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NRSG 421: GI Exam Questions With Verified Answers.

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NRSG 421: GI Exam Questions With Verified Answers. What are the six categories for acute abdominal pain? - answer- Inflammatory (bacterial or chemical cause) - Mechanical (ileus or obstruction) - Neoplastic (tumour obstructing nerves or vessels) - Vascular (clot or atherosclerosis - Congenital - Traumatic Acute pancreatitis can be divided into three categories. What are these categories? - answer- Mild acute pancreatitis - Moderately severe acute pancreatitis - Severe acute pancreatitis What is mild acute pancreatitis? - answerAbsence of organ failure and local or systemic complications What is moderately severe acute pancreatitis? - answerCharacterized by transient organ failure (resolves within 48 hours) and/or local or systemic complications without persistent organ failure What is severe acute pancreatitis? - answerPersistent organ failure that may involve one or multiple organs What are some causes of acute pancreatitis? - answer- Gallstones* - Alcohol - Infection (mumps, coxsackie B) - Pancreatic tumours ©SIRJOEL EXAM SOLUTIONS 10/10/2024 11:44 AM - Medications (azathioprine, thiazide, valproic acid) - Trauma - Idiopathic (tropical pancreatitis, CF) What are the two main causes for chronic pancreatitis? - answer- Alcoholism - Idiopathic What are some signs and symptoms of pancreatitis? - answer- Acute onset of persistent, severe epigastric abdominal pain (may be in upper right quadrant). Pain may vary depending on cause. Pain partially relieved by sitting up or bending forwards - Nausea and vomiting - Dyspnea due to diaphragmatic inflammation, secondary to pancreatitis - Foul smelling, foamy, grey coloured stools - Back pain What are some clinical findings that indicate pancreatitis? - answer- Upper epigastric abdominal pain on palpation - Abdominal distention and hypoactive bowel sounds (ileus from inflammation) - May have jaundice - Severe pancreatitis may have fever, tachypnea, hypoxemia and hypotension - Cullen's sign - Grey turner sign What is Cullen's sign? - answerBruising around umbilicus What is Grey Turner's sign? - answerBruising of the flanks How is pancreatitis diagnosed? - answerDiagnosis is made if 2 of the following 3 criteria are met: - Abdominal pain strongly suggestive of pancreatitis - Amylase and/or lipase levels at least three times higher than normal - Characteristic findings of pancreatic inflammation on either transabdominal CT or ultrasound ©SIRJOEL EXAM SOLUTIONS 10/10/2024 11:44 AM Why are NG suction and NPO status used as medical management for pancreatitis? - answerThese interventions suppress/reduce pancreatic enzyme secretions. This decrease in stimulation allows the pancreas to rest Why might antibiotics be used to medically manage pancreatitis? - answerAbx therapy can aid in the early phase of infection due to inflammation and necrotic pancreatic tissue being a good medium for bacteria growth. What are some surgical interventions that can be done to treat pancreatitis? - answer- Surgical drainage of retained necrotic fluid - If the acute pancreatitis is due to gallstones then urgent ERCP and endoscopic sphincterotomy is performed along with laparoscopic cholecystectomy in order to decrease the risk of recurrence. What medications can be used to manage acute pancreatitis? - answer- Mophine: relief of pain - Nitroglycerin: relaxation of smooth muscle and relief of pain - Antispasmodics: decrease vagal stimulation and pancreatic outflow - Carbonic anhydrase inhibitor: reduces amount of pancreatic secretions and concentration of bicarbonate - Antacids: neutralize gastric pH - H2 receptor antagonist: decreases HCl secretion which helps to reduce pancreatic activity What medications are used to manage chronic pancreatitis? - answer- Pancrelipase - Insulin - HCl What patient teaching should be provided for pancrelipase? - answer- Will be taking for life - Assess for pork allergy - Take drug before, during, or immediately after meals - Avoid crushing microspheres within capsules - Do not switch to a different brand without consulting your doctor Describe sepsis as a complication of pancreatitis - answerAbscess may form within the pancreas as a result of necrosis. There is subsequent risk of infection and perforation into the blood an adjacent organs

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NRSG 421
Module
NRSG 421

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©SIRJOEL EXAM SOLUTIONS
10/10/2024 11:44 AM



NRSG 421: GI Exam Questions With
Verified Answers.


