Quiz 6: Gastroenterology
Nursing
Q 1Q 1
All of the following are considered part of the lower gastrointestinal tract EXCEPT the:
A) jejunum.
B) large intestine.
C) ileum.
D) duodenum.
Free
Multiple Choice
D
Q 2Q 2
All of the following contribute to the pathogenesis of diverticulosis EXCEPT:
A) decreased colon motility.
B) herniation of mucosa and submucosa through the teniae coli.
C) increased colon pressure.
D) low-fiber diet.
Free
Multiple Choice
A
Q 3Q 3
Your patient, who has a history of cholecystitis, is experiencing pain in her right shoulder. She is most likely experiencing ________ pain.
A) somatic
B) visceral
C) referred
D) peritoneal
Free
Multiple Choice
C
Q 4Q 4
Your patient is a 22-year-old female in mild distress that is complaining of left lower quadrant abdominal pain and nausea. Which of the following questions would be least helpful when determining the etiology of her abdominal pain?
A) "When did the pain start?"
B) "How would you describe the pain: dull, sharp, constant, intermittent?"
C) "Are you having any vomiting or diarrhea?"
D) "Have you ever had a sexually transmitted disease?"
Free
Multiple Choice
Q 5Q 5
Your patient is a 44-year-old female complaining of a three-day history of localized abdominal pain in her midepigastric region after eating. The pain tends to subside with antacids. Today she is experiencing nausea, and the pain did not subside with antacids. The patient gives a history of smoking and moderate alcohol consumption. The patient's skin is warm and dry, and she has a blood pressure of 128/88, a heart rate of 84, and respirations of 20. Your course of treatment should consist of:
A) sodium bicarbonate IV.
B) transporting the patient in a position of comfort and giving reassurance.
C) high-concentration oxygen by nonrebreathing mask.
D) IV of NS with 250 cc fluid bolus.
Free
Multiple Choice
Q 6Q 6
While palpating the lower abdomen of a 63-year-old male complaining of back pain, you note a pulsating mass. You should:
A) ask the patient to take a deep breath, then palpate the mass while he exhales.
B) ask your partner to confirm the finding.
C) determine if the mass is fixed or freely mobile in the abdomen.
D) stop palpating.
Free
Multiple Choice
Q 7Q 7
Your patient is a 42-year-old male with a history of alcohol abuse who is in severe distress with dysphagia and hematemesis. You note that he is becoming lethargic and is having trouble keeping his head up. His skin is cool and clammy. HR = 138, BP = 82/56, RR = 8, SaO2 = 90%. Proper treatment of this patient would include all of the following EXCEPT:
A) IV of NS with fluid challenge.
B) aggressive suctioning of the airway and intubation.
C) dopamine infusion.
D) placing the patient in shock position.
Free
Multiple Choice
Q 8Q 8
Your patient is a 46-year-old male truck driver who is sitting on a toilet complaining of bleeding with defecation. He states that he had to strain significantly to produce a bowel movement, then noted blood on his stool afterward. He claims no significant medical history, has had no recent illness, and takes no medications. You note the presence of bright red blood on the surface of his stool. Of the following, which is the most likely cause of his clinical condition?
A) Crohn's disease
B) Colitis
C) Upper GI bleed
D) Hemorrhoids
Free
Multiple Choice
Q 9Q 9
Your patient is a 12-year-old male who is conscious and alert and complaining of diffuse abdominal pain. He states that the pain began about 3 hours after eating supper. He has had severe diarrhea and some vomiting. Any of the following could be therapeutic EXCEPT:
A) diazepam.
B) Compazine.
C) IV of NaCl or lactated Ringer's solution.
D) Zofran.
Free
Multiple Choice
Q 10Q 10
Which three mechanisms can produce visceral pain?
