NR603 CEA PREP- GI EXAM
QUESTIONS & VERIFIED ANSWERS
ALL PASSED LATEST VERSION
Which of the following gastrointestinal changes is associated with normal aging? -
Correct Answer ✔✔ Decreased production of gastric acid
A 63-year-old male presents with a suspected lower GI bleed. He reports passing frank
small amounts of blood several times today. He denies use of NSAID's or blood
thinners. What questions would be important to ask to further differentiate your
diagnosis? - Correct Answer ✔✔ All options are appropriate
Rationale: All the above, these questions would help determine if this bleed was
associated with a potential diverticular bleed (typically painless), painful bowel
movement associated with IBD (UC/Crohn's), and changes in bowel habit/colonoscopy
risk for malignancy.
Anorexia nervosa occurs most commonly in which of the following? - Correct Answer
✔✔ High-level athletes
A 29-year-old male presents with severe abdominal pain, he has a history of alcohol
abuse, and recurrent pancreatitis. Patient's Lipase is elevated, and he has nausea and
vomiting as well. Abdominal CT shows inflammatory changes around the pancreas.
What is the most important intervention to consider in the acute phase? - Correct
Answer ✔✔ Admit to the hospital for fluid resuscitation to avoid hypovolemic state, and
reduce risk of developing further complications
An adult female returns to the clinic with severe profuse watery diarrhea, abdominal
pain, and cramping after treatment with Cipro x 10 days. WBC is 12.5, stool culture is
positive for c diff. The NP would recommend: - Correct Answer ✔✔ Metronidazole 500
tid for 10-14 d
Rationale: Treatment of C Diff should include metronidazole (Flagyl) or PO vancomycin.
An adult presents with increasing abdominal girth. The nurse practitioner suspects
ascites. Which finding on physical exam would confirm the suspicion of ascites? -
Correct Answer ✔✔ Dullness shifts to the more dependent side
Rationale: In the fluid wave test for ascites, dullness shifts to the more dependent side.
The impulse of the wave should be easily palpable.
, A 45-year-old woman presents with chronic diarrhea, weight loss, and abdominal pain.
Endoscopy reveals villous atrophy of the small intestine. What is the most appropriate
initial management? - Correct Answer ✔✔ Gluten-free diet
Rationale: Villous atrophy in the small intestine supports a diagnosis of celiac disease
which can be managed by avoidance of gluten.
A 49-year-old male presents to your service with symptoms of fever 102.3, jaundice,
and abdominal pain. Imagining reveals a biliary obstruction. Which diagnosis is most
likely for this patient? - Correct Answer ✔✔ Cholangitis
Rationale: The most common cause of this is a biliary stone causing obstruction and
allowing for ascending of bacteria and infection
An adult female presents with a 1-week history of left lower quadrant abdominal pain.
T=101.2 degrees F. (38.4 degrees C) and an elevated WBC count. This is the patient's
first episode of severe abdominal pain. The nurse practitioner suspects diverticulitis.
Which of the following diagnostic tests would confirm the diagnosis? - Correct Answer
✔✔ CT scan of the abdomen
The most common side effect of the oral ribavirin used in the treatment of hepatitis C is:
- Correct Answer ✔✔ Depression
Rationale: It is important to note that ribavirin will not treat hepatitis C unless it is taken
with another medication called pegylated-interferon α (PEG-IFNα).
A 59-year-old male presents with symptoms of abdominal pain, jaundice, and weight
loss which he has not been trying to lose weight. What would be a malignancy
associated with these symptoms? - Correct Answer ✔✔ Pancreatic cancer
Rationale: Pancreatic cancer, the most typically presentation includes abdominal pain,
jaundice, and weight loss. Although weight loss and abdominal pain may be present
with adenocarcinoma it is unlikely to present with jaundice, and you're unlikely to have
abdominal pain or jaundice with any esophageal malignancy.
An adult female with rheumatoid arthritis presents to the office for a follow up. She is
currently taking methotrexate and over the counter Ibuprofen. Today she complains of
severe stomach pain and intense abdominal cramping. After the nurse practitioner
makes appropriate adjustments to the patient's medication regimen, the patient still
complains of abdominal discomfort and reports dark stools. The practitioner suspects: -
Correct Answer ✔✔ Gastric ulceration
Rationale: The overuse of NSAIDs such as ibuprofen (Advil) have caused the
prostaglandin inhibition-related thinning of the mucosal lining of the stomach, thereby
predisposing the patient to gastric ulceration and GI bleeding.
