CEN Gastrointestinal and Genitourinary Emergencies 3

Question 1

A patient presents with sudden onset severe right flank pain radiating to the groin, hematuria, and costovertebral angle tenderness. Which imaging study is the gold standard for diagnosis?

Accepted Answer

Non-contrast CT scan of abdomen and pelvis

Answer

Abdominal plain film (KUB)

Answer

Renal ultrasound

Answer

IV pyelogram (IVP)

Question 2

A patient with acute liver failure develops worsening confusion, decorticate posturing, and papilledema. The most immediately life-threatening complication is:

Accepted Answer

Cerebral edema with increased intracranial pressure

Answer

Hepatorenal syndrome

Answer

Spontaneous bacterial peritonitis

Answer

Acute variceal hemorrhage

Question 3

Which nursing intervention is the highest priority for a patient with confirmed small bowel obstruction presenting with abdominal distension and bilious vomiting?

Accepted Answer

Insert a nasogastric tube and connect to low intermittent suction

Answer

Administer a Fleet enema to stimulate passage

Answer

Encourage small sips of clear fluids

Answer

Position the patient in Trendelenburg

Question 4

A patient develops profuse watery diarrhea, abdominal cramping, and low-grade fever 10 days after completing a course of clindamycin. Which pathogen is most likely responsible?

Accepted Answer

Clostridioides difficile

Answer

Salmonella typhi

Answer

Escherichia coli O157:H7

Answer

Campylobacter jejuni

Question 5

A patient presents with scrotal swelling, crepitus on palpation, foul odor, fever of 40°C, and severe pain. The nurse recognizes this as Fournier's gangrene. What is the priority intervention?

Accepted Answer

Prepare the patient for emergent surgical debridement

Answer

Apply topical antifungal and antibacterial cream to the area

Answer

Insert a Foley catheter and obtain wound cultures only

Answer

Apply warm compresses and administer IV analgesics

Question 6

Which sign, elicited on abdominal examination, is most specific for peritonitis?

Accepted Answer

Rebound tenderness (Blumberg's sign)

Answer

Cullen's sign (periumbilical ecchymosis)

Answer

Grey Turner's sign (flank ecchymosis)

Answer

Chvostek's sign (facial muscle twitch)

Question 7

A patient with 72 hours of persistent vomiting has ABG results showing pH 7.52, HCO3 32 mEq/L, and labs showing K+ 2.8 mEq/L, Cl- 88 mEq/L. Which IV fluid replacement is most appropriate?

Accepted Answer

0.9% Normal saline with potassium chloride (KCl)

Answer

Lactated Ringer's solution

Answer

D5W with sodium bicarbonate

Answer

3% Hypertonic saline