Download Quiz 5 - GI, Cancer

1. Functional dysphagia is caused by:
a. Lower esophageal sphincter dysfunction
b. Tumors arising from inside the esophagus
c. Tumors arising from outside the esophagus
d. Neurological dysfunction
2. Your patient tells you that he has heartburn every day, but that he just ignores it most of the time. You tell
him:
a. As long as he can tolerate the symptoms, heartburn requires no treatment
b. Untreated heartburn can lead to esophageal cancer
c. Untreated heartburn can lead to duodenal ulcers
d. Esophageal varices
3. Your patient tells you that his voice has been hoarse and he has been getting sinusitis a lot lately. You know
that possible causes of his symptoms include: (Check all that apply)
a. Infectious processes
b. Allergies
c. Gastroesophageal reflux disease
d. Excessive prednisone use
4. The major causes of Peptic Ulcer Disease is (check all that apply)
a. NSAIDS
b. H. Pylori
c. ETOH
d. Stress at work
5. The "stress" in stress induce ulcers refers to
a. Nursing students studying for this exam
b. Driving home in West Palm Beach traffic
c. Worrying about the war on terror
d. Conditions that cause gastric ischemia
6. Choose the two medications below that reduce gastric acid secretions either directly or indirectly.
a. Ranitidine (Zantac)
b. Lansoprazole (Prevacid)
c. Magnesium Hydroxide (Milk of Magnesia)
d. Sucralfate (Carafate)
7. Sucralfate (Carafate) works by:
a. Inhibiting gastric acid production
b. Inhibiting gastric acid secretion
c. Forming a protective gel
d. Neutralizing existing gastric acid
8. Calcium carbonate (check all that apply)
a. Is a potent antacid
b. Can cause constipation
c. Can cause rebound acid secretion
d. Is often used as a supplement to dietary calcium
e. Causes hypocalcemia
9. The two main nursing considerations when administering laxative salts such as magnesium citrate are:
a. Monitor heart rate
b. Check renal function
c. Maintain adequate hydration
d. Monitor for s/s of bleeding
10. Complications of diarrhea include (check all that apply)
a. Electrolyte imbalance
b. Dehydration
c. Hemorrhoids
d. death
e. pseudomembranous colitis
11. Patients who have had prolonged diarrhea should have (check all that apply)
a. A recent medication history
b. Stool Cultures
c. Travel history
d. Basic metabolic panel
e. Blood Cultures
f. Quarantine
12. The two major differences between Ulcerative Colitis and Crohn's Disease are:
a. Crohn's disease can occur anywhere in the GI tract
b. Ulcerative colitis usually affects younger patients
c. Ulcerative colitis has no genetic component
d. Crohn's disease usually affects younger patients
13. How do laxatives cause "constipation"
a. They cause a rebound slowing of the intestine
b. It takes 1-3 days for food to go through the GI tract after a complete bowel purge
c. They do not cause constipation at all
d. They cause addiction
14. The most common surfactant laxative is
a. Magnesium Citrate
b. Bisacodyl
c. Castor oil
d. Docusate sodium
15. Osmotic laxatives work by
a. Drawing water into the intestines
b. Stimulating the bowels to move faster
c. Allowing water to penetrate the stool more quickly
d. Holding onto water by forming a gel
16. The main use of lactulose is:
a. As a gentle laxative
b. To remove ammonia from the blood in liver failure
c. To remove uric acid from the blood in kidney failure
d. As a diuretic
17. The main difference between treatment of diverticulosis and diverticulitis is
a. Use of antibiotics
b. High fiber diet
c. Avoid nuts
18. Lomotil is:
a. Not a controlled substance
b. Extremely addicting
c. Not likely to be abused due to the side effects from atropine
d. Not very effective
19. Loperamide (Imodium)
a. Is essentially mperidine (Demerol) that cannot be absorbed through the intestinal wall.
