancreatitis.

Question 3

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

Accepted Answer

Administer lactulose

Answer

Lactulose reduces ammonia absorption, treating hepatic encephalopathy that causes confusion and asterixis.

Question 4

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

Accepted Answer

Metabolic alkalosis with hypokalemia

Answer

Loss of gastric acid and potassium from NG suction produces hypokalemic metabolic alkalosis.

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

Melena is black, tarry stool from digested blood, signaling an upper GI bleeding source.

CCRN Review Practice Test