NUR 402 – Nursing Course – Exam 1
Comprehensive Study Questions with
Correct Elaborate Answers | Latest
Edition |
1. What is gastric outlet obstruction? - ANSWER Both acute and chronic PUD
can result in gastric outlet obstruction.
Obstruction in the distal stomach and duodenum is the result of edema,
inflammation, or pylorospasm and fibrous scar tissue formation. With
obstruction the patient reports discomfort or pain that is worse toward the end
of the day as the stomach fills and dilates.
2. Belching or self-induced vomiting may provide some relief. Vomiting is
common and often projectile. The vomitus may contain food particles that
were ingested hours or days before. Constipation occurs because of
dehydration and decreased diet intake secondary to anorexia. Over time
dilation of the stomach and visible swelling in the upper abdomen may
occur.
3. What does endoscopy allow for? - ANSWER Endoscopy allows for direct
viewing of the gastric and duodenal mucosa (Fig. 41-14). During endoscopy,
tissue specimens are obtained to determine if H. pylori is present and rule
out stomach cancer. Endoscopy can also be used to determine the degree of
ulcer healing after treatment.
,4. What surgeries are done for PUD and stomach cancer? - ANSWER Surgical
procedures include partial gastrectomy, vagotomy, and pyloroplasty. Partial
gastrectomy with removal of the distal two thirds of the stomach and
anastomosis of the gastric stump to the duodenum is called a
gastroduodenostomy or Billroth I operation (Fig. 41-15, A). If the gastric
stump is anastomosed to the jejunum, the surgery is a gastrojejunostomy or
Billroth II operation (Fig. 41-15, B).
5. When do symptoms of dumping syndrome occur? - ANSWER Symptoms
begin within 15 to 30 minutes after eating. The patient usually describes
feelings of generalized weakness, sweating, palpitations, and dizziness.
These symptoms are due to the sudden decrease in plasma volume. The
patient complains of abdominal cramps, borborygmi (audible abdominal
sounds produced by hyperactive intestinal peristalsis), and the urge to
defecate. These manifestations usually last less than 1 hour after eating. A
short rest period after each meal reduces the chance of dumping syndrome.
6. What is pernicious anemia caused by? - ANSWER Vitamin B12 deficiency
7. What is melena? - ANSWER A black, tarry stool indicating a GI bleed
8. What is Hematemesis? - ANSWER Bloody vomitus appearing as fresh,
bright red blood or "coffee-ground" appearance (dark, grainy digested
blood).
9. What is occult bleeding? - ANSWER Small amounts of blood in gastric
secretions, vomitus, or stools not apparent by appearance. Detectable by
guaiac test
A pancreatic pseudocyst is an accumulation of fluid, pancreatic enzymes,
tissue debris, and inflammatory exudates surrounded by a wall adjacent to
the pancreas. Manifestations of pseudocyst are abdominal pain, palpable
, epigastric mass, nausea, vomiting, and anorexia. The serum amylase level
frequently remains elevated. CT, MRI, and endoscopic ultrasound (EUS)
may be used in the detection of a pseudocyst. The cysts usually resolve
spontaneously within a few weeks but may perforate, causing peritonitis or
rupture into the stomach or the duodenum. Treatment options include
surgical drainage, percutaneous catheter placement and drainage, and
endoscopic drainage.
10.What are the diagnostic tests for acute pancreatitis? - ANSWER The
primary diagnostic tests for acute pancreatitis are serum amylase and lipase
(Table 43-17). The serum amylase level is usually elevated early and
remains elevated for 24 to 72 hours. Serum lipase level, which is also
elevated in acute pancreatitis, is an important test because other disorders
(e.g., mumps, cerebral trauma, renal transplantation) may increase serum
amylase levels. Other serum findings include an increase in liver enzymes,
triglycerides, glucose, and bilirubin and a decrease in calcium.