b. Is very addicting
c. Does not cause constipation
d. Is not available over the counter
20. Irritable Bowel Syndrome
a. Is always constipation and only happens in women
b. Is always diarrhea and only happens in men
c. Can be either constipation or diarrhea and can occur in both men and women
21. The key consideration when giving an antiemetic is:
a. Do not give the antiemetic until the patient asks for it.
b. Do not give the antiemetic until the patient starts vomiting
c. It is easier to prevent vomiting than stop vomiting, so give the antiemetic early
22. Zofran works by
a. Modifying dopamine receptors
b. Modifying serotonin receptors
c. Stimulating peristalsis
d. Causing suppression of inflammation
23. Dronabinol (Marinol) is (check all that apply):
a. Used as an antiemetic
b. Used as an appetite stimulant
c. Not addictive
d. Can cause temporal dissociation
e. Can cause depersonalization
24. The relationship between Sulfasalazine and Mesalamine is:
a. They are the same drug
b. Mesalamine is the active metabolite of Sulfasalazine
c. Sulfasalazine has fewer side effects
d. There is no relationship between the drugs
25. The factor that prevents portal hypertension from resolving after formation of collateral veins is:
a. Venous blockage
b. Fibrosis of the liver
c. Dilation of Splanchnic arteries
d. Decreased plasma oncotic pressure
26. Which of the following are examples of collateral circulation formed as a result of portal hypertension
(check all that apply):
a. Caput Medusa
b. Esophageal varices
c. Hemorrhoids
d. Varicose veins of the legs
27. A patient with ascites will usually have:
a. Low PT/INR
b. High blood pressure
c. Normal albumin
d. Lower extremity edema
28. The number one cause of liver cancer in the United States is:
a. Alcohol use
b. Hepatitis A
c. Statin medications
d. Hepatitis C
29. When performing paracentesis the patient may become hypotensive because:
a. His vasculature was hypovolemic, but the weight of the ascites helped compress the vessels
b. As the ascites is drained, new ascites fluid is robbing the vasculature of volume
c. Patients actually beome hypertensive
30. Hepatitis A is primarily transmitted by:
a. Sexual transmission
b. Fecal-oral transmission
c. Blood contact
31. Hepatitis B is primarily transmitted by:
a. Sexual transmission
b. Fecal-oral transmission
c. Blood contact
32. Hepatitis C is primarily transmitted by:
a. Sexual transmission
b. Fecal-oral transmission
c. Blood contact
33. Cholelithiasis
a. Is treated with high fat meals
b. Rarely requires surgical intervention
c. Can cause pancreatitis if severe enough
34. Pancreatitis is particularly painful because:
a. Fat digestion is impaired
b. The common bile duct is blocked
c. The pancreas begins to digest itself
35. Cyclosporine works by:
a. Preventing proliferation of T cells
b. Killing B cells
c. Preventing Hematopoiesis
d. Suppressing inflammation
36. Your patient is two days s/p liver transplant. His temperature is 100.2. He is likely to receive:
a. Nothing
b. Tylenol
c. Antibiotics
d. Methylprednisolone (Solu-Medrol) 1000mg IV
37. The adult form of rickets is called
a. Paget's disease
b. Rickets
c. Scurvy
d. Osteomalacia
e. Osteopenia
38. Osteoporosis is defined as:
a. A hip or vertebral fracture
b. Bone loss of 10% (1 SD)
c. Bone loss of 25% (2.5 SD)
d. Bone loss of 50% (5 SD)
39. True ulcers
a. Do not penetrate the muscularis
b. Do not bleed
c. Can cause bleeding and are a major source of iron deficiency anemia
d. Do not hurt
40. Your patient is NPO. Which of the following drugs is most likely to be prescribed for his GERD
a. Pantoprazole (Protonix)
b. Omeprazole (Prilosec)
c. Esomeprazole (Nexium)
d. Rabeprazole (Aciphex)
41. The absolute best treatment for osteoporosis is
a. High Calcium intake between the ages of 18 and 35.
