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NUR 631 ( LATEST 2024 / 2025 ) EXAM 2 | ACTUAL QUESTIONS AND ANSWERS 100% CORRECT

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NUR 631 Exam 2

1. What are examples of things that can cause visceral pain?
Answer
Intestine, biliary tree, liver disease

2. What are examples of things that can cause parietal pain?
Answer
Appendicitis, peritonitis

3. What are examples of things that can cause referred pain?
Answer
Cholecystitis

4. What are examples of things that can cause colicky pain?
Answer
Renal stones

5. What is the order in which you should perform an abdominal physical exam?

Answer
1. inspection

2. auscultation
3. percussion
4. palpation

6. What diagnosis would you consider for a 30 year old with heart burn, early satiety, burping
and generalized abdominal pain?

Answer
Dyspepsia related to gastritis

7. What diagnosis would you consider for a 50YEAR OLD SMOKER with heart burn and
abdominal pain?

,Answer
Colon cancer

8. How high is the bilirubin level when the patient is starting to develop physical jaundice?
Answer
2.5 or higher

9. bilirubin is unconjugated, which means that it has not been metabolized
by the liver or made into a water soluble form of bilirubin

Answer
Indirect bilirubin

10. is processed bilirubin that is water soluble

Answer
Direct biliru- bin

11. What are some of the causes of elevated indirect bilirubin levels?

Answer
- hemol- ysis

- heart failure
- Gilbert syndrome
- neonates
- hyperthyroidism
- chronic hepatitis & advanced liver cirrhosis

12. What are some of the causes of elevated direct bilirubin levels?
Answer
- choledo- cholithiasis

- tumors
- AIDS
- acute/chronic pancreatitis
- viral hepatitis
- alcoholic hepaitits
- biliary tree cholangitis
- sepsis

,- TPN

- postoperative cholestasis
- sickle cell disease
- pregnancy
- end stage liver disease

13. What does a history of fever, chills and RUQ pain indicate?
Answer
Acute cholan- gitis

14. What does RUQ pain with a history of anorexia, malaise and myalgias indicate?
Answer
Viral hepatitis

15. What is the terminology for when the gallbladder is so distended that you can palpate it?
Answer
Courvoiser Sign

16. What is the terminology for inspiratory arrest that occurs when you are putting pressure on
the RUQ due to inflammed gallbladder?

Answer
Murphey's Sign

17. Which liver enzyme is specific for hepatocytes?
Answer
ALT

18. Which liver enzyme is more specific to alcohol, statins and tylenol use?
Answer
-

AST

19. If the ratio of AST to ALT is 2 to 1, what does this indicate?

, Answer
Liver damage due to alcohol, statins or tylenol

20. If the ratio of ALT is twice as high as AST, what does this indicate?
Answer
Viral hepatitis

21. What is the normal range for ALT and AST?
Answer
30-40

22. What does an elevated ALT, AST and Alk Phos indicate?
Answer
Gallbladder ob- struction

23. What are the signs and symptoms in a patient that has MILD melena?
Answer
-

Resting tachycardia

24. What are the signs and symptoms in a patient that has melena with a blood volume loss of at
least 15%?

Answer
Orthostatic hypotension

25. What are the signs and symptoms of a patient that has melena with a blood volume loss of at
least 40%?

Answer
Supine hypotension + abdominal pain

26. What type of anemia would someone with melena have?
Answer
Iron deficiency anemia

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