Gastrointestinal and Hepatic Care Flashcards
7 cards from real CMSRN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Gastrointestinal and Hepatic Care flashcards as text
Which clinical manifestation most specifically differentiates hepatic encephalopathy from other causes of altered mental status?
Answer: Asterixis (liver flap tremor)
Asterixis, a flapping tremor of the outstretched hands, is the hallmark neurological sign of hepatic encephalopathy caused by ammonia's toxic effect on the brain.
A patient with liver cirrhosis develops ascites. The nurse understands the primary pathophysiology involves:
Answer: Decreased serum albumin and increased portal hypertension
Decreased albumin reduces plasma oncotic pressure while portal hypertension increases hydrostatic pressure, together forcing fluid from the vasculature into the peritoneal cavity.
Following a large-volume paracentesis, which finding requires the nurse's most immediate assessment?
Answer: Hypotension and tachycardia
Hypotension and tachycardia following paracentesis signal hypovolemia from rapid fluid shifts or hemorrhage, which requires immediate hemodynamic intervention.
A patient diagnosed with hepatitis B asks how the virus is transmitted. The nurse correctly responds that it spreads through:
Answer: Blood, sexual contact, and perinatal transmission
Hepatitis B is a bloodborne pathogen transmitted via blood and blood products, sexual contact with an infected person, and vertically from infected mother to newborn.
A patient with ulcerative colitis is in a severe flare. Which finding most indicates the need for emergency surgical intervention?
Answer: Toxic megacolon with high fever and massive abdominal distension
Toxic megacolon is a life-threatening complication requiring emergency colectomy to prevent bowel perforation, peritonitis, and sepsis.
Which dietary instruction is most essential for a patient newly diagnosed with celiac disease?
Answer: Eliminate all foods containing gluten
Celiac disease is an autoimmune condition triggered by gluten found in wheat, barley, and rye; complete and permanent dietary elimination is the only definitive treatment.
A patient is receiving total parenteral nutrition (TPN). Which nursing monitoring parameter is the highest priority?
Answer: Blood glucose monitoring every 4 to 6 hours
The high dextrose concentration in TPN frequently causes hyperglycemia, which must be detected early through regular glucose monitoring to prevent serious metabolic complications.