FREE Certified Gastroenterology RN MCQ Question and Answers
After consuming vegetables contaminated with E. coli (0157:H7), a 76-year-old woman experienced stomach cramps and non-bloody diarrhea for 48 hours, followed by 4 days of bloody diarrhea. Which of the following conditions is the PATIENT'S HIGHEST RISK for developing?
Explanation:
The patient is at risk for developing uremic syndrome (HUS), which can result in renal failure if she consumed vegetables contaminated with E. coli (0157.H7) and experiences cramping in her stomach and non-bloody diarrhea that continued for 48 hours before turning bloody for 4 days. The risk of developing HUS is highest in children under 5 and older adults. Microangiopathic hemolytic anemia, thrombocytopenia, and severe renal failure are characteristics of HUS.
Ten individuals were affected by a 2-week-long epidemic of Clostridium difficile infections in the gastroenterology unit. Which of the following should staff members focus their efforts on in order to stop the spread of the infection?
Explanation:
The nurse and staff members should concentrate efforts on the use of appropriate contact precautions and hand hygiene as the infection is easily spread through contaminated hands if the gastroenterology unit has experienced an outbreak of Clostridium difficile infections involving 10 patients over a two-week period. On environmental surfaces, the pores can survive for a very long time. Additionally, cleaning protocols should be examined.
Infliximab, a biologic response modifier, will be used as the first step in treating a patient with Crohn's disease. Which of the following tests should be performed on the patient before starting treatment?
Explanation:
Before starting treatment with infliximab or another biologic response modifier for Crohn's disease, the patient should undergo TB and hepatitis B testing. The medications' immunosuppressive properties can cause both diseases to become active once again. As they are made from proteins rather than chemicals, biologic response modifiers can induce severe allergic reactions in certain people and are also not recommended for those who have a history of lymphoma.
Which of the following symptoms, after an esophagoscopy to obtain a biopsy of the thoracic esophagus, MOST suggests the need for urgent management of perforation?
Explanation:
Chest pain, dysphagia, and tachycardia are signs that a perforation needs urgent care after an esophagoscopy to acquire a biopsy of the thoracic esophagus. The start of fever is frequently quick, and the presence of air leaking into the mediastinum is indicated by the positive Hamann's sign (a crunching, rasping precordial sound that coincides with a heartbeat). If the perforation cannot be visible on an x-ray, a CT scan or endoscopy may be required. Perforation is typically confirmed radiologically.
Which of the following phases should pain control be started at, according to the WHO's three-step ladder approach to pain management, if a patient's abdominal discomfort is related to colon cancer and ranges from 4 to 8 on the pain scale?
Explanation:
The WHO's three-step ladder approach to pain management recommends starting pain control at the step that is most appropriate for the patient's current level of pain, which can later be changed to a higher or lower step, if necessary. If a patient's abdominal pain from colon cancer ranges from 4 to 8 on the pain scale, pain control should be started at that step. Despite the fact that this is a three-part method, not all pain management needs to begin at step one.
Which one of the following is a benzodiazepine reversal medication for an overly sedated patient?
Explanation:
For patients who have received a benzodiazepine dose of 0.2 mg over 30 seconds with repeat doses as necessary at one-minute intervals, Romazicon (Flumazenil) is a reversal medication for excessive sedation. The third and subsequent dosages are 0.5 mg, with the second dose being 0.3 mg. Naloxone is used to treat opioid overdoses, epinephrine to treat asystole, VF, and PEA urgently, and N-acetylcysteine to treat acetaminophen overdose.
How soon after the collection should the laboratory get the duodenal aspirate?
Explanation:
The laboratory should get the duodenal aspirate right away because it needs to be evaluated within 60 minutes of collection. In a sterile centrifuge tube, the aspirate should be collected in an amount of at least 2 mL. Strongyloides stercoralis and Giardia duodenalis may be diagnosed using duodenal aspirates. It's also possible to consider culture and sensitivity. Maintaining the specimen at room temperature is recommended.
