Med-surg: GI, perioperative & oncology worksheet with answers

Where should a diathermy return electrode (plate) be placed?

1. AOver a metal joint replacement
2. BOn clean, dry skin over a well-perfused muscle
3. COn skin covered with spirit-based prep that is still wet
4. DOver a bony area such as the hip bone

Why are rectal temperatures and suppositories avoided in a patient with neutropenia?

1. AThey interfere with the absorption of chemotherapy
2. BThey always give falsely low temperature readings
3. CThey make the patient's white cell count fall even further
4. DThey can damage the mucosa and let bacteria into the blood

Which fluid is usually used for initial burn resuscitation in adults?

1. AHartmann's (lactated Ringer's)
2. BSterile water for injection, given IV
3. C50% glucose solution IV
4. DOral fizzy cola drinks

Which drug class is commonly used to reduce acid after endoscopic treatment of a bleeding peptic ulcer?

1. ALoop diuretics
2. BProton pump inhibitors
3. CH1 antihistamines such as cetirizine
4. DBeta-blockers

What is a paralytic ileus?

1. ALoss of bowel movement without a physical blockage
2. BA twist in the large bowel cutting off its blood supply
3. CAn infection of the bowel wall with fever
4. DA blockage of the bowel lumen by a tumour

Why is a gastrostomy tube with an internal bumper usually advanced and rotated regularly once the tract has healed?

1. ATo remove any feed left in the stomach
2. BTo stop the inner bumper becoming buried in the stomach wall
3. CTo check that the patient is still hungry
4. DTo make the tube longer as the patient grows or gains weight

During bowel preparation, an older patient becomes dizzy and confused. Blood tests show sodium 127 mmol/L. What should the nurse do?

1. AGive the rest of the preparation more quickly
2. BRecord it and continue as planned, as this is expected
3. CStop the preparation and escalate to the medical team
4. DEncourage plain water only, as much as possible

A patient with bowel obstruction develops constant severe pain (no longer colicky), fever, a heart rate of 120/min and a rigid, tender abdomen. What does this suggest?

1. ANormal progress that only needs regular simple analgesia
2. BThe obstruction is resolving as the bowel starts to move
3. CStrangulation or perforation needing urgent surgical review
4. DConstipation that should be treated with a stimulant laxative