GI/GU SYSTEM STUDY QUIZ

1. Problem of the GI system caused by HCl acid and pepsin eroding the GI mucosa is
1. Pyloric obstruction
2. Perforation
3. Ulcerative Colitis
4. PUD

2. Distended or swollen veins in the anorectal region are called?

3. Complications of Peptic Ulcer Disease include all of the following except

1. Hemorrhage
2. Perforation
3. Hemorrhoids
4. Pyloric obstruction

4. Bowel to skin fistulas, rectal fistulas, strictures, and bowel obstruction are complications of what disease?

5. TPN is given via a central line, which gets diluted quickly by the vascular system, then is dispersed quickly @ the superior vena cava.  It is given to pts with Inflamatory Bowel Disease for what main reason?

6. Following surgery for Ulcerative Colitis, what is the most important nursing intervention to prevent complications

1. Offer bedpan at frequent intervals
2. Take frequent coffee breaks and allow the pt to rest peacefully
3. Walk your pt around their room
4. Give pt an enema

7. H. Pylori is believed to be the main cause of what GI system disease?

8. Normal stomach emptying rate, normal to low secretions of gastric acid, and increased diffusion of gastric acid back into the stomach describe which form of PUD?

9. Which form of ulcer are NSAIDS a probable cause of?

10. What is the reason we do not feed pts after they have an Endoscopy procedure?

11. Tarry stools, coffee ground emesis, bright red bleeding can be symptoms of the main complication of Peptic Ulcer Disease which is _________________.

12. This complication of PUD is described by erosion of peptic ulcer thru the muscular wall, resulting in peritonitis, and it typically requires surgery to correct

1. vagotomy
2. perforation
3. pyloric obstruction
4. UTI

13. Dx studies for a UTI include all of the following except

1. Urine culture & sensitivity
2. Hemocult
3. Urinalysis
4. CT scan
5. IVP

14. Signs/symptoms for UTI include frequency & urgency of urination, dysuria, cloudy or foul-smelling urine, fever & chills, and low back pain.  Which intervention is helpful in killing the organism which causes UTI?
1. proper perineal hygiene
2. drinking cranberry juice
3. antibiotic therapy
4. increasing fluid intake

15. Bactrim and Macrodantin are antibiotics useful in tx of what infection?

16. Fever, bloody diarrhea, abdominal pain, and loss of appetite are symptoms of what GI problem?

17. An antibacterial drug which also has positive side effects which include anti-inflammatory properties, and is either given orally or via enema is __________________________.  This drug is given for Ulcerative Colitis after an acute exacerbation for how long-  _________.

18. Surgical removal of the colon, rectum, and sutured closure of the anus, where the ileum portion of the sm. Intestine is brought to the outer abdominal wall & a stoma is created describes which surgery?  

19. The surgery in #18 is performed for which GI disease?

20. Does the surgery in #18 cure the disease?

21. True or False, the surgery in #18 will ensure the resumption of formed stool and otherwise normal function.

22. Anticholinergenic meds, such as probanthine, (increases or decreases) gastric motility?  Circle One.

23. Name the 2 likely medications given IV for PAIN control in an acute exacerbation of Ulcerative Colitis?  ______________   ______________

24. Surgical intervention for Ulcerative Colitis which includes the introduction of a “coke” pouch (1-way valve) sutured onto the abdomen which is drained regularly by catheter & irrigated q 2-4 h for removal of mucous, in which the body adapts itself & eventually re-learns the sensation of needing to drain is called:

25. What is the major complication of the surgery in #24?

26. What is the most important aspect of preparation for a GI surgical procedure

1. regular exercise
2. cleaning out the bowel
3. discussing the possible outcomes of the procedure
4. making sure pt has a caregiver for post-op

27. Many pts suffering from Inflamatory Bowel Diseases must have surgical intervention to help them live a more normal life.  Many times, pts may only have 1-2 surgeries for resection of the bowels to prevent what syndrome?

28. What is the main problem with the syndrome in answer #27?

29. What is the probable lifelong outcome for the problem in #28?

30. Pts with Crohn’s Disease who are suffering an acute episode are put on an _______________ diet.  Describe this diet:

31. This form of ulcer is characterized by an increase in gastric acid secretion, normal diffusion of gastric acid back into the stomach, and increased rate of gastric emptying ________________.

32. The major symptom of Peptic ulcer disease is _________ and is described as gnawing, burning, or aching confined usually to a small area of the upper abdomen.

33. Where and when is pain normally felt for pts with a gastric ulcer?   

34. Same as #33, where and when is the pain normally felt for pts with a duodenal ulcer?

35. Which type of ulcer pain is usually relieved by eating?  Gastric or Duodenal

36. What is the initial drug of choice for treatment of PUD?

37. True or False.  Medications for PUD are generally more effective if taken before meals.

38. True or False.  Antacids systematic relief of PUD in addition to healing the ulcers.

39. Prevacid (lansoprazole), Protonix (pantoprazole), and Prilosec (omeprazole) are meds which suppress the enzyme system of gastric acid production and are in the classification of this type of medication: _____________  ________ ______________. 

