CEN Gastrointestinal and Genitourinary Emergencies 2

Question 1

A patient with a history of heavy alcohol use presents with epigastric pain radiating to the back, nausea, and vomiting. Serum lipase is 1,800 U/L. What is the priority nursing intervention?

Accepted Answer

Establish IV access and initiate aggressive fluid resuscitation

Answer

Aggressive IV fluid resuscitation is the cornerstone of acute pancreatitis management to prevent hypovolemia, systemic inflammatory response, and organ failure.

Question 2

A 17-year-old male presents with sudden onset severe scrotal pain without trauma, nausea, and vomiting. The affected testicle is high-riding with a horizontal lie. The nurse's priority action is:

Accepted Answer

Prepare the patient for emergent surgical consultation

Answer

Testicular torsion is a surgical emergency requiring manual detorsion or operative intervention within 4-6 hours to preserve testicular viability.

Question 3

Which ECG finding in a dialysis patient with missed sessions is most immediately life-threatening?

Accepted Answer

Peaked T waves with widened QRS

Answer

Peaked T waves with widened QRS indicate severe hyperkalemia with impending cardiac dysrhythmia, requiring immediate calcium gluconate administration.

Question 4

A patient with suspected hyperkalemia (K+ 7.1 mEq/L) and peaked T waves on ECG is being treated. What is the priority first intervention?

Accepted Answer

Administer calcium gluconate IV

Answer

Calcium gluconate IV is the immediate priority as it stabilizes cardiac membranes within minutes, protecting against fatal dysrhythmias before potassium-lowering measures take effect.

Question 5

Which urine finding best differentiates prerenal azotemia from intrinsic renal failure?

Accepted Answer

Urine sodium <20 mEq/L with concentrated urine indicates prerenal

Answer

Urine sodium <20 mEq/L indicates prerenal azotemia because functional kidneys are avidly conserving sodium in response to reduced renal perfusion.

CEN - Certified Emergency Nurse Practice Test

CEN - Certified Emergency Nurse Practice Test

CEN Gastrointestinal and Genitourinary Emergencies 2