NURS 623 EXAM 3 LATEST EXAM | ALL
QUESTIONS AND CORRECT ANSWERS
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ANSWERS | JUST RELEASED |
MARYVILLE UNIVERSITY
Describe the clinical presentation for Gastroesophageal Reflux Disease
(GERD)? ------CORRECT ANSWER---------------heartburn, regurgitation,
water brash (reflex salivation), sour taste in morning, belching, coughing,
and hoarseness. Objective: only sign may be occult blood in stool.
How is GERD diagnosed (when to refer to GI)? ------CORRECT ANSWER--
-------------With symptoms, sometimes with upper endo; refer if failed
treatment of step 2- after 6 weeks of treatment
Discuss the patient education regarding lifestyle changes for management
of GERD. ------CORRECT ANSWER---------------lifestyle changes including
diet
weight loss, raising the head of their bed 6-8 inches, avoid nicotine
products avoid recumbency or sleeping for 3 to 4 hours after a meal, avoid
bedtime snacks, avoid fatty and late meals, foods such as chocolate,
alcohol, peppermint, caffeine, onions, garlic, citrus, and tomatoes, wearing
loose comfortable clothing, and starting a routine exercise and weight loss
program
Describe medical management of GERD? ------CORRECT ANSWER--------
-------step-up: LIFESTYLE changes, PRN OTC H2ra and antacid; PPI;
referral
,Step-down: starts with PPI then step down until Sx under control
46 year old male complains of dysphasia hoarseness and cough he states
he wakes up with a sour taste in his mouth. What is the most likely cause of
the patient symptoms? ------CORRECT ANSWER---------------GERD
Managment of peptic/gastric ulcer ------CORRECT ANSWER---------------
*relieve pain, heal the ulcer, and prevent complications/reoccurrence
*PHARMACOLOGICAL therapy is the foundation of management (H2Ra,
PPI, antacids, antibx w/H-pylori)
Describe the diagnosis criteria IBS ------CORRECT ANSWER---------------3
Criteria:
1. pain relieved by defacation or change in BMs for 3 months
2. BM with patterns of constipation/diarrhea 25% of the time
3. 2 features of either: altered frequency, form, sensory act of defecation or
varied bloating and pain
What are the risk factors are associated with Cholelithiasis? ------
CORRECT ANSWER---------------female gender
obesity
pregnancy
increased age
drug induced (oral contraceptives, clofibrates)
cystic fibrosis
rapid weight loss, spinal cord injury
ileal disease with extensive resection
diabetes mellitus
sickle cell anemia
,Cirrhosis
Biliary issues
What is the clinical presentation of cholecystitis? ------CORRECT
ANSWER---------------colicky type pain
Indigestion
N/V (after high-fat meals)
Pain localized to RUQ
referred pain to back & RT shoulder
What laboratory findings would you expect to see with acute cholecystitis? -
-----CORRECT ANSWER---------------Elevated Alkaline Phosphatase &
Bilirubin
45 year old obese woman with severe pain in tenderness in the right upper
quadrant accompanied by nausea and vomiting and fever there is a
positive Murphy sign what is the most likely diagnosis? ------CORRECT
ANSWER---------------Cholecystitis
What elevated laboratory test is considered the gold standard for diagnosis
of non-alcoholic pancreatitis? ------CORRECT ANSWER---------------Serum
amylase, concurrent with Lipase
What is the clinical presentation of chronic pancreatitis? ------CORRECT
ANSWER---------------LUQ can radiate to lumbar area
weight loss
diarrhea
N/V
dyspepsia
, PE findings with pancreatitis? ------CORRECT ANSWER---------------
epigastric tenderness with no rebounding tenderness, may feel
pseudeocyst/mass mild jaundice.
What are the recommendations/guidelines for colon cancer screenings for
average risk? ------CORRECT ANSWER---------------Average Risk: 50-75 or
African American 45+
fecal occult blood every 1 yr
flex sig every 5 yrs
Colonoscopy every 10 years
What are the recommendations/guidelines for colon cancer screenings for
high risk? ------CORRECT ANSWER---------------fecal occult blood every 1
yr
At 40 y/o Barium enema or colonoscopy every 3-5 yrs
What is the clinical presentation of diverticular disease? ------CORRECT
ANSWER---------------*LLQ pain (worse after eating) relieved with passing
stool or gas
*colonic distention
*W/itis: anorexia, vomiting, chills, tachycardic
more common in elderly
How would you manage a patient with an incidental finding of
uncomplicated diverticular disease? ------CORRECT ANSWER---------------
Requires no further intervention and can be managed with a high-fiber diet
or a daily fiber supplementation with psyllium
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