Certified Gastroenterology RN Managing GI Health Conditions 4 — Questions and Answers
Question 1: A patient is diagnosed with H. pylori infection. Which regimen does the nurse expect to be prescribed?
- A PPI plus two antibiotics (Correct answer)
- A single course of metronidazole alone
- Sucralfate monotherapy for 8 weeks
- Daily famotidine with antacids as needed
Correct answer: A PPI plus two antibiotics
H. pylori eradication requires combination therapy with a PPI and at least two antibiotics.
Question 2: Which symptom pattern is most consistent with a gastric ulcer rather than a duodenal ulcer?
- Pain shortly after eating with weight loss (Correct answer)
- Pain relieved by food occurring 2-3 hours after meals
- Pain that awakens the patient at 2 AM relieved by antacids
- Painless melena with weight gain
Correct answer: Pain shortly after eating with weight loss
Gastric ulcer pain typically worsens soon after meals, leading to food avoidance and weight loss.
Question 3: A patient with short bowel syndrome after extensive ileal resection is at greatest risk for which deficiency?
- Vitamin B12 deficiency (Correct answer)
- Vitamin C deficiency
- Iron overload
- Hypernatremia
Correct answer: Vitamin B12 deficiency
Vitamin B12 is absorbed in the terminal ileum, so ileal resection causes B12 deficiency.
Question 4: A patient with chronic pancreatitis reports bulky, foul-smelling stools. Which intervention addresses this problem?
- Pancreatic enzyme replacement with meals (Correct answer)
- Increasing dietary fat to 50% of calories
- Loperamide before each meal
- Daily magnesium citrate
Correct answer: Pancreatic enzyme replacement with meals
Steatorrhea from exocrine insufficiency is treated with pancreatic enzyme replacement taken with food.
Question 5: Which patient statement indicates correct understanding of hepatitis C transmission?
- "I should not share razors or toothbrushes with my family." (Correct answer)
- "I can't hug my grandchildren anymore."
- "I must use separate dishes and utensils."
- "I got this from eating contaminated shellfish."
Correct answer: "I should not share razors or toothbrushes with my family."
Hepatitis C is bloodborne, so avoiding shared razors and toothbrushes prevents transmission.
Question 6: A patient with toxic megacolon secondary to C. difficile colitis should be monitored most closely for which complication?
- Bowel perforation (Correct answer)
- Esophageal stricture
- Biliary colic
- Hiatal hernia
Correct answer: Bowel perforation
Toxic megacolon can rapidly progress to colonic perforation and life-threatening peritonitis.
Question 7: Which instruction is essential for a patient starting azathioprine for Crohn's disease?
- Report fever or sore throat immediately due to bone marrow suppression risk (Correct answer)
- Take the medication only during disease flares
- Expect results within 48 hours of the first dose
- Double the dose if a flare occurs
Correct answer: Report fever or sore throat immediately due to bone marrow suppression risk
Azathioprine can cause leukopenia, so signs of infection must be reported promptly.
Certified Gastroenterology RN Managing GI Health Conditions 4
A patient is diagnosed with H. pylori infection.
Which regimen does the nurse expect to be prescribed?