b. High Calcium intake after diagnosis
c. Estrogen
d. Alendronate (Fosamax)
42. The calcium salt that is best absorbed orally is:
a. Calcium carbonate
b. Calcium gluconate
c. Calcium citrate
d. Calcium hydroxide
43. Raloxefine (Evista) works by
a. Becoming absorbed into bone and preventing bone loss
b. Stimulating estrogen receptors in bone
c. Mimicking Calcitonin
d. Mimicking Parathyroid hormone
44. The main consideration when taking a Calcium supplement is
a. The time of day
b. It must be taken on an empty stomach
c. The amount of elemental calcium in the supplement
d. Whether the patient has heart burn
45. Which of the following is a common cause of chronic pancreatitis?
a. Gall stones
b. Trauma
c. Steroids
d. Alcohol
1. Patient C is a 72-year-old white male recovering from a colectomy and ostomy creation secondary to colon
cancer. He is on Heparin 5000 units SC BID. He is two days post op and complains of increasing fatigue with
ambulation. His temperature is 100.3 degrees Fahrenheit. The physician is considering putting the patient on
antibiotics.
Electrolytes
Na: 132 mEq/L
BUN 15 mg/dl
Ca 9.2 mg/dl
Gluc 98 mg/dl
Cl: 88 mEq/L
K: 4.6 mEq/L
Creat. 1.1 mg/dl CO2 24 mmol/L
Mag 2.0 MEq/L Phos 3.4 mg/dl
Albumin 4.4 g/dl
Complete Blood Count
RBC 3.5 mill/mm3
Hgb 9 g/dl
MCV 72 fl
MCH 24 pg
Retic 0.7%
Total Bili. 0.1 mg/dl
Polys 78%
Lymphs 14%
Bands 2%
Monos 2%
Eos 3%
Basos 1%
Hct 33%
MCHC 28%
WBC 21,000/mm3
Platelets 175,000/mm3
Which of the following does not indicate that Patient C has an infection?
a. WBC
b. Polys
c. Temperature
d. RBCs
2. Patient C has:
a. Leukocytosis with shift to the right
b. Leukocytosis with shift to the left
c. Lymphocytosis with shift to the right
d. Lymphocytosis with shift to the left
3. The physician orders vancomycin IV. What action should the nurse take before administering the
vancomycin?
a. Check to see if the patient has an indication for vancomycin
b. Recommend that the physician order vancomycin PO instead.
c. Check to make sure the right dose has been ordered.
d. Call the pharmacy with the patient's correct weight.
4. Patient C has purulent drainage from his surgical wound. Before administering the first dose of antibiotics,
you should:
a. Check the white blood cell count
b. Make sure the patient has voided.
c. Take the patient's temperature
d. Obtain a culture of the drainage.
5. What is patient C's ANC is (no units, no comma)
Answer: ______________________
6. Patient C's electrolyte imbalance is most likely due to:
a. Vomiting
b. Colon resection
c. Diuretics
d. Inadequate sodium intake
7. To replace Patient C's sodium, he is most likely to have:
a. 0.9% NaCl IV Solution
b. 3% NaCl IV Solution
c. 0.45% NaCl IV Solution
d. Oral NaCl
8. Patient C has
a. Normocytic-normochromic anemia
b. Microcytic-hypochromic anemia
c. Macrocytic-hypochromic anemia
d. Normocytic-hyperchromic anemia
9. The most likely cause of Patient C's anemia is:
a. Inadequate iron intake
b. Gastrointestinal bleeding from medications
c. Gastrointestinal bleeding from colon cancer
d. Inadequate B12 intake
e. Inadequate Folic acid intake
10. If Patient C undergoes chemotherapy his anemia will most likely:
a. Stay the same
b. Become iron deficiency anemia
c. Become anemia of chronic disease
d. Become aplastic anemia
11. Because of his medications, Patient C needs to have:
a. Careful regulation of PTT levels
b. Regular PT/INR monitoring
c. Neither PT/INR nor PTT levels monitored
d. Both PT/INR and PTT levels monitored
12. The physician orders Percocet (oxycodone/acetaminophen) 5/325 mg PO Q 6 hours for patient C. Due to
his colectomy he is:
a. More at risk for constipation
b. Less at risk for constipation
c. More at risk for euphoria
d. More at risk for physical dependence.