40. The meds in #39 are generally used for what GI problems?

41. Name the 2 mucosal protective agents we have studied.

42. One of the mucosal protective agents mentioned above actually helps to heal ulcers & decrease pain caused by the ulcer by coating the ulcer and preventing irritation from pepsin & gastric acid.  Name it:

43. True or False.   The mucosal protective agent in #42 must be taken with food.

44. The role of diet intervention in tx of PUD is controversial.  This is because although a bland diet is started initially with 6 small meals each day, there is no proof that this intervention will facilitate healing.  True or False.

45. One of the most helpful interventions a pt can do to assist in prevention of PUD is

1. Go to Chili’s
2. Drink beer & smoke cigarettes
3. Keep a diary of what causes their gastric pain to occur
4. Poop often

46.  Zantac (ranitidine), Tagamet (cimetidine), Pepcid (famotidine), and Axid (nizatidine) are in the classification of medications called:  ______________  _____________ _______________.  These are used to treat what GI problem?  _________________

When are these medications normally to be taken?  ________________.

47.  Since the cause of PUD is believed to be by the bacterium H. Pylori, which medication is usually the 1^st treatment attempted?  ___________________

48. If the medication in #47 is ineffective, this med is given next _______________.

49. A Salem Sump is the NG tubing often used for decompression of the stomach for pts with a pyloric obstruction.  This clear tube has a blue port used for even air exchange.  If this port is used for insertion of a fluid into the stomach (even though it probably shouldn’t be), you could re-establish the port for air by doing this. 

1. Blowing 3 times into the port
2. Checking for placement
3. Sucking 20 cc of fluid out with syringe
4. Inserting 30 cc’s of air with syringe

50. True or False.  Hemorrhoids are internal only, and are caused by obesity, straining at stool, heredity and pregnancy.

51. True or False.  UTI’s can be caused by catheterization, which is why we’re taught to perform insertion of a Foley as a sterile procedure.

52. An upper UTI is called ___________________.

53. A lower UTI is called ___________________.

54. Ulcerative Colitis occurs most often in the stomach, and is caused by food allergies, heredity, and there’s an auto-immune link.  True or False.

55. Ulcerative Colitis is most commonly found in which of these individuals

1. Jewish women
2. African-american men
3. Obese men and women
4. Hispanics
5. Jen & Amanda, because they drink too many margaritas

56. A very probable cause of Inflamatory Bowel Diseases is ______________________ because when Prednisone is given, it tends to reduce the signs & symptoms.

57. Nutritional needs of Young Adults change.  Because the body is full sized, and skeletal growth is complete, the body now has a decreased need for

1. daily calorie intake
2. calcium phosphorus intake
3. protein intake
4. carbohydrate intake

58. Diagnostic test which requires cleaning out of the bowel with a gallon of laxative/e-lyte fluid, clear liquids 24-48 hrs before the test and NPO after midnight in order to look into the colon via scope include:

59. Diagnostic test which requires an enema, where dye is injected and a plug is inserted to hold it in so that the colon can be examined is:

60. What is the most important follow-up by a nurse after the test described in #59?

61. A chronic complication of Ulcerative Colitis includes _____________ ____________ which is when the colon becomes enlarged & poisoned because waste stays in there & ferments.

62. Long-term vitamin deficiency, another chronic complication found in Ulcerative Colitis, could cause a pt to suffer from ________________.

63. Long-term hypoxia can lead to this complication of Ulcerative Colitis and Crohn’s Disease.  ___________________________________

64. Hypovolemic shock is a severe complication of Ulcerative Colitis which is caused by

1. Tachycardia
2. Anemia
3. Dehydration
4. Bloody diarrhea

65. Cyclosporin is an _________________________ drug used in severe cases of Ulcerative Colitis and often in transplants, when pts are not responding to other meds.

66. 2-part surgical procedure for Ulcerative Colitis which starts with removal of the colon (colectomy), then a reveral of the ileostomy where a reservoir is created to collect stool, in which the disease is cured is called

1. Small Bowel Obstruction
2. Bowel Resection
3. Total colectomy with rectal mucosal stripping & ileoanal reservoir
4. Holy shit, this sounds painful!
5. Maybe we can try this on Shelia in the lab, she’s always up for a new challenge.

67. Having O blood type is most frequently found in this form of ulcer.  Gastric or Duodenal.

68. What is the mucosal protective agent which can be used for pts with ulcers who must continue taking NSAID meds?

69. What is diverticulitis?

1. infection obtained from diving into a swimming pool
2. outpouching of the swimtrunks of male divers
3. outpouching of the bikini top of female divers
4. outpouching of small areas of the mucosal lining of the colon which has become infected by feces

70. What type of diet do pts with diverticulitis eat & what is prohibited?

71.  I think 70 questions is plenty….don’t you?  YES  or  NO