What are the six categories for acute abdominal pain? - answer✔- Inflammatory (bacterial or
chemical cause)
- Mechanical (ileus or obstruction)
- Neoplastic (tumour obstructing nerves or vessels)
- Vascular (clot or atherosclerosis
- Congenital
- Traumatic

Acute pancreatitis can be divided into three categories. What are these categories? - answer✔-
Mild acute pancreatitis
- Moderately severe acute pancreatitis
- Severe acute pancreatitis

What is mild acute pancreatitis? - answer✔Absence of organ failure and local or systemic
complications

What is moderately severe acute pancreatitis? - answer✔Characterized by transient organ failure
(resolves within 48 hours) and/or local or systemic complications without persistent organ failure

What is severe acute pancreatitis? - answer✔Persistent organ failure that may involve one or
multiple organs

What are some causes of acute pancreatitis? - answer✔- Gallstones*
- Alcohol
- Infection (mumps, coxsackie B)
- Pancreatic tumours

, ©SIRJOEL EXAM SOLUTIONS
10/10/2024 11:44 AM


- Medications (azathioprine, thiazide, valproic acid)
- Trauma
- Idiopathic (tropical pancreatitis, CF)

What are the two main causes for chronic pancreatitis? - answer✔- Alcoholism
- Idiopathic

What are some signs and symptoms of pancreatitis? - answer✔- Acute onset of persistent, severe
epigastric abdominal pain (may be in upper right quadrant). Pain may vary depending on cause.
Pain partially relieved by sitting up or bending forwards
- Nausea and vomiting
- Dyspnea due to diaphragmatic inflammation, secondary to pancreatitis
- Foul smelling, foamy, grey coloured stools
- Back pain

What are some clinical findings that indicate pancreatitis? - answer✔- Upper epigastric
abdominal pain on palpation
- Abdominal distention and hypoactive bowel sounds (ileus from inflammation)
- May have jaundice
- Severe pancreatitis may have fever, tachypnea, hypoxemia and hypotension
- Cullen's sign
- Grey turner sign

What is Cullen's sign? - answer✔Bruising around umbilicus

What is Grey Turner's sign? - answer✔Bruising of the flanks

How is pancreatitis diagnosed? - answer✔Diagnosis is made if 2 of the following 3 criteria are
met:
- Abdominal pain strongly suggestive of pancreatitis
- Amylase and/or lipase levels at least three times higher than normal
- Characteristic findings of pancreatic inflammation on either transabdominal CT or ultrasound

, ©SIRJOEL EXAM SOLUTIONS
10/10/2024 11:44 AM


Why are NG suction and NPO status used as medical management for pancreatitis? -
answer✔These interventions suppress/reduce pancreatic enzyme secretions. This decrease in
stimulation allows the pancreas to rest

Why might antibiotics be used to medically manage pancreatitis? - answer✔Abx therapy can aid
in the early phase of infection due to inflammation and necrotic pancreatic tissue being a good
medium for bacteria growth.

What are some surgical interventions that can be done to treat pancreatitis? - answer✔- Surgical
drainage of retained necrotic fluid
- If the acute pancreatitis is due to gallstones then urgent ERCP and endoscopic sphincterotomy
is performed along with laparoscopic cholecystectomy in order to decrease the risk of recurrence.

What medications can be used to manage acute pancreatitis? - answer✔- Mophine: relief of pain
- Nitroglycerin: relaxation of smooth muscle and relief of pain
- Antispasmodics: decrease vagal stimulation and pancreatic outflow
- Carbonic anhydrase inhibitor: reduces amount of pancreatic secretions and concentration of
bicarbonate
- Antacids: neutralize gastric pH
- H2 receptor antagonist: decreases HCl secretion which helps to reduce pancreatic activity

What medications are used to manage chronic pancreatitis? - answer✔- Pancrelipase
- Insulin
- HCl

What patient teaching should be provided for pancrelipase? - answer✔- Will be taking for life
- Assess for pork allergy
- Take drug before, during, or immediately after meals
- Avoid crushing microspheres within capsules
- Do not switch to a different brand without consulting your doctor

Describe sepsis as a complication of pancreatitis - answer✔Abscess may form within the
pancreas as a result of necrosis. There is subsequent risk of infection and perforation into the
blood an adjacent organs

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NRSG 421

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