NR 511 Final Exam QUESTIONS &
SOLUTIONS
IBD - ANSWERmucosal surface of the colon is inflamed-most often occurs in the
rectosigmoid areas, but may involve the entire colon
Ulcerative colitis - ANSWER•Results in friability, erosions, and bleeding
•Characterized by bloody and purulent diarrhea
UC treatment - ANSWER•total colectomy is a treatment option that can completely
resolve this problem.
diverticulitis - ANSWERpresent with bleeding not associated with pain or discomfort.
who is at high risk ? - ANSWERobesity
what are the symptoms if diverticula become inflamed? - ANSWERsymptoms of
infection-fever, chills, and tachycardia
diverticulitis-typically present with? - ANSWERlocalized pain and tenderness in the LLQ
of the abdomen with associated anorexia, nausea and vomiting
diverticulitis-best management? - ANSWERHigh-fiber diet
diagnostic tests for diverticulitis? - ANSWER•CT scan with contrast may sometimes be
done to r/o if the gynecologic etiology (such as ovarian cyst or tumor) as well as bowel
pathology such as abdominal abscess
C. Diff - ANSWER-infection of lg intestine
-exists in air, water, soil, processed food and human feces
-cause profuse watery mucoid diarrhea
-certain types can be dangerous or life-threatening if not treated
C. Diff risk factors - ANSWER-Working in healthcare facility
-Long duration hospitalization
-Long-term use of antibiotics that affects normal GI flora
-Long-term use of medications that reduce GI acidity
-Consumption of contaminated food or water
-Touching infected soil, objects and surfaces
C. diff mild-moderate infection - ANSWER-Watery diarrhea three or more times/day for
two or more days
-Mild abdominal cramping and tenderness
, C. Diff severe infection - ANSWER-Watery diarrhea (10-15 stools/day)
-Strong foul odor
-Acute abdomen secondary to toxic megacolon with perforation
-Abdominal distention
-Fever
-Nausea/vomiting/dehydration requiring hospitalization
-Blood or pus in the stools (severe cases)
C. Diff Dx - ANSWER•Complete blood count (CBC): elevated WBC count
•Enzyme-linked immunodeficiency assay (ELISA): identifies toxins that produce C. diff
bacteria
•Cell cytotoxicity assay: identifies the effects of bacterial toxins on human cells
•Polymerase chain reaction (PCR): detects bacterial genes
•Endoscopy: if the patient is unresponsive to treatment; will show pseudomembranes
that suggest c-diff infection
C. Diff Tx - ANSWER•Metronidazole
•Probiotics- to restore the healthy growth of normal GI bacteria
•Colectomy in severe cases
•Maintain fluids
•Clear liquid diet
•Eat starchy foods to prevent diarrhea
•Avoid caffeine, spicy foods, milk and greasy foods
•May require a GI consult
GERD-LES dysfunction - ANSWER•reduced pressure or improper relaxation allows
gastric acid to flow back into the esophagus
GERD-hiatal hernia - ANSWERcontributes to GERD by disrupting the normal barrier
between the esophagus and stomach
GERD-esophageal motility disorder - ANSWER• impaired esophageal peristalsis and
reduces esophageal clearance can lead to pooling of gastric acid in the esophagus
GERD sx - ANSWER•Symptoms occur at night with regurgitation; heartburn is classic
for GERD (mild to severe). Dysphagia is frequently a prominent symptom of GERD. It is
usually associated with other symptoms, including regurgitation, water brash (reflex
salivation), sour taste in the mouth in the morning, odynophagia, belching, coughing,
hoarseness, or wheezing, usually at night.