A) Peritonitis, cholecystitis, and a ruptured abdominal aorta
B) Blunt trauma, penetrating trauma, and medical illness
C) Somatic, referred, and peritonitis
D) Distension, ischemia, and inflammation
Free
Multiple Choice
Q 11Q 11
Your patient is a 68-year-old female who is being treated for colon cancer. She is conscious and alert, in mild distress, and complaining of progressive weakness over the past three days. Palpation of her abdomen reveals tenderness to the lower right quadrant. Her skin is pale, cool, and dry, and you note the smell and appearance of melena in her stool. HR = 108, BP = 100/60, RR = 12, SaO2 = 97%. Proper treatment of this patient might include:
A) IV of normal saline with a 250 mL fluid challenge, repeated if necessary.
B) IV of 5 percent dextrose solution at 30 mL per hour.
C) two large-bore IVs of lactated Ringer's solution, wide open.
D) two large-bore IVs of normal saline, 20 mL/kg fluid bolus.
Free
Multiple Choice
Q 12Q 12
Your male patient complaining of abdominal pain describes his pain as a dull, crampy sensation that is making him nauseous. The patient is most likely describing ________ pain.
A) visceral
B) referred
C) somatic
D) parietal
Free
Multiple Choice
Q 13Q 13
Which of the following correctly lists the organs and regions of the gastrointestinal tract in sequence after the stomach?
A) Duodenum, jejunum, ileum, descending colon, transverse colon, ascending colon, rectum, anus
B) Duodenum, ileum, jejunum, large intestine, anus, rectum
C) Jejunum, duodenum, ileum, large intestine, anus, rectum
D) Duodenum, jejunum, ileum, ascending colon, transverse colon, descending colon, rectum, anus
Free
Multiple Choice
Q 14Q 14
Your patient is a 68-year-old female complaining of diffuse abdominal pain. She has a history of intestinal hernias and adhesions from previous abdominal surgery. Your suspicion should be highest for:
A) appendicitis.
B) diverticulitis.
C) bowel obstruction.
D) ulcerative colitis.
Free
Multiple Choice
Q 15Q 15
Your patient is a 38-year-old female with a history of Crohn's disease. She is conscious and alert and complaining of abdominal pain. She describes a one-week history of increasingly diffuse, crampy abdominal pain. She also states that she has had nausea and vomiting, fever, and diarrhea the past two days. Physical examination reveals that her skin is warm and dry and that her abdomen is tender to palpation in all quadrants with no masses or distension noted. HR = 100, BP = 118/78, RR = 14, SaO2 = 99%. Which of the following treatments is appropriate in the prehospital management of this patient?
A) Diphenydramine
B) Ketorolac (Toradol)
C) Methylprednisolone
D) Antiemetics
Free
Multiple Choice
Q 16Q 16
Increased hepatic resistance to blood flow, as happens in cirrhosis, results in:
A) hepatic arterial hypertension and obstruction of the common bile duct.
B) portal vein hypertension and esophageal varices.
C) portal artery hypertension and ascites.
D) hepatic vein hypertension and hepatic vein aneurysm.
Free
Multiple Choice
Q 17Q 17
Bleeding in the gastrointestinal tract proximal to the ligament of Treitz is considered to be in the:
A) small intestine.
B) lower GI tract.
C) upper GI tract.
D) colon.
Free
Multiple Choice
Q 18Q 18
Which of the following properly accounts for the differences between visceral and somatic pain?
A) Spilled organ contents and bacteria can result in visceral pain, while somatic pain is caused by organ distension.
B) Visceral pain originates in the walls of hollow organs, while somatic pain originates in skeletal muscle.
C) The nerves that carry somatic pain impulses enter the spinal column at various levels, while the nerves that carry visceral impulses enter the spinal column via specific nerve routes.
D) The nerves that carry visceral pain impulses enter the spinal column at various levels, while the nerves that carry somatic impulses enter the spinal column via specific nerve routes.
Free
Multiple Choice
Q 19Q 19
Pain that is well localized, allowing an examiner to pinpoint the area of irritation is ________ pain.
