CMSRN Gastrointestinal and Hepatic Care

Question 1

A patient with Crohn's disease involving the terminal ileum is at highest risk for deficiency of which nutrient?

Accepted Answer

Vitamin B12

Answer

Iron

Answer

Folate

Answer

Thiamine

Question 2

Which assessment finding is most indicative of a perforated peptic ulcer requiring emergency intervention?

Accepted Answer

Sudden severe pain with board-like abdominal rigidity

Answer

Intermittent cramping relieved by antacids

Answer

Melena with gradual onset of epigastric pain

Answer

Epigastric burning that worsens between meals

Question 3

A patient with hepatic encephalopathy is prescribed lactulose. What is the primary therapeutic goal of this medication?

Accepted Answer

Decrease serum ammonia levels

Answer

Reduce portal hypertension

Answer

Improve liver enzyme levels

Answer

Prevent formation of esophageal varices

Question 4

A patient with cirrhosis and esophageal varices should be monitored most closely for which immediate life-threatening complication?

Accepted Answer

Massive upper GI hemorrhage

Answer

Hepatic coma

Answer

Spontaneous bacterial peritonitis

Answer

Hepatorenal syndrome

Question 5

The nurse understands a patient with acute pancreatitis is kept NPO primarily to:

Accepted Answer

Rest the pancreas by minimizing enzyme secretion

Answer

Prevent aspiration during episodes of nausea

Answer

Reduce the risk of wound infection

Answer

Decrease abdominal distension and pain

Question 6

Which laboratory value is the most specific and sensitive marker the nurse would expect to be elevated in acute pancreatitis?

Accepted Answer

Serum lipase

Answer

Serum bilirubin

Answer

Alkaline phosphatase

Answer

Alanine aminotransferase (ALT)

Question 7

A patient who just had a colostomy surgery expresses distress about body image changes. Which nursing intervention is the priority?

Accepted Answer

Allow the patient to verbalize feelings and validate their concerns

Answer

Provide written educational materials about colostomy care

Answer

Encourage the patient to look at and touch the stoma

Answer

Arrange an immediate visit from a certified wound ostomy nurse