NSG 123 EXAM 2 2026 TEST PAPER
QUESTIONS AND SOLUTIONS FULL SOLUTION
◉ Abnormal Labs in Ulcerative Colitis. Answer: laboratory test
results reveal low hematocrit and hemoglobin levels in addition to
an elevated white blood cell count, low albumin levels (indicating
malabsorptive disorders), and an electrolyte imbalance. C-reactive
protein levels are elevated.
◉ Barrett's Esophagus Definition and Long Term. Answer: Barrett's
Esophagus: condition in which the lining of the esophageal mucosa
is altered. Occurs with GERD usually. Long Term: Reflux can
eventually cause changes in the cells lining the lower esophagus. The
cells that are laid to cover the exposed area no longer form the
normal, squamous mucosa, but instead form columnar-lined
epithelium that resembles the intestines
◉ GERD. Answer: GERD: Gastroesophageal reflux disease (GERD) is
a fairly common disorder marked by backflow of gastric or duodenal
contents into the esophagus that causes troublesome symptoms
and/or mucosal injury to the esophagus. Excessive reflux may occur
because of an incompetent lower esophageal sphincter, pyloric
stenosis, hiatal hernia, or a motility disorder.
,◉ Management of GERD. Answer: Management of GERD:
Management begins with educating the patient to avoid situations
that decrease lower esophageal sphincter pressure or cause
esophageal irritation. The patient is instructed to eat a low-fat diet;
avoid caffeine, tobacco, beer, milk, foods containing peppermint or
spearmint, and carbonated beverages; avoid eating or drinking 2
hours before bedtime; maintain normal body weight; avoid tight-
fitting clothes; and elevate the head of the bed by at least 30 degrees
◉ S/S of Cholelithiasis. Answer: Signs and Symptoms of Gallstones:
Gallstones may be silent, producing no pain and only mild GI
symptoms. Such stones may be detected incidentally during surgery
or evaluation for unrelated problems. The symptoms may be acute
or chronic. Epigastric distress, such as fullness, abdominal
distention, and vague pain in the right upper quadrant of the
abdomen, may occur
◉ Causes of Gallstones. Answer: In gallstone-prone patients, there is
decreased bile acid synthesis and increased cholesterol synthesis in
the liver, resulting in bile supersaturated with cholesterol, which
precipitates out of the bile to form stones. 2-4 times more women
than men. Stone formation is more frequent in people who use oral
contraceptives, estrogens, or clofibrate (Atromid-S); these
medications are known to increase biliary cholesterol saturation
, ◉ Gallstone Composition. Answer: There are two major types of
gallstones: those composed predominantly of pigment (10-25%)
and those composed primarily of cholesterol (75%).
◉ Cholelithiasis Dietary Teaching. Answer: The diet immediately
after an episode is usually low-fat liquids. These can include
powdered supplements high in protein and carbohydrate stirred
into skim milk. Cooked fruits, rice or tapioca, lean meats, mashed
potatoes, non-gas-forming vegetables, bread, coffee, or tea may be
added as tolerated. The patient should avoid eggs, cream, pork, fried
foods, cheese, rich dressings, gas-forming vegetables, and alcohol. It
is important to remind the patient that fatty foods may induce an
episode of cholecystitis. Dietary management may be the major
mode of therapy in patients who have had only dietary intolerance
to fatty foods and vague GI symptoms
◉ 2 Medications for Dissolving Gallstones. Answer: Medications for
Dissolving Gallstones:
Ursodeoxycholic acid (UDCA [Urso, Actigall])
Chenodeoxycholic acid (chenodiol or CDCA [Chenix])
have been used to dissolve small, radiolucent gallstones composed
primarily of cholesterol
Six to 12 months of therapy is required in many patients to dissolve
stones, and monitoring of the patient for recurrence of symptoms or
the occurrence of side effects (e.g., GI symptoms, pruritus, headache)
is required during this time. The effective dose of medication
depends on body weight
QUESTIONS AND SOLUTIONS FULL SOLUTION
◉ Abnormal Labs in Ulcerative Colitis. Answer: laboratory test
results reveal low hematocrit and hemoglobin levels in addition to
an elevated white blood cell count, low albumin levels (indicating
malabsorptive disorders), and an electrolyte imbalance. C-reactive
protein levels are elevated.