A) parietal
B) visceral
C) referred
D) somatic
Free
Multiple Choice
Q 20Q 20
Your patient is a 66-year-old female who is conscious and alert, complaining of a one-week history of progressive "lightheadedness" with exertion. She also complains of mild nausea; dark, sticky stools; and pain in her lower abdomen. Which of the following is the most likely cause of this patient's condition?
A) Acute cholecystitis
B) Diverticulosis
C) Gastrointestinal bleeding
D) Ingestion of an iron or a bismuth-containing medication
Free
Multiple Choice
Q 21Q 21
Your patient is a 19-year-old male complaining of a two-day history of abdominal pain described as diffuse and colicky, located around his umbilical area. He also states a loss of appetite and a low-grade fever over the same period. Palpation of his abdomen reveals tenderness and guarding to the periumbilical area. Of the following, which is the most likely cause of his clinical condition?
A) Bowel obstruction
B) Appendicitis
C) Peptic ulcer disease
D) Cholecystitis
Free
Multiple Choice
Q 22Q 22
Murphy's sign is:
A) bruising around the umbilicus.
B) pain produced by pressing under the right costal margin in the presence of an inflamed gallbladder.
C) pain produced by pushing 1 to 2 inches above the iliac crest on a line to the umbilicus.
D) petechial hemorrhage of the abdominal wall.
Free
Multiple Choice
Q 23Q 23
McBurney's point, a common site of pain secondary to appendicitis, is located:
A) at the midway point of a line from 1 to 2 inches above the right iliac crest to the umbilicus.
B) 2 inches above the umbilicus in the midline.
C) 1 to 2 inches above the iliac crest in the right midaxillary line.
D) at the midway point of a line from the symphysis pubis to the right anterior, superior iliac crest.
Free
Multiple Choice
Q 24Q 24
Your patient is a 24-year-old male complaining of a one-week history of abdominal pain. He describes the pain as in the upper right quadrant, dull and reproducible with movement and palpation. He also describes a decreased appetite, weight loss, and clay-colored stool over the same period. Of the following, which is the most likely cause of his clinical condition?
A) Colitis
B) Cholecystitis
C) Acute hepatitis
D) Pancreatitis
Free
Multiple Choice
Q 25Q 25
The mortality rate of ruptured esophageal varices is ________ percent.
A) over 35
B) 10 to 15
C) 20 to 30
D) 15
Free
Multiple Choice
Q 26Q 26
Your 43-year-old male patient is alert and oriented and complaining of abdominal pain. He states that he is experiencing nausea and has vomited twice. Which of the following is the most appropriate follow-up question?
A) "What were you doing when the vomiting started?"
B) "Do you drink more than three alcoholic beverages a day?"
C) "Did you become dizzy or faint while you were vomiting?"
D) "What did the material you vomited look like?"
Free
Multiple Choice
Q 27Q 27
Your patient is a 44-year-old female with a history of hiatal hernia. She is complaining of diffuse abdominal pain. All four quadrants are tender to palpation. She also states that she has vomited numerous times and describes the presence of bile. You note that her abdomen is slightly distended, and auscultation of her abdomen reveals absent bowel sounds. Of the following, which is the most likely cause of her clinical condition?
A) Pancreatitis
B) Cholecystitis
C) Diverticulitis
D) Bowel obstruction
Free
Multiple Choice
Q 28Q 28
A 52-year-old male is in moderate distress and complaining of nausea and vomiting. He describes a three-day history of left upper quadrant abdominal pain described as sharp and radiating to his back. You note a slightly distended abdomen. He called EMS today when he developed nausea and vomiting. He denies any change of bowel habits and states he has a history of alcoholism. Of the following, which is the most likely cause of his clinical condition?
A) Pancreatitis
B) Hepatitis
C) Peptic ulcer disease
D) Gastroenteritis
Free
Multiple Choice
Q 29Q 29
Which of the following questions would best help you determine if the pathology of a patient's complaint has been progressing?
