PCCN Gastrointestinal

Question 1

A patient with liver cirrhosis is at risk for hepatic encephalopathy. Which assessment finding most supports this diagnosis?

Accepted Answer

Asterixis (flapping hand tremor)

Answer

Hypoactive bowel sounds

Answer

Clay-colored stools

Answer

Right upper quadrant pain

Question 2

Which laboratory result is most indicative of acute pancreatitis?

Accepted Answer

Elevated amylase and lipase

Answer

Elevated alkaline phosphatase

Answer

Low bilirubin

Answer

Decreased ALT and AST

Question 3

Which intervention is most appropriate for a patient with upper gastrointestinal bleeding and hematemesis?

Accepted Answer

Administering proton pump inhibitor

Answer

Providing oral fluids

Answer

Encouraging ambulation

Answer

Initiating a high-fiber diet

Question 4

A nurse caring for a patient with a nasogastric (NG) tube notes abdominal distention and high residual volumes. What is the priority nursing action?

Accepted Answer

Hold the feeding and notify the provider

Answer

Increase the feeding rate

Answer

Flush the NG tube with air

Answer

Position the patient in supine

Question 5

Which finding would be most concerning in a patient with suspected bowel perforation?

Accepted Answer

Rigid, board-like abdomen

Answer

Nausea

Answer

Abdominal cramping

Answer

Hyperactive bowel sounds

Question 6

Which nursing intervention helps prevent complications of portal hypertension in a patient with cirrhosis?

Accepted Answer

Administering lactulose

Answer

Encouraging high-protein intake

Answer

Limiting fluid intake

Answer

Restricting physical activity

Question 7

What is the most serious complication associated with esophageal varices?

Accepted Answer

Massive upper GI bleeding

Answer

Acid reflux

Answer

Aspiration pneumonia

Answer

Strangulated hernia

Question 8

A patient receiving total parenteral nutrition (TPN) via a central line suddenly becomes febrile and hypotensive. What is the nurse’s priority action?

Accepted Answer

Stop the TPN and obtain blood cultures

Answer

Increase the TPN infusion rate

Answer

Send the TPN solution for glucose testing

Answer

Flush the central line with heparin

Question 9

In assessing a patient with cholecystitis, which clinical sign is most commonly expected?

Accepted Answer

Murphy’s sign (pain with inspiration during palpation of RUQ)

Answer

Left lower quadrant pain

Answer

Hematochezia

Answer

Ascites