QUESTIONS & VERIFIED ANSWERS
ALL PASSED LATEST VERSION
Which of the following gastrointestinal changes is associated with normal aging? -
Correct Answer ✔✔ Decreased production of gastric acid
A 63-year-old male presents with a suspected lower GI bleed. He reports passing frank
small amounts of blood several times today. He denies use of NSAID's or blood
thinners. What questions would be important to ask to further differentiate your
diagnosis? - Correct Answer ✔✔ All options are appropriate
Rationale: All the above, these questions would help determine if this bleed was
associated with a potential diverticular bleed (typically painless), painful bowel
movement associated with IBD (UC/Crohn's), and changes in bowel habit/colonoscopy
risk for malignancy.
Anorexia nervosa occurs most commonly in which of the following? - Correct Answer
✔✔ High-level athletes
A 29-year-old male presents with severe abdominal pain, he has a history of alcohol
abuse, and recurrent pancreatitis. Patient's Lipase is elevated, and he has nausea and
vomiting as well. Abdominal CT shows inflammatory changes around the pancreas.
What is the most important intervention to consider in the acute phase? - Correct
Answer ✔✔ Admit to the hospital for fluid resuscitation to avoid hypovolemic state, and
reduce risk of developing further complications
An adult female returns to the clinic with severe profuse watery diarrhea, abdominal
pain, and cramping after treatment with Cipro x 10 days. WBC is 12.5, stool culture is
positive for c diff. The NP would recommend: - Correct Answer ✔✔ Metronidazole 500
tid for 10-14 d
Rationale: Treatment of C Diff should include metronidazole (Flagyl) or PO vancomycin.
An adult presents with increasing abdominal girth. The nurse practitioner suspects
ascites. Which finding on physical exam would confirm the suspicion of ascites? -
Correct Answer ✔✔ Dullness shifts to the more dependent side
Rationale: In the fluid wave test for ascites, dullness shifts to the more dependent side.
The impulse of the wave should be easily palpable.
, A 45-year-old woman presents with chronic diarrhea, weight loss, and abdominal pain.
Endoscopy reveals villous atrophy of the small intestine. What is the most appropriate
initial management? - Correct Answer ✔✔ Gluten-free diet
Rationale: Villous atrophy in the small intestine supports a diagnosis of celiac disease
which can be managed by avoidance of gluten.
A 49-year-old male presents to your service with symptoms of fever 102.3, jaundice,
and abdominal pain. Imagining reveals a biliary obstruction. Which diagnosis is most
likely for this patient? - Correct Answer ✔✔ Cholangitis
Rationale: The most common cause of this is a biliary stone causing obstruction and
allowing for ascending of bacteria and infection
An adult female presents with a 1-week history of left lower quadrant abdominal pain.
T=101.2 degrees F. (38.4 degrees C) and an elevated WBC count. This is the patient's
first episode of severe abdominal pain. The nurse practitioner suspects diverticulitis.
Which of the following diagnostic tests would confirm the diagnosis? - Correct Answer
✔✔ CT scan of the abdomen
The most common side effect of the oral ribavirin used in the treatment of hepatitis C is:
- Correct Answer ✔✔ Depression
Rationale: It is important to note that ribavirin will not treat hepatitis C unless it is taken
with another medication called pegylated-interferon α (PEG-IFNα).
A 59-year-old male presents with symptoms of abdominal pain, jaundice, and weight
loss which he has not been trying to lose weight. What would be a malignancy
associated with these symptoms? - Correct Answer ✔✔ Pancreatic cancer
Rationale: Pancreatic cancer, the most typically presentation includes abdominal pain,
jaundice, and weight loss. Although weight loss and abdominal pain may be present
with adenocarcinoma it is unlikely to present with jaundice, and you're unlikely to have
abdominal pain or jaundice with any esophageal malignancy.
An adult female with rheumatoid arthritis presents to the office for a follow up. She is
currently taking methotrexate and over the counter Ibuprofen. Today she complains of
severe stomach pain and intense abdominal cramping. After the nurse practitioner
makes appropriate adjustments to the patient's medication regimen, the patient still
complains of abdominal discomfort and reports dark stools. The practitioner suspects: -
Correct Answer ✔✔ Gastric ulceration
Rationale: The overuse of NSAIDs such as ibuprofen (Advil) have caused the
prostaglandin inhibition-related thinning of the mucosal lining of the stomach, thereby
predisposing the patient to gastric ulceration and GI bleeding.