A) "On a scale of 0 to 10, with 10 being the worst pain possible, how would you have rated the pain when it started? How would you rate the pain now?"
B) "When did your pain first start?"
C) "Have you ever felt this pain before?"
D) "On a scale of 1 to 10, with 10 being the worst pain possible, how would you rate this pain?"
Free
Multiple Choice
Q 30Q 30
Gastrointestinal emergencies account for ________ percent of emergency room visits annually.
A) 5
B) 10
C) 2.5
D) 7.5
Free
Multiple Choice
Q 31Q 31
A 46-year-old female alcoholic is hypotensive, in severe distress, complaining of dysphagia, and vomiting bright red blood. Of the following, which is the most likely cause of this patient's clinical condition?
A) Hemorrhagic pancreatitis
B) Acute gastroenteritis
C) Esophageal varices
D) Acute gastric ulcer perforation
Free
Multiple Choice
Q 32Q 32
A 56-year-old female is conscious and alert and complaining of diarrhea and nausea. The patient describes a two-day history of her symptoms and states that the pain is "all over her abdomen." All four quadrants are tender to palpation. She also describes hematochezia. PMH includes CAD, and she recently began taking 325 mg of ASA once a day. Of the following, which is the most likely cause of her clinical condition?
A) Diverticulitis
B) Peptic ulcer
C) Acute pancreatitis
D) Acute gastroenteritis
Free
Multiple Choice
Q 33Q 33
Your patient is a 25-year-old female who is complaining of pain in the midline of the lower abdomen. Which of the following questions helps least when determining the etiology of the patient's pain?
A) "Do you feel nauseated?"
B) "Are you having any pain with urination?"
C) "Are you experiencing pain anywhere other than your lower abdomen?"
D) "When was your last menstrual period?"
Free
Multiple Choice
Q 34Q 34
Which of the following statements about hepatitis is TRUE?
A) Hepatitis is caused by a wide range of potential causes.
B) All types of hepatitis are typically fatal within six months to two years.
C) The most common cause of hepatitis is alcohol abuse.
D) All types of hepatitis lead to chronic liver disease.
Free
Multiple Choice
Q 35Q 35
Which of the following statements would be most typical of a patient with hepatitis?
A) "It seems like everything has a yellow tinge to it."
B) "I have sharp pain on the left side of my abdomen."
C) "I have to urinate all the time."
D) "My stools are really light in color."
Free
Multiple Choice
Q 36Q 36
Which of the following is the most common chief complaint related to acute pancreatitis?
A) Headache
B) Intense abdominal pain
C) Blood in the stool
D) Diarrhea
Free
Multiple Choice
Q 37Q 37
Which of the following assessment findings should you most expect in a patient with chronic pancreatitis?
A) Dark-colored urine
B) Right lower quadrant pain
C) Clay-colored stool
D) Hypotension
Free
Multiple Choice
Q 38Q 38
Upon palpation of your patient's abdomen you note that it is very tender under the right costal margin. This should be documented as a positive ________ sign.
A) Murphy's
B) Cullen's
C) McBurney's
D) Grey-Turner's
Free
Multiple Choice
Q 39Q 39
Pain at McBurney's point is associated with:
A) cholecystitis.
B) kidney stones.
C) appendicitis.
D) pancreatitis.
Free
Multiple Choice
Q 40Q 40
Your patient is a 55-year-old male whose wife called EMS after the patient complained of bright red bleeding during a bowel movement. The patient refuses transport, stating he has hemorrhoids and has had similar bleeding in the past. Which of the following statements is most appropriate?
A) "I'm sure you are right; there is nothing to worry about."
B) "Similar bleeding can be caused by more serious conditions."
C) "This does not sound like hemorrhoids."
D) "Even though this sounds like hemorrhoids, the bleeding may become life-threatening."
Free
Multiple Choice
Q 41Q 41
Which of the following best explains the underlying problem in diverticulitis?