11.What are the symptoms of acute pancreatitis? - ANSWER Abdominal pain
is the predominant manifestation of acute pancreatitis. The pain is due to
distention of the pancreas, peritoneal irritation, and obstruction of the biliary
tract. The pain is usually located in the left upper quadrant, but it may be
mid-epigastric. It commonly radiates to the back because of the
retroperitoneal location of the pancreas. The pain has a sudden onset and is
described as severe, deep, piercing, and continuous or steady. The pain is
aggravated by eating. It frequently has its onset when the patient is
recumbent. It is not relieved by vomiting and may be accompanied by
flushing, cyanosis, and dyspnea. The patient may assume various positions
involving flexion of the spine in an attempt to relieve the severe pain.
Other areas of ecchymoses are the flanks *(Grey Turner's spots or sign, a bluish
flank discoloration) and the periumbilical area (Cullen's sign, a bluish
periumbilical discoloration)*. These result from seepage of bloodstained
exudate from the pancreas and may occur in severe cases.
, 12.What are the main systemic complications of acute pancreatitis? - ANSWER
The main systemic complications of acute pancreatitis are pulmonary
(pleural effusion, atelectasis, pneumonia, and acute respiratory distress
syndrome [ARDS]) and cardiovascular (hypotension). The pulmonary
complications are likely due to the passage of exudate containing pancreatic
enzymes from the peritoneal cavity through transdiaphragmatic lymph
channels. Enzyme-induced inflammation of the diaphragm occurs with the
result being atelectasis caused by reduced diaphragm movement. Trypsin
can activate prothrombin and plasminogen, increasing the patient's risk for
intravascular thrombi, pulmonary emboli, and disseminated intravascular
coagulation (DIC).
13.What is the normal range for lipase? - ANSWER 31 - 186
14.What is the normal range for amylase? - ANSWER 30 - 122 u/L
15.What is the normal range for total bilirubin? - ANSWER 0.2-1.2 mg/dL
16.What is the normal range for albumin? - ANSWER 3.5 - 5.0 g/dL
17.What is the normal range for sodium? - ANSWER 135 - 145
18.What is the normal range of ammonia? - ANSWER 15-45 mcg
19.What is the normal range for ALT? - ANSWER 10-40 U/L
20.What is the normal range for AST? - ANSWER 10 - 30 U/L
21.What is the normal range for potassium? - ANSWER 3.5-5.0 mEq/L
Comprehensive Study Questions with
Correct Elaborate Answers | Latest
Edition |
1. What is gastric outlet obstruction? - ANSWER Both acute and chronic PUD
can result in gastric outlet obstruction.
Obstruction in the distal stomach and duodenum is the result of edema,
inflammation, or pylorospasm and fibrous scar tissue formation. With
obstruction the patient reports discomfort or pain that is worse toward the end
of the day as the stomach fills and dilates.
2. Belching or self-induced vomiting may provide some relief. Vomiting is
common and often projectile. The vomitus may contain food particles that
were ingested hours or days before. Constipation occurs because of
dehydration and decreased diet intake secondary to anorexia. Over time
dilation of the stomach and visible swelling in the upper abdomen may
occur.
3. What does endoscopy allow for? - ANSWER Endoscopy allows for direct
viewing of the gastric and duodenal mucosa (Fig. 41-14). During endoscopy,
tissue specimens are obtained to determine if H. pylori is present and rule
out stomach cancer. Endoscopy can also be used to determine the degree of
ulcer healing after treatment.
,4. What surgeries are done for PUD and stomach cancer? - ANSWER Surgical
procedures include partial gastrectomy, vagotomy, and pyloroplasty. Partial
gastrectomy with removal of the distal two thirds of the stomach and
anastomosis of the gastric stump to the duodenum is called a
gastroduodenostomy or Billroth I operation (Fig. 41-15, A). If the gastric
stump is anastomosed to the jejunum, the surgery is a gastrojejunostomy or
Billroth II operation (Fig. 41-15, B).
5. When do symptoms of dumping syndrome occur? - ANSWER Symptoms
begin within 15 to 30 minutes after eating. The patient usually describes
feelings of generalized weakness, sweating, palpitations, and dizziness.
These symptoms are due to the sudden decrease in plasma volume. The
patient complains of abdominal cramps, borborygmi (audible abdominal
sounds produced by hyperactive intestinal peristalsis), and the urge to
defecate. These manifestations usually last less than 1 hour after eating. A
short rest period after each meal reduces the chance of dumping syndrome.
