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

The terminal ileum is the exclusive absorption site for vitamin B12, so Crohn's disease affecting this region causes B12 deficiency.

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

Sudden severe pain with board-like abdominal rigidity indicates peritonitis from gastric contents leaking into the peritoneal cavity, a surgical emergency.

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

Lactulose acidifies the colon, trapping ammonia as ammonium ion and promoting its fecal excretion, thereby reducing the serum ammonia causing encephalopathy.

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

Esophageal varices are thin-walled, dilated veins that can rupture suddenly and cause massive, rapidly fatal upper GI hemorrhage.

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

Oral intake triggers pancreatic enzyme secretion; NPO status eliminates this stimulus, allowing the inflamed pancreas to rest and recover.

CMSRN - Medical-Surgical Nursing Practice Test

CMSRN - Medical-Surgical Nursing Practice Test

CMSRN Gastrointestinal and Hepatic Care