CEN Gastrointestinal and Genitourinary Emergencies

Question 1

A patient presents with sudden onset severe epigastric pain, a rigid 'board-like' abdomen, and absent bowel sounds. Which condition is most likely?

Accepted Answer

Perforated peptic ulcer

Answer

Perforated peptic ulcer causes sudden, severe pain with board-like abdominal rigidity due to chemical peritonitis from gastric contents spilling into the peritoneum.

Question 2

A patient with active upper GI bleeding presents with hematemesis, BP 82/50 mmHg, and HR 128 bpm. Which assessment finding represents the highest priority concern?

Accepted Answer

Hematemesis with hemodynamic instability

Answer

Hematemesis with hemodynamic instability indicates massive active hemorrhage requiring immediate resuscitation and emergency endoscopy.

Question 3

A cirrhotic patient presents with confusion, asterixis, and jaundice. The nurse anticipates which primary diagnosis?

Accepted Answer

Hepatic encephalopathy

Answer

Hepatic encephalopathy presents with altered mental status and asterixis (flapping tremor) in cirrhotic patients due to ammonia accumulation from impaired liver detoxification.

Question 4

Which medication is the priority pharmacological intervention for a patient with suspected esophageal variceal bleeding?

Accepted Answer

IV octreotide

Answer

Octreotide reduces portal hypertension and splanchnic blood flow by inhibiting vasoactive intestinal peptides, making it the drug of choice for acute variceal bleeding.

Question 5

A patient presents with acute right lower quadrant pain, fever of 38.6°C, nausea, and rebound tenderness at McBurney's point. The nurse anticipates which diagnosis?

Accepted Answer

Acute appendicitis

Answer

Acute appendicitis classically presents with RLQ pain at McBurney's point, fever, nausea, and rebound tenderness due to peritoneal inflammation.

CEN - Certified Emergency Nurse Practice Test

CEN - Certified Emergency Nurse Practice Test

CEN Gastrointestinal and Genitourinary Emergencies