Gastrointestinal System

1. A 34-year-old patient named Laurent, with a history of seasonal allergies, arrives at the emergency department complaining of abdominal pain that has progressively worsened over the past 12 hours. He states that the pain started near his navel but has since moved to the lower right side of his abdomen. Laurent is experiencing nausea and has had a slight fever since this morning. Upon examination, the LPN notes that Laurent is guarding his abdomen and appears to be in discomfort. His vital signs are as follows: temperature 38.2°C, pulse 104 bpm, respiration 24 bpm, and BP 122/84. Laurent mentions that the pain intensifies when he tries to walk or cough. Which of the following clinical manifestations best relates to the LPN’s concerns? *
2. Marie-Laure Tremblay, a 25-year-old client, underwent a laparoscopic appendectomy last night due to acute appendicitis. This morning, during your assessment, you note that her wound appears dry, and she reports she has been able to drink fluids without difficulty. She complains of mild to moderate pain around her incision site, which she rates as 4 out of 10 on the pain scale. However, you also note that Marie-Laure’s temperature is 38.5°C. Which assessment finding should concern you? *
3. Étienne Laflamme, a 52-year-old client, presents to the clinic with persistent abdominal discomfort and reports a long-standing history of gastrointestinal issues. He explains that he has recently experienced a sharp, gnawing pain in his upper abdomen, particularly after meals, and notes that the discomfort often comes about 30 to 60 minutes after he eats. Étienne also reports feeling bloated and sometimes nauseated, but he has not experienced significant weight loss. He mentions that he occasionally takes antacids, which provide some relief. During the assessment, the nurse considers the possibility of a gastric ulcer based on Étienne's symptoms. Which assessment data support the nurse’s suspicion of a gastric ulcer in Étienne? *
4. A client is admitted to the hospital after vomiting bright red blood and is diagnosed with a bleeding duodenal ulcer. The client develops a sudden, sharp pain in the midepigastric region along with a rigid, boardlike abdomen. These clinical manifestations most likely indicate which of the following? *
5. Mr. Létourneau, 47, arrives at the emergency room with sudden severe upper abdominal pain that began after a heavy meal with alcohol. He has a history of chronic alcohol use and reports nausea and multiple episodes of vomiting. On assessment, he is sitting forward, stating that this position “helps a little.” His abdomen is tender in the epigastric area. His skin appears slightly jaundiced, and the nurse notes abdominal guarding. Which clinical manifestation is most associated with the suspected condition? *
6. Ms. Bérubé, 59, presents with right upper quadrant abdominal pain following a fatty meal. She reports nausea, fever, and worsening pain that radiates to her right shoulder. The nurse palpates the right upper quadrant, and the patient suddenly stops inhaling due to sharp pain. Which sign best correlates with her condition? *
7. Mr. Renaud, 28, comes to the clinic with sudden abdominal pain that started around his umbilicus and migrated to the right lower quadrant. He feels nauseous, has a mild fever, and reports the pain worsens when walking or coughing. The LPN notes rebound tenderness in the RLQ. Which clinical manifestation is characteristic of appendicitis? *
8. Ms. Fortier, 71, has a history of peptic ulcer disease and presents with dizziness, fatigue, and dark tarry stools for two days. She appears pale, her heart rate is elevated, and she reports mild epigastric discomfort. The LPN notes her hemoglobin is significantly low. Which manifestation is associated with her suspected condition? *
9. Mr. Paquin, 33, arrives after experiencing 12 hours of vomiting, diarrhea, abdominal cramps, and low-grade fever. He recently ate at a buffet and says several coworkers are also sick. He appears dehydrated. Which clinical manifestation is most consistent with his condition? *
10. Ms. Tremblay, 24, diagnosed with Crohn’s disease, reports worsening abdominal pain, diarrhea up to 8 times per day, and unintentional weight loss. She appears fatigued, pale, and says she has occasional pain in the right lower quadrant. Which manifestation is associated with Crohn’s disease? *