13. Which of the following viruses have been shown to cause cancer in humans? (Choose all that apply)
a. Hepatitis C
b. HIV
c. HPV
d. Herpes-Zoster
14. The strongest evidence for the role of the immune system in preventing the establishment of malignant
tumors (immune surveillance) is:
a. Paucity of tumors in the very young
b. Increased incidence of tumors in the aged
c. Increased incidence of malignancies in persons who are immunosuppressed
d. Hereditary pattern of malignancies
15. Which of the following examples would result in disuse atrophy?
a. Decreased endocrine stimulation of the thyroid gland
b. Leg in cast for several weeks
c. Acute lack of blood flow to a body part
d. The normal process of aging
16. An example of pathologic hypertrophy is:
a. The bulging muscles of a weight lifter
b. The thickened skin developed because of mechanical stimuli
c. The breast during lactation
d. The thickened myocardium of the left ventricle in hypertension
17. A person's skin cells multiply to form a callus in response to irritative stimuli. This is an example of:
a. Metaplasia
b. Hyperplasia
c. Hypertrophy
d. Dysplasia
18. Differentiation of a type of normal cell not ordinarily found in a particular body area is called:
a. Metaplasia
b. Hyperplasia
c. Dysplasia
d. Atrophy
19. All of the following are characteristic of dysplasia except:
a. It is potentially reversible
b. It serves a specific adaptive purpose
c. It is associated with areas of inflammation
d. There is variation in the size, shape, or appearance of cells
20. The primary difference between benign and malignant neoplasms is:
a. ability to invade neighboring tissue
b. Rate of cell death
c. Body part of origin
d. Requirements for cellular nutrition
21. A characteristic of malignant tumors is their ability to:
a. Be cohesive and grow slowly
b. Metastasize and invade
c. Irregularly expand and remain local
d. Encapsulate and metastasize
22. What term describes malignant cells that are poorly differentiated and lack resemblance to the normal
resident tissue cells?
a. Metaplasia
b. Anaplasia
c. Dysplasia
d. Hyperplasia
23. The two parts of the cell analyzed in exfoliative cytology examinations are the:
a. Nucleus and cytoplasm
b. Cell membrane and cytoplasm
c. DNA and RNA
d. Mitochondria and nucleus
24. The genes that malfunction in cancer normally:
a. Control RNA transcription
b. Are responsible for sex determination
c. Are not present in most body cells unless inserted by a virus
d. Regulate cell division
25. All your cells contain protooncogenes, which can change into cancer causing genes. Why do cells possess
such potential time bombs?
a. Viruses infect cells with protooncogenes.
b. Protooncogenes are unavoidable environmental carcinogens.
c. Cells produce protooncogenes as a byproduct of mitosis.
d. Protooncogenes are necessary for normal control of cell division.
e. Protooncogenes are genetic junk--most likely the product of evolution.
26. The structure that forms an end cap on chromosomes, shortens with each cell replication, and eventually
triggers cellular senescence (except in cancer and germ cells) is called a:
a. Centromere
b. Telomere
c. Nucleosome
d. Histone
27. The final confirmation of a neoplasm is achieved with:
a. Presence of a tumor marker
b. Palpation of a mass
c. The client's presenting symptoms
d. Microscopic examination of the tissue
28. The largest environmental factor in Florida affecting cancer risk is:
a. Nuclear radiation
b. Ultraviolet radiation
c. Pollution
d. Asbestos
29. Multiple Myeloma is cancer of the
a. Muscle cells
b. B cells
c. Bone cells
d. Plasma cells
30. Patients with multiple myeloma are expected to have
a. Elevated epinephrine levels
b. Elevated thyroid hormone level
c. Alpha Feto-protein
d. Elevated immunoglobulins
31. The most common leukemia in children is
a. ALL
b. AML
c. CLL
d. CML
32. Cancer patients become cachectic from (Choose all that apply)
a. Loss of appetite
b. Medical marijuana
c. Chronic Pain
d. Increased metabolic demand