Deck 10: Abdominal Disorders

Question 1

Kefka Jones, 60 years old, has diabetes and is now having urinary tract symptoms.The nurse practitioner orders a glomerular filtration rate (GFR)from a urine sample.Which of the following would indicate a stage 1 chronic kidney disease (CKD)?
1)GFR greater than or equal to 120mL/min.
2)GFR greater than or equal to 90 mL/min with other symptoms.
3)GFR of 45 to 59 mL/min.
4)GFR less than 15 mL/min.

Answer 1

2

Question 2

Thom is 60 years old and has been treated for nonalcoholic fatty liver disease (NAFLD)for over 10 years.He still suffers from fatigue, abdominal pain, and an enlarged liver.The nurse practitioner discusses which of the following home-care plans to assist him in adjusting to his disease? Select all that apply.
1)Monitor weight and stay within optimal weight limits.
2)Avoid anti-lipid medications, such as atorvastatin.
3)Obtain a hepatitis A and B vaccine, if not immune.
4)May drink alcohol socially, but not daily.
5)If obese, set a goal for rapid weight loss.

Answer 2

1, 3

Question 3

Lucy is 65 years old and has been coping with irritable bowel syndrome-diarrhea (IBS-D)for over 10 years.She has tried various treatments with minimal effectiveness.She asks the nurse practitioner if there is anything else that might be helpful to control this diarrhea.The nurse practitioner suggests which of the following? Select any that apply.
1)Antispasmodics
2)Caffeinated beverages
3)Antidiarrheal medications
4)Eluxadoline,75 mcg, twice daily with food
5)Rifaximin

Answer 3

4, 5

Question 4

Jane Smith is a 70-year-old Caucasian woman who comes to see her nurse practitioner for pain in her abdomen.The nurse practitioner is aware that Mrs.Smith is obese and has diabetes.Which of the following is a definitive diagnostic test for cholecystitis?
1)A flat plate of the abdomen.
2)Complete blood count (CBC).
3)Lipase, amylase, and liver function tests.
4)Real-time ultrasonography of the gallbladder and biliary tree.

Question 5

Bill James, 67 years old, is being seen in the clinic for complaints of regurgitation, pyrosis, hoarseness, chronic cough, and atypical chest pain.The nurse practitioner suspects gastroesophageal reflux disease (GERD).As home-going instructions are developed, the nurse practitioner includes which of the following? Select any that apply.
1)Raise the head of the bed 2 inches.
2)Avoid tight, restrictive clothing.
3)Avoid smoking and ingestion of fatty foods.
4)Avoid eating a meal for at least 20 minutes before becoming recumbent.
5)Avoid caffeine and acidic foods.

Question 6

Jose Mirrare is a 65-year-old male who is being treated for cirrhosis of the liver.Which of the following does the nurse practitioner include in his discharge teaching? Select all that apply.
1)Eliminate all alcohol consumption.
2)Attend an alcohol treatment program.
3)Do not self-medicate with over-the-counter (OTC)medications, including herbal products.
4)Eat three large meals of a balanced diet containing 4 to 5 mg protein/kg body weight per day.
5)Be cautious when driving, as you have encephalopathy.

Question 7

Part of the abdominal examination the nurse practitioner will conduct is the assessment of skin color.As the nurse practitioner assesses the abdominal skin, the findings include which of these signs that are concerning?
1)Generalized pinkness.
2)Bluish discoloration on the flanks.
3)Yellow tint around the lower left quadrant.
4)Blue in the upper left quadrant.

Question 8

J.T.is a 69-year-old Caucasian male who presents with dysuria.During the examination, he asks the nurse practitioner if there is a chance he has cancer.The nurse practitioner tells him that before she can determine what is causing the problem she will need to perform a physical examination and order which of the following diagnostic tests?
1)Computed tomography (CT)scan of the abdomen and pelvis
2)IV pyelogram
3)Urine dipstick and cytology
4)Ultrasound

Question 9

Mrs.M.W.comes into the primary care office for her regular yearly checkup.The nurse practitioner begins the assessment by asking if there are concerns Mrs.M.W.has that need to be addressed.The patient says that she has been experiencing periodic episodes of abdominal cramps and diarrhea that just comes and goes.The nurse practitioner continues the assessment with which of the following?
1)Asking about the sequence of events and events that triggered each episode.
2)Conducting a complete neurological examination.
3)Collecting a urine specimen.
4)Evaluating abdominal pain.

Question 10

Dan is 70 years old and has been having frequent bouts of kidney stones.They are painful, and he has had one procedure done for nephrolithiasis.Dan asks the nurse practitioner if there is anything he can do to prevent these.He says his brother also has them, so he wonders if it is just familial.How does the nurse practitioner respond? Select all that apply.
1)Increase the amount of fluids you drink daily.
2)Avoid eating foods such as dairy, spinach, and nuts.
3)Some medications can contribute to stone formation.
4)Kidney stones are not familial.
5)Report signs of possible urinary tract infections to a physician for treatment.

Question 11

Mark is 60 years old.He reports a swelling in his right side, loss of weight, and a slight discoloration of his skin.The nurse practitioner conducts a history and physical examination and orders which of the following to rule out cancer of the liver? Select all that apply.
1)CBC to identify anemia.
2)Serum alkaline phosphatase, AST, ALT for liver damage.
3)Ultrasound to identify any enlargement.
4)Magnetic resonance imaging (MRI).
5)Radiology for lesions found in the liver.

Question 12

A patient who is an 80-year-old female comes to the emergency department with complaints of a low-grade fever and left lower quadrant pain aggravated by movement.She also reports that the pain is precipitated by eating and describes a colicky pain in the right side of the abdomen.Which diagnostic tests does the nurse practitioner order? Select all that apply.
1)A total body CT scan
2)Abdominal x-rays
3)CBC, amylase, lipase
4)Urinalysis
5)Sigmoidoscopy

Question 13

Mrs.M.W.asks the nurse practitioner what she is listening to in her belly and what it means.The nurse practitioner tells her that she is listening to determine:
1)That her bowels are moving properly.
2)If the blood vessels are not circulating blood.
3)Circulation and bowel function.
4)A diagnosis of her symptoms.

Question 14

Ms.Jenny is 80 years old and is diagnosed with Clostridium difficile-associated diarrhea (CDAD).As she discusses her condition with her nurse practitioner, she asks how she obtained this disease.The nurse practitioner tells her which of the following? Select all that apply.
1)It used to be hospital-acquired only disease, but now this infection is in the community.
2)Risk factors include antibiotic exposure, being an older adult, and church or synagogue exposure.
3)Inflammatory bowel disease and compromised immunity can lead to CDAD.
4)Lesser known risk factors include prior hospitalization within several months and a state of malnourishment of the body.
5)The source of CDAD is currently unknown.

Question 15

Mr.Person comes to the health-care clinic with a presenting symptom of not urinating as much as usual.The nurse practitioner assesses Mr.Person by asking which of the following?
1)How much do you drink per day?
2)Is your urine a clear yellow color?
3)Do you experience urgency and frequency of urination?
4)What medications have you taken recently or are you currently taking?