GERD-If patient has been treated with diet modifications and 6 weeks of omeprazole
without improvement of symptoms, whats next? - ANSWERendoscopy
GERD-pt should be instructed to avoid what? - ANSWER• coffee, alcohol, chocolate,
peppermint, and spicy foods; eat smaller meals; stop smoking; remain upright for 2
SOLUTIONS
IBD - ANSWERmucosal surface of the colon is inflamed-most often occurs in the
rectosigmoid areas, but may involve the entire colon
Ulcerative colitis - ANSWER•Results in friability, erosions, and bleeding
•Characterized by bloody and purulent diarrhea
UC treatment - ANSWER•total colectomy is a treatment option that can completely
resolve this problem.
diverticulitis - ANSWERpresent with bleeding not associated with pain or discomfort.
who is at high risk ? - ANSWERobesity
what are the symptoms if diverticula become inflamed? - ANSWERsymptoms of
infection-fever, chills, and tachycardia
diverticulitis-typically present with? - ANSWERlocalized pain and tenderness in the LLQ
of the abdomen with associated anorexia, nausea and vomiting
diverticulitis-best management? - ANSWERHigh-fiber diet
diagnostic tests for diverticulitis? - ANSWER•CT scan with contrast may sometimes be
done to r/o if the gynecologic etiology (such as ovarian cyst or tumor) as well as bowel
pathology such as abdominal abscess
C. Diff - ANSWER-infection of lg intestine
-exists in air, water, soil, processed food and human feces
-cause profuse watery mucoid diarrhea
-certain types can be dangerous or life-threatening if not treated
C. Diff risk factors - ANSWER-Working in healthcare facility
-Long duration hospitalization
-Long-term use of antibiotics that affects normal GI flora
-Long-term use of medications that reduce GI acidity
-Consumption of contaminated food or water
-Touching infected soil, objects and surfaces
C. diff mild-moderate infection - ANSWER-Watery diarrhea three or more times/day for
two or more days
-Mild abdominal cramping and tenderness
, C. Diff severe infection - ANSWER-Watery diarrhea (10-15 stools/day)
-Strong foul odor
-Acute abdomen secondary to toxic megacolon with perforation
-Abdominal distention
-Fever
-Nausea/vomiting/dehydration requiring hospitalization
-Blood or pus in the stools (severe cases)
C. Diff Dx - ANSWER•Complete blood count (CBC): elevated WBC count
•Enzyme-linked immunodeficiency assay (ELISA): identifies toxins that produce C. diff
bacteria
•Cell cytotoxicity assay: identifies the effects of bacterial toxins on human cells
•Polymerase chain reaction (PCR): detects bacterial genes
•Endoscopy: if the patient is unresponsive to treatment; will show pseudomembranes
that suggest c-diff infection
C. Diff Tx - ANSWER•Metronidazole
•Probiotics- to restore the healthy growth of normal GI bacteria
•Colectomy in severe cases
•Maintain fluids
•Clear liquid diet
•Eat starchy foods to prevent diarrhea
•Avoid caffeine, spicy foods, milk and greasy foods
•May require a GI consult
GERD-LES dysfunction - ANSWER•reduced pressure or improper relaxation allows
gastric acid to flow back into the esophagus
GERD-hiatal hernia - ANSWERcontributes to GERD by disrupting the normal barrier
between the esophagus and stomach
GERD-esophageal motility disorder - ANSWER• impaired esophageal peristalsis and
reduces esophageal clearance can lead to pooling of gastric acid in the esophagus
GERD sx - ANSWER•Symptoms occur at night with regurgitation; heartburn is classic
for GERD (mild to severe). Dysphagia is frequently a prominent symptom of GERD. It is
usually associated with other symptoms, including regurgitation, water brash (reflex
salivation), sour taste in the mouth in the morning, odynophagia, belching, coughing,
hoarseness, or wheezing, usually at night.
GERD-If patient has been treated with diet modifications and 6 weeks of omeprazole
without improvement of symptoms, whats next? - ANSWERendoscopy
GERD-pt should be instructed to avoid what? - ANSWER• coffee, alcohol, chocolate,
peppermint, and spicy foods; eat smaller meals; stop smoking; remain upright for 2
