nclex review questions: gi disorders

July 19, 2009 at 8:46 am | Posted in Uncategorized | Leave a comment

Part of my nursing program is to answer, at 80% competency, a certain number of NCLEX questions . Part of this blog’s purpose is to be instructive, not only for myself, but anyone who happens upon it. Here are my notes from my most recent NCLEX question study session.

I’ve been working pretty intently for about a week on gastrointestinal (GI) disorders, and finally reached my goal of achieving 80% competency in that particular set. Here are my notes I developed as I worked on the questions:

  • Propantheline Bromide (trade name: Pro-Banthine, comes in tablet form) — considered a GI anticholinergic, which decreases the activity of the central and peripheral nervous system by blocking the neurotransmitter acetylcholine. It decreases GI motility and spasticity, including contractions of the bile duct and gallbladder; also decreases the production of gastric secretions. Should be taken 30 minutes before meals to decrease the motility and at bedtime. Contraindications include most forms of GI obstruction.
  • Chronic pancreatitic diet — eat foods that inhibit action of the pancreas. Maintain high fiber, low fat diet, avoiding caffeine and gas-forming foods. Eat a high number of carbohydrates, which are easily metabolized, and avoid large meals.
  • Cullen’s sign — is a bruising of the umbilical area that may predict an acute pancreatitic attack. Primarily indicative of intraperitoneal hemorrhage, whether from blunt trauma, ectopic pregnancy rupture, or an AAA.
  • In an adult, average-sized patient, enemas should be inserted 3-4 inches.
  • A Mallory-Weiss tear is a tear in the junction of the stomach and esophagus, usually caused by severe retching, vomiting, or coughing. Indications my be bloody sputum or vomit. For most patients, it clears up on its own though may require endoscopy to confirm if the problem continues, as it may lead to active upper GI bleeding and associated side effects of blood loss.
  • Two primary side effects of gentamycin are ototoxicity (hearing) and nephrotoxicity (kidneys), so hearing tests, as well as urinary output and BUN/Creatinine, should be used to assess for side effects.
    Other drugs that cause ototoxicity: antibiotics (aminoglycosides like Vancomycin), chemotherapeutic agents that contain platinum (like cisplatin), diuretics (like ethacrynic acid or furosemide), quinine, and salicylates
    Other drugs that cause nephrotoxicity: acetominophen (especially in high doses for acute toxicity), acyclovir, aminoglycosides, amphotericin B, ciprofloxacin, cisplatin, methotrexate (in high doses), NSAIDs, rifampicin, sulfonamides, tetracyclines (except for doxycycline and minocycline), vancomycine
  • Five rights of delegation: right task, right circumstance, right person, right circumstance/direction, and right supervision/evaluation (for a complete description of these, click here)
  • Norwalk Virus, or norovirus, is a virus transmitted via fecal matter that causes approximately 90% of gastroenteritis in the world, and estimated 50% of cases of gastroenteritis in the U.S. Outbreaks require enteric precautions, including the use of gloves when handling patients. It is highly susceptible to chlorine-based disinfectants.
  • For hepatic function, you should assess for behavioral changes, alterations in LOC, disorientation, irritability, and drowsiness for decreasing function. Liver function tests should be drawn, as well as serum ammonia levels.
  • Aphthous stomatitis, or an aphthous ulcer, is little more than a canker sore. There is a long list of possible causes, including minor traumas like brushing teeth, or other causes like Celiac disease, stress, fatigue, some drugs, and the consumption of citrus foods. Recurrent stomatitis needs to be ruled out from other similar oral disorders like herpes.
  • “Standard” drip factor is 15gtt/ml, though there are tubing sets that deliver as low as 10gtt/min and as high as 60gtt/ml. That was a really stupid mistake, on my part.

I think that’s all I can type up and still retain some of the information. I’ll come back to it in a few days to absorb more.

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