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NR 511 final exam|80 Questions And Answers 2024
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NR 511 final exam|80 QuestionsAnd Answers 2024
mesenteric infarction - -Patient presents with mid epigastric pain, LUQ
radiating to back, mild to very severe pain. Also has associated nausea and
vomiting diaphoresis, pain is worse with lying supine. Physical assessment
shows diminished bowel sounds and abdominal arteriogram.
-Urinary stones/kidney stones - -Patient presents with a colicky flank pain
progressing to constant and severe radiating to the groin in both lower
quadrant, patient has associated nausea vomiting fever chills and abdominal
distention. Costovertebral angle tenderness hematuria; do urinalysis IVP and
US
-intestinal perforation - -Patient presents with severe, parietal, diffuse pain;
has associated guarding, rebound tenderness, pain is relieved while lying
still. Physical exam shows decreased bowel sounds, guarding, rebound
tenderness; get abdominal x-ray
-intestinal obstruction - -Patient presents with colicky right lower quadrant
and left lower quadrant pain; has associated nausea vomiting, Anorexia,
obstipation; physical exam shows hyperactive high-pitched bowel sounds are
hypo active bowel sounds, get an abdominal x-ray
-Pancreatitis - -Patient presents with severe, visceral, diffuse pain. Has
associated hypotension tachycardia; pain is relieved by leaning forward.
Physical exam shows abdominal distention, diminished bowel sounds, diffuse
rebound tenderness; will have elevated amylase levels
-ectopic pregnancy - -Patient will present with persistent right lower
quadrant pain or left lower quadrant pain. May have vaginal bleeding.
Physical exam will show tender adnexal mass and will have a positive hCG
test.
-Dissection or Rupture of Aortic Aneurysm - -Patient will present with
ripping, tearing, intense pain in chest, abdomen, lower back. Will have
associated hypotension, feelings of doom, shock. Physical exam will show
shock, diminished femoral pulses; get x-ray and CT scan
-Peptic Ulcer Disease (PUD) - -Patient presents with annoying pain in
epigastric region radiating to the back, right shoulder, or side. Associated
nausea, hunger; worse with empty stomach, alcohol, NSAIDs, ASA; relieved
with food and antacids. Will have epigastric tenderness to palpation. Studies
done is endoscopy and barium swallow
, -gastroesophageal reflux disease (GERD) - -Patient will present with
epigastric, retrosternal pain. This pain will be intermittent. Patient may have
sour taste, low-grade bleeding, hoarseness, pharyngitis; worse with bending
at the waist, NSAIDs, ASA, alcohol, caffeine, recumbency; relieved with
antacids. Test are barium swallow, upper G.I., esophageal endoscopy with
biopsy
-gastritis - -Patient will present with epigastric pain that is constant. May
have associated nausea, vomiting, diarrhea, fever, hemorrhage; worse with
alcohol, NSAIDs, aspirin; is rarely worse with food
-salpingitis - -Patient will present with right lower quadrant and or left lower
quadrant pain. Pain will be worse around menstruation and when ascending
stairs. There will be cervical motion and adnexal tenderness
-irritable bowel syndrome (IBS) - -Patient will present with left lower
quadrant pain right lower quadrant pain the pain will be intermittent and
recurrent. Will have associated diarrhea, mucus in store; worse with stress
and eating; often relieved by defecation. There will be: tender to palpation;
small bowel follow through to rule out other causes
-Inflammatory bowel disease (Crohn's disease, ulcerative colitis) - -Patient
will present with pain in the right lower quadrant and left lower quadrant;
may have diarrhea, weight loss, rectal bleeding, tenesmus, fever; worse with
stress. Physical exam will show tenderness in the right lower quadrant left
lower quadrant; order CBC with differential small bowel follow through
(crohns) and a colonoscopy (UC)
-gastroenteritis - -This pain will be diffuse. May have associated nausea,
vomiting, diarrhea, fever, chills; worse with food; relieved with vomiting or
defecation. Physical exam will show hyperactive bowel sounds; stool ova and
parasites, stool culture
-Diverticulitis - -Patient will present with left lower quadrant intermittent
pain. May have associated constipation, diarrhea, fever. Physical assessment
Michelle left lower quadrant mass, mild tenderness in the left iliac fossa;
laparoscopy will diagnose; other labs are normal
-Cholecystitis/Cholelithiasis - -Patient will present with right upper quadrant
pain radiating to the infrascapular region, also mid at the gastric pain; starts
as visceral progressing to parietal. May have associated nausea, vomiting,
jaundice, dark urine, light colored stools, fever, chills; worse with high fat
foods, estrogen containing medication, cholestyramine. Order ultrasound,
CBC with differential, liver function test, amylase
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