Certified Gastroenterology RN Managing GI Health Conditions 5 — Questions and Answers
Question 1: A patient with achalasia asks why swallowing is difficult. Which explanation is accurate?
- The lower esophageal sphincter fails to relax and peristalsis is impaired (Correct answer)
- Stomach acid has eroded the esophageal lining
- A hiatal hernia is compressing the esophagus
- The gag reflex is hyperactive
Correct answer: The lower esophageal sphincter fails to relax and peristalsis is impaired
Achalasia involves failure of LES relaxation and loss of esophageal peristalsis.
Question 2: Which lab result supports a diagnosis of spontaneous bacterial peritonitis in a patient with ascites?
- Ascitic fluid absolute neutrophil count of 350 cells/mm³ (Correct answer)
- Ascitic fluid neutrophil count of 100 cells/mm³
- Serum sodium of 140 mEq/L
- Ascitic fluid albumin equal to serum albumin
Correct answer: Ascitic fluid absolute neutrophil count of 350 cells/mm³
An ascitic fluid absolute neutrophil count of 250 cells/mm³ or greater confirms SBP.
Question 3: A patient with dumping syndrome after gastrectomy should be taught which strategy?
- Eat small, frequent meals low in simple sugars and avoid fluids with meals (Correct answer)
- Drink 16 oz of juice with every meal
- Eat two large meals daily with plenty of liquids
- Consume high-carbohydrate meals and remain standing after eating
Correct answer: Eat small, frequent meals low in simple sugars and avoid fluids with meals
Small, low-sugar meals with fluids between meals slow gastric emptying and prevent dumping symptoms.
Question 4: A patient with hemochromatosis-related liver disease will most likely be managed with which therapy?
- Scheduled therapeutic phlebotomy (Correct answer)
- Weekly iron infusions
- High-dose vitamin C supplementation
- Blood transfusions every month
Correct answer: Scheduled therapeutic phlebotomy
Phlebotomy removes excess iron and is the mainstay of hemochromatosis management.
Question 5: Which patient with chronic constipation warrants urgent diagnostic evaluation rather than routine laxative therapy?
- A 58-year-old with new constipation, weight loss, and blood in the stool (Correct answer)
- A 25-year-old with constipation after starting iron supplements
- A 30-year-old with constipation during a sedentary work week
- A 40-year-old with constipation while taking opioids post-surgery
Correct answer: A 58-year-old with new constipation, weight loss, and blood in the stool
New-onset constipation with weight loss and rectal bleeding after age 50 are alarm features for colorectal cancer.
Question 6: A patient with lactose intolerance can typically tolerate which food best?
- Aged hard cheese (Correct answer)
- A large glass of whole milk
- Soft-serve ice cream
- Cream-based soup
Correct answer: Aged hard cheese
Aged hard cheeses contain minimal lactose and are usually well tolerated.
Question 7: During a colonoscopy recovery, a patient reports severe abdominal pain, distension, and shoulder pain. What should the nurse suspect?
- Bowel perforation with free air (Correct answer)
- Normal post-procedure gas retention
- Delayed sedation reaction
- Referred pain from positioning
Correct answer: Bowel perforation with free air
Severe pain, distension, and referred shoulder pain suggest perforation with free air irritating the diaphragm.
Certified Gastroenterology RN Managing GI Health Conditions 5
A patient with achalasia asks why swallowing is difficult.
Which explanation is accurate?