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

Hepatic encephalopathy is a neurological complication of liver cirrhosis caused by the accumulation of toxins, primarily ammonia, in the bloodstream. Asterixis, often called a 'liver flap,' is a characteristic motor disturbance seen in patients with this condition. It indicates impaired neurological function due to the liver's inability to detoxify harmful substances.

Question 2

Which laboratory result is most indicative of acute pancreatitis?

Accepted Answer

Elevated amylase and lipase

Answer

Acute pancreatitis involves inflammation of the pancreas, leading to the release of digestive enzymes into the bloodstream. Amylase and lipase are pancreatic enzymes, and their levels become significantly elevated in acute pancreatitis, often several times the normal range. Lipase is generally considered more specific for pancreatitis than amylase.

Question 3

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

Accepted Answer

Administering proton pump inhibitor

Answer

Upper gastrointestinal bleeding, especially with hematemesis, often results from conditions like peptic ulcers or erosions where stomach acid plays a significant role. Proton pump inhibitors (PPIs) reduce gastric acid secretion, which helps to stabilize the clot, prevent further bleeding, and promote healing of the gastric mucosa. This is a critical intervention to manage the underlying cause and prevent re-bleeding.

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

Abdominal distention and high residual volumes in a patient with an NG tube receiving feedings indicate delayed gastric emptying or intolerance to the feeding. Continuing the feeding could lead to aspiration, nausea, vomiting, or further abdominal discomfort. The priority is to stop the feeding to prevent complications and then notify the provider for further assessment and orders.

Question 5

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

Accepted Answer

Rigid, board-like abdomen

Answer

A rigid, board-like abdomen is a classic sign of peritonitis, which is severe inflammation of the peritoneum, often caused by the leakage of gastrointestinal contents into the abdominal cavity due to bowel perforation. This finding indicates a medical emergency requiring immediate surgical intervention. Other symptoms like nausea and cramping are common but less specific for perforation.

PCCN Exam Practice Test

PCCN Exam Practice Test

PCCN Gastrointestinal