A) Infection in an outpouching of the distal colon
B) Ulceration of the lining of the colon
C) Increased motility of the colon with increased mucus production
D) The presence of polyps in the sigmoid colon
Free
Multiple Choice
Q 42Q 42
Which of the following would be most typical of a patient suffering from diverticulitis?
A) Dark, tarry stools
B) Diffuse abdominal pain
C) Left lower quadrant pain
D) Inability to have a bowel movement
Free
Multiple Choice
Free
Multiple Choice
Q 44Q 44
Esophageal varices are most associated with:
A) kidney disease.
B) liver disease.
C) gastroesophageal reflux disease.
D) pancreatitis.
Free
Multiple Choice
Q 45Q 45
What is the most common cause of chronic gastroenteritis?
A) Microbial infection
B) Floral infection
C) Elevated cortisol
D) Use of NSAIDs
Free
Multiple Choice
Q 46Q 46
With occlusion of the SMA or IMA vascular structures, what gastrointestinal emergency may occur?
A) Renal infarction
B) Hepatic encephalitis
C) Pancreatitis
D) Mesenteric ischemia
Free
Multiple Choice
Q 47Q 47
Which of the following mechanisms is NOT characteristic for a rectal foreign body?
A) Adhesion progression
B) Accidental trauma
C) Accidental swallowing of something
D) Tumor growth
Free
Multiple Choice
Q 48Q 48
Abdominal pain that is dull in nature and cannot be narrowed to one specific area is known as:
A) referred pain.
B) somatic pain.
C) visceral pain.
D) Kehr's sign.
Free
Multiple Choice
Q 49Q 49
Abdominal pain that is sharp in nature and can be localized is known as:
A) referred pain.
B) somatic pain.
C) visceral pain.
D) Kehr's sign.
Free
Multiple Choice
Q 50Q 50
Abdominal pain that is originating in a region other than where it is felt is known as:
A) referred pain.
B) somatic pain.
C) visceral pain.
D) Kehr's sign.
Free
Multiple Choice
Q 51Q 51
You are examining a patient who was recently involved in a traumatic incident. You notice that the patient is now exhibiting periumbilical ecchymosis. This is known as:
A) Grey Turner's sign.
B) Cullen's sign.
C) Edwards' sign.
D) rigidity sign.
Free
Multiple Choice
Q 52Q 52
You are examining a patient who is exhibiting signs of hypovolemia. Upon inspection of the patient's flank, you notice ecchymosis. This is known as:
A) Grey Turner's sign.
B) Cullen's sign.
C) Edwards' sign.
D) rigidity sign.
Free
Multiple Choice
Q 53Q 53
Persistent abdominal pain is considered a surgical emergency when lasting longer than:
A) 2 days.
B) 2 hours.
C) 6 days.
D) 6 hours.
Free
Multiple Choice
Q 54Q 54
The main purpose of the GI tract is:
A) to convert food into nutrients for the body.
B) to expel waste products.
C) to facilitate metabolism.
D) glucogenolysis.
Free
Multiple Choice
Q 55Q 55
You respond to a call of an ill person. Upon arrival, you find your patient complaining of diffuse abdominal pain and hematemesis. When asked, the patient states that the emesis was "coffee ground" in nature. You suspect:
A) lower GI bleed.
B) upper GI bleed.
C) melena.
D) esophageal varices.
Free
Multiple Choice
Q 56Q 56
You respond to a patent who complains of having dark, tarry stools. Upon arrival, you notice that the patient is pale, cool, and clammy. After initiation of two large-bore IVs, your initial fluid bolus should be:
A) 10 mL/kg.
B) 20 mL/kg.
C) 250 mL.
D) 1000 mL.
Free
Multiple Choice
Q 57Q 57
The cause of esophageal varices can be attributed to:
A) pulmonary hypertension.
B) portal hypertension.
C) pulmonary hypotension.
D) portal hypotension.
Free
Multiple Choice