6. What is pernicious anemia caused by? - ANSWER Vitamin B12 deficiency
7. What is melena? - ANSWER A black, tarry stool indicating a GI bleed
8. What is Hematemesis? - ANSWER Bloody vomitus appearing as fresh,
bright red blood or "coffee-ground" appearance (dark, grainy digested
blood).
9. What is occult bleeding? - ANSWER Small amounts of blood in gastric
secretions, vomitus, or stools not apparent by appearance. Detectable by
guaiac test
A pancreatic pseudocyst is an accumulation of fluid, pancreatic enzymes,
tissue debris, and inflammatory exudates surrounded by a wall adjacent to
the pancreas. Manifestations of pseudocyst are abdominal pain, palpable
, epigastric mass, nausea, vomiting, and anorexia. The serum amylase level
frequently remains elevated. CT, MRI, and endoscopic ultrasound (EUS)
may be used in the detection of a pseudocyst. The cysts usually resolve
spontaneously within a few weeks but may perforate, causing peritonitis or
rupture into the stomach or the duodenum. Treatment options include
surgical drainage, percutaneous catheter placement and drainage, and
endoscopic drainage.
10.What are the diagnostic tests for acute pancreatitis? - ANSWER The
primary diagnostic tests for acute pancreatitis are serum amylase and lipase
(Table 43-17). The serum amylase level is usually elevated early and
remains elevated for 24 to 72 hours. Serum lipase level, which is also
elevated in acute pancreatitis, is an important test because other disorders
(e.g., mumps, cerebral trauma, renal transplantation) may increase serum
amylase levels. Other serum findings include an increase in liver enzymes,
triglycerides, glucose, and bilirubin and a decrease in calcium.
11.What are the symptoms of acute pancreatitis? - ANSWER Abdominal pain
is the predominant manifestation of acute pancreatitis. The pain is due to
distention of the pancreas, peritoneal irritation, and obstruction of the biliary
tract. The pain is usually located in the left upper quadrant, but it may be
mid-epigastric. It commonly radiates to the back because of the
retroperitoneal location of the pancreas. The pain has a sudden onset and is
described as severe, deep, piercing, and continuous or steady. The pain is
aggravated by eating. It frequently has its onset when the patient is
recumbent. It is not relieved by vomiting and may be accompanied by
flushing, cyanosis, and dyspnea. The patient may assume various positions
involving flexion of the spine in an attempt to relieve the severe pain.
Other areas of ecchymoses are the flanks *(Grey Turner's spots or sign, a bluish
flank discoloration) and the periumbilical area (Cullen's sign, a bluish
periumbilical discoloration)*. These result from seepage of bloodstained
exudate from the pancreas and may occur in severe cases.
, 12.What are the main systemic complications of acute pancreatitis? - ANSWER
The main systemic complications of acute pancreatitis are pulmonary
(pleural effusion, atelectasis, pneumonia, and acute respiratory distress
syndrome [ARDS]) and cardiovascular (hypotension). The pulmonary
complications are likely due to the passage of exudate containing pancreatic
enzymes from the peritoneal cavity through transdiaphragmatic lymph
channels. Enzyme-induced inflammation of the diaphragm occurs with the
result being atelectasis caused by reduced diaphragm movement. Trypsin
can activate prothrombin and plasminogen, increasing the patient's risk for
intravascular thrombi, pulmonary emboli, and disseminated intravascular
coagulation (DIC).
13.What is the normal range for lipase? - ANSWER 31 - 186
14.What is the normal range for amylase? - ANSWER 30 - 122 u/L
15.What is the normal range for total bilirubin? - ANSWER 0.2-1.2 mg/dL
16.What is the normal range for albumin? - ANSWER 3.5 - 5.0 g/dL
17.What is the normal range for sodium? - ANSWER 135 - 145
18.What is the normal range of ammonia? - ANSWER 15-45 mcg
19.What is the normal range for ALT? - ANSWER 10-40 U/L
20.What is the normal range for AST? - ANSWER 10 - 30 U/L
21.What is the normal range for potassium? - ANSWER 3.5-5.0 mEq/L