11. Mr. Bélanger, 39, presents with frequent episodes of bloody diarrhea, abdominal cramping relieved after defecation, and fatigue. He has a known history of ulcerative colitis and reports urgency and tenesmus. Which finding best correlates with his condition? *
12. Ms. Santos, 32, recently returned from vacation and now reports fatigue, nausea, dark urine, and right upper quadrant discomfort. The LPN notices scleral icterus. She mentions eating seafood from a street vendor. Which manifestation supports hepatitis? *
13. Mr. Caron, 68, presents with diffuse abdominal pain, vomiting that smells like stool, abdominal distension, and absence of bowel movements for two days. His abdomen is firm and tympanic. Which clinical manifestation is most associated with bowel obstruction? *
14. Ms. Hogan, 62, reports left lower quadrant abdominal pain, low-grade fever, constipation, and nausea. She has a history of diverticulosis and says the pain worsens when moving. Which finding correlates with diverticulitis? *
15. Ms. Lambert, a 34-year-old woman, comes to the clinic reporting months of abdominal bloating, chronic diarrhea, and significant fatigue. She mentions an unintentional 12-lb weight loss despite having a normal appetite. She also describes recurrent abdominal cramping after meals, especially when eating bread, pasta, or baked goods. During assessment, the LPN notes pale skin, thinning hair, and signs of mild malnutrition. Ms. Lambert states her stools have become unusually greasy and difficult to flush. Blood work from her physician shows iron-deficiency anemia. Which clinical manifestation most strongly supports the suspected diagnosis? *
16. Mr. Halim, a 56-year-old man who underwent a partial gastric resection six months ago, presents with ongoing digestive difficulties. He reports abdominal bloating, early satiety, and diarrhea shortly after eating. Over the last few weeks, he has noticed stools that float, have a shiny appearance, and are difficult to clean from the toilet. He also reports fatigue, mild weight loss, and tingling in his feet. His diet consists mostly of small frequent meals, but he admits he often eats high-fat foods because they are easier to tolerate. Which clinical manifestation is most consistent with malabsorption after gastric surgery? *
17. Mr. André Gagnon, 52, presents with sudden severe epigastric pain radiating to his back after a night of heavy alcohol intake. His history includes alcohol use disorder, hypertension, and hypertriglyceridemia. He is pale, sweating, and guarding his abdomen. Labs show amylase 688 U/L, lipase 1,240 U/L, and triglycerides 10.2 mmol/L. His HR increases from 108 to 134 bpm, BP decreases from 112/70 to 86/58 mmHg, and urine output drops to 15 mL/hr. His skin becomes cool and mottled, and he becomes increasingly restless. Which complication is now most likely occurring? *
18. Ms. Léa Bérubé, 27, arrives with right lower quadrant pain for 18 hours. She has nausea, anorexia, and a low-grade fever. She reports a sudden decrease in pain 20 minutes ago “like something popped,” followed by increasing abdominal distension and difficulty breathing. Her HR is 128 bpm, temperature rises to 38.9°C, and her abdomen becomes firm with rebound tenderness. CBC shows WBC 18.4 ×10⁹/L. Which complication does this change most strongly indicate? *
19. Mr. Félix Couture, 63, with a history of NSAID use for arthritis, presents with epigastric burning relieved by food. Overnight he develops dizziness, weakness, and black tarry stools. Morning vitals: HR 118 bpm, BP 90/58 mmHg, RR 22. His conjunctiva are pale, and he reports “coffee-ground” vomiting. Hemoglobin drops from 128 to 84 g/L in 6 hours. What complication is the nurse most concerned about? *
20. Ms. Emilie Rochefort, 33, has long-standing ulcerative colitis. For 3 days she’s had severe abdominal cramping, >12 bloody stools/day, and fever of 39.1°C. Today she reports worsening abdominal distension and appears lethargic. Vitals: HR 142, BP 92/50. Abdomen is tense and tympanic. WBC 20.3 ×10⁹/L. X-ray shows massive colonic dilation. Which complication is most likely developing? *
21. Mr. Jacques Leblanc, 41, with known Crohn’s disease, presents with abdominal pain, weight loss, and chronic diarrhea. Over the past week he notices stool-like discharge from the skin near his perineum. The area is tender, red, and draining. CBC shows mild anemia, CRP elevated. CT scan notes bowel wall thickening and a tract connecting the ileum to the perianal skin. Which complication has likely occurred? *