◉ Barrett's Esophagus Definition and Long Term. Answer: Barrett's
Esophagus: condition in which the lining of the esophageal mucosa
is altered. Occurs with GERD usually. Long Term: Reflux can
eventually cause changes in the cells lining the lower esophagus. The
cells that are laid to cover the exposed area no longer form the
normal, squamous mucosa, but instead form columnar-lined
epithelium that resembles the intestines
◉ GERD. Answer: GERD: Gastroesophageal reflux disease (GERD) is
a fairly common disorder marked by backflow of gastric or duodenal
contents into the esophagus that causes troublesome symptoms
and/or mucosal injury to the esophagus. Excessive reflux may occur
because of an incompetent lower esophageal sphincter, pyloric
stenosis, hiatal hernia, or a motility disorder.
,◉ Management of GERD. Answer: Management of GERD:
Management begins with educating the patient to avoid situations
that decrease lower esophageal sphincter pressure or cause
esophageal irritation. The patient is instructed to eat a low-fat diet;
avoid caffeine, tobacco, beer, milk, foods containing peppermint or
spearmint, and carbonated beverages; avoid eating or drinking 2
hours before bedtime; maintain normal body weight; avoid tight-
fitting clothes; and elevate the head of the bed by at least 30 degrees
◉ S/S of Cholelithiasis. Answer: Signs and Symptoms of Gallstones:
Gallstones may be silent, producing no pain and only mild GI
symptoms. Such stones may be detected incidentally during surgery
or evaluation for unrelated problems. The symptoms may be acute
or chronic. Epigastric distress, such as fullness, abdominal
distention, and vague pain in the right upper quadrant of the
abdomen, may occur
◉ Causes of Gallstones. Answer: In gallstone-prone patients, there is
decreased bile acid synthesis and increased cholesterol synthesis in
the liver, resulting in bile supersaturated with cholesterol, which
precipitates out of the bile to form stones. 2-4 times more women
than men. Stone formation is more frequent in people who use oral
contraceptives, estrogens, or clofibrate (Atromid-S); these
medications are known to increase biliary cholesterol saturation
, ◉ Gallstone Composition. Answer: There are two major types of
gallstones: those composed predominantly of pigment (10-25%)
and those composed primarily of cholesterol (75%).
◉ Cholelithiasis Dietary Teaching. Answer: The diet immediately
after an episode is usually low-fat liquids. These can include
powdered supplements high in protein and carbohydrate stirred
into skim milk. Cooked fruits, rice or tapioca, lean meats, mashed
potatoes, non-gas-forming vegetables, bread, coffee, or tea may be
added as tolerated. The patient should avoid eggs, cream, pork, fried
foods, cheese, rich dressings, gas-forming vegetables, and alcohol. It
is important to remind the patient that fatty foods may induce an
episode of cholecystitis. Dietary management may be the major
mode of therapy in patients who have had only dietary intolerance
to fatty foods and vague GI symptoms
◉ 2 Medications for Dissolving Gallstones. Answer: Medications for
Dissolving Gallstones:
Ursodeoxycholic acid (UDCA [Urso, Actigall])
Chenodeoxycholic acid (chenodiol or CDCA [Chenix])
have been used to dissolve small, radiolucent gallstones composed
primarily of cholesterol
Six to 12 months of therapy is required in many patients to dissolve
stones, and monitoring of the patient for recurrence of symptoms or
the occurrence of side effects (e.g., GI symptoms, pruritus, headache)
is required during this time. The effective dose of medication
depends on body weight
