Exam (elaborations)
2024 VERIFIED CHAMBERLAIN NR 511 MIDTERM EXAM WITH ANSWERS
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2024 VERIFIED CHAMBERLAIN NR 511 MIDTERM EXAM WITH ANSWERS
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2024 VERIFIED CHAMBERLAIN NR511 MIDTERM EXAM WITH
ANSWERS
Most common causes of N/V associated with gastritis - CORRECT-
ANSWERSAlcohol, NSAIDs, ASA, ABX, and illicit substances
What is one characteristic of Crohn's that differentiates it from UC related to
the bowel tissues themselves? - CORRECT-ANSWERSCrohn's affects the
tissue to a deeper level and can affect any or all layers of the bowel.
Acute Gastroenteritis (AGE) - CORRECT-ANSWERSmost common cause of
nausea and vomiting
What is the theory behind the etiology of IBD? - CORRECT-ANSWERSAn
initiating factor such as a virus, allergic, or bacterial process occurs and
inflames the intestine. Subsequently, those with a certain genetic
predisposition may produce antibodies that chronically attack the intestine
(autoimmune). Sometimes other relatives are found to also have IBD
demonstrating a genetic component.
Describe IBS as it pertains to its effect on the bowels... - CORRECT-
ANSWERSDisordered sensation or abnormal function of the small or large
intestine.
What is the most consistent characteristics of IBS? - CORRECT-
ANSWERSAlteration in bowel habits alternating. Abdominal pain is also
common. Painless diarrhea may occur.
What are the three most common areas of abdominal tenderness for patients
with suspected IBS? - CORRECT-ANSWERSLLQ, umbilicus, or epigastrium.
T or F: The physical exam for patients with suspected IBS is usually abnormal
- CORRECT-ANSWERSFalse: It's usually normal because there is no
anatomical abnormality behind this condition.
T or F: Digital rectal exams are usually normal in patients with suspected IBS
but may exacerbate symptoms. - CORRECT-ANSWERSTrue
,T or F: Extensive testing such as thyroid testing, abdominal imaging, and
stool studies are indicated in patients with suspected IBS - CORRECT-
ANSWERSFalse: Start with basic labs such as CBC and ESR, although
elevated ESR and leukocytosis is typically seen with IBD, not IBS.
T or F: Colonoscopy and barium enema are abnormal in a patient with
suspected IBS - CORRECT-ANSWERSFalse: Those tests would be normal
because there is no anatomical abnormality behind this condition.
What are 4 main points of diagnosis for patients with suspected IBS? -
CORRECT-ANSWERS1. Reveal an increase in bowel symptoms with the onset
of pain.
2. Relief of pain with defecation
3. Heightened sensation in bowel activity
4. Sense of incomplete defecation
T or F: Symptoms of IBS are accompanied by fever and/or bleeding. -
CORRECT-ANSWERSFalse
What is the first step to treating a newly diagnosed IBS patient? - CORRECT-
ANSWERSDetermine whether they are IBS-D, IBS-C, or IBS-M
What are the 4 main points of IBS treatment? - CORRECT-ANSWERS1. Diet
2. Education
3. Pharmacological therapy
4. Supportive interventions: i.e.reduce stress
T of F: There is proven treatment for IBS - CORRECT-ANSWERSFalse
At what severity are pharmacological measures taken in patients with IBS?
Mild, moderate, or severe? - CORRECT-ANSWERSModerate to severe
What is the first-line treatment for IBS-D? - CORRECT-ANSWERS1. High fiber
diet and hydration
2. Exercise
3. Bulking agents
T of F: Stimulant laxatives can be used as long as is needed to treat IBS-D
when first-line treatment fails. - CORRECT-ANSWERSFalse. Not for long-term
use.
What stimulant laxatives can be used for IBD-D on a short-term basis? And if
these fail? - CORRECT-ANSWERS1. Lactulose, magnesium hydroxide.
2. Linzess (linaclotide), Trulance (plecanatide), or Amitiza (lubiprostone)
,What medication can be used to help with abdominal pain/spasms due to
IBS? - CORRECT-ANSWERSAntispasmodics: Bentyl (dicyclomine) or Levisn
(hyoscyamine)
T of F: Patients with IBS and comorbid BPH or glaucoma, especially in the
elderly, should avoid anticholinergics to treat abdominal pain. - CORRECT-
ANSWERSTrue
T or F: Tricyclics antidepressants and SSRIs have shown to have favorable
outcomes in patients with IBS - CORRECT-ANSWERSTrue
T or F: APRNs should not be managing patients with IBS and should
immediately refer to a gastroenterologist - CORRECT-ANSWERSFalse. APRNs
can manage IBS with the conservative treatment. If these fail, they should
then be referred.
What symptoms are shared by ulcerative colitis (UC) and Crohn's under the
Inflammatory Bowel Disease umbrella? - CORRECT-ANSWERS1. Fever
2. Rectal bleeding
3. Leukocytosis
4. Cramping abdominal pain/diarrhea
T or F: Cross-sectional imaging and/or colonoscopy can usually detect signs
of IBD. - CORRECT-ANSWERSTrue
Crohn's Disease represents an abnormality in intestinal immune response.
What is the result of this abnormality with regard to the bowel tissue and
subsequent complications? - CORRECT-ANSWERS1. Causes fibrosis which
thickens the bowel wall
2. Narrows the lumen of the bowel leading to obstructions, fistulas, and
ulcerations.
T or F: Patients with Crohn's are at higher risk than the general population
for developing colon cancer. - CORRECT-ANSWERSTrue
What is the supposed etiology of ulcerative colitis (UC) and what tissue does
it affect? - CORRECT-ANSWERSAn inflammatory response of unknown origin
that occurs in the thinner mucosa of the rectum and sigmoid colon resulting
in tissue damage.
What type of tissue damage occurs ulcerative colitis (UC)? - CORRECT-
ANSWERS1. Ulcers form in the eroded tissue.
2. Abscesses form in the crypts which become necrotic and ulcerated.
, What happens to the mucosa in ulcerative colitis (UC)? - CORRECT-
ANSWERSIt becomes edematous and thickened, narrowing the lumen of the
colon.
T of F: There is a higher risk of perforation of the colon in patients with UC -
CORRECT-ANSWERSTrue
What are the most common presenting symptoms of Crohn's Disease? -
CORRECT-ANSWERS1. Abdominal cramping
2. Fever
3. Anorexia and weight loss
4. Flatulence
5. RLQ pain or mass
What are the possible components of the stool that show up in patients with
Crohn's? - CORRECT-ANSWERS1. Blood
2. Mucus
3. Pus
T of F: Periods of stress can exacerbate Crohn's symptoms - CORRECT-
ANSWERSTrue
T or F: Fatty, spicy, and dairy foods are well tolerated in patients with
Crohn's Disease - CORRECT-ANSWERSFalse, they are usually poorly
tolerated.
T of R: Crohn's is characterized by periods of acute exacerbation alternating
with complete remission. - CORRECT-ANSWERSTrue
What is history of antibiotic use important when a patient presents with
diarrhea? - CORRECT-ANSWERSBecause antibiotics disrupt the normal
balance of bacteria in the GI tract which in turn affects digestion.
What are the most common presenting symptoms of ulcerative colitis (UC)? -
CORRECT-ANSWERS1. Rectal bleeding
2. Abdominal cramping
3. Urge to defecate
What is characteristic of stool in patients with UC? - CORRECT-
ANSWERSWatery diarrhea with blood and mucus
T or F: Fecal leukocytes are almost always present in the presence of
ulcerative colitis. - CORRECT-ANSWERSTrue
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