22. Mr. Samir Haddad, 58, with alcoholic cirrhosis, arrives confused, irritable, and forgetful. His wife reports he hasn’t taken his lactulose for 5 days. Assessment reveals a distended abdomen with large ascites, jaundice, asterixis (liver flap), and fetor hepaticus. Labs: ammonia 78 µmol/L, bilirubin 88 µmol/L. He becomes increasingly drowsy and disoriented to time and place. What complication is the nurse observing? *
23. Mrs. Gabrielle Létourneau, 49, presents with right upper quadrant pain after eating fatty food. She has nausea, vomiting, and fever. Ultrasound shows gallstones and gallbladder wall thickening. After several hours, her pain intensifies, she becomes very still, and her abdomen becomes rigid. BP drops to 88/52, HR 130. She reports pain spreading to her entire abdomen. What complication must the nurse suspect? *
24. Mr. Benoît Langlois, 56, underwent a partial gastrectomy 2 weeks ago. After eating breakfast, he suddenly feels abdominal cramping, palpitations, dizziness, and urgent diarrhea. His skin is flushed, HR 128 bpm. He feels shaky and unsteady. Symptoms resolve after lying down for 20 minutes. Which postoperative complication is most likely? *
25. Mrs. Rosa Delgado, 70, with chronic constipation, arrives with left lower quadrant pain and fever. CT confirms diverticulitis. After 48 hours of antibiotics, she still has persistent fever, chills, and worsening pain. Her WBC remains elevated, and she now reports pain intensifying with movement. CT repeat shows a localized fluid collection. Which complication is most likely forming? *
26. Ms. Sophie Raymond, 29, is diagnosed with celiac disease. She reports abdominal bloating, foul-smelling bulky stools, and extreme fatigue. Despite eating normally, she continues losing weight. Labs show low iron, low vitamin D, and mild anemia. Stool analysis reveals high fat content. She follows the gluten-free diet inconsistently. These symptoms most likely indicate which complication? *
27. A 25-year-old woman arrives at the emergency room for abdominal pain, nausea, and vomiting that have been increasing for two days. She confesses that although she has resumed taking amphetamines, she has not taken anything for the past few days. The patient is skinny and has circles around her eyes; her pupils are dilated and her hands are shaking. In addition, she has lost seven pounds and her condition is getting worse. The emergency physician meets with the patient and tells that she’s suffering from acute pancreatitis. Which of the following clinical manifestations relates to the patient’s condition? *
28. A patient is hospitalized in the medical unit for abdominal cramps that have persisted for two weeks. He does not any diarrhea or vomiting. While reading the 11:00 pm report, the LPN learns that the 27-year-old patient was hospitalized during the day. His skin and urine are a dark yellow colour. He refuses to eat, as he says he has had no appetite for several days. The patient has been on a drip since 7:00 pm and everything is going well. At 8:00 pm, his vital signs are as follows: B.P. at 130/70, pulse at 88 beats/minute, resp. at 24 breaths/min, SpO2 at 94% and buccal temperature at 37’C. The patient explains to the LPN that ever since he got back from his business trip abroad, he’s been feeling feverish. He complains of GERD and nausea. The results of the laboratory tests confirm hepatisis A. Which of the following clinical manifestations relates to the patient’s condition? *
29. A 23-year-old woman has just been admitted to the surgery unit for a sharp abdominal pain near the navel. The mother of the young woman explains to the LPN that her daughter suffers from generalized pains. Her stomach is hard and bloated to the touch, and the pain is more localized on the right. The LPN performs the requested venipuncture STAT. The patient tells the LPN that she did not eat during the day and that she is experiencing nausea and vomiting. The LPN takes her vital signs, which are as follows: B.P. at 110/78, pulse at 80 beats/minute, resp. at 20 breaths/min, SpO2 at 97% and buccal temperature at 37%’C. Further to her lab results which indicates a high level of white blood cells, the patient is sent to emergency surgery for acute appendicitis. Which of the following clinical manifestations relate to the patient’s condition? *
30. A 77-year-old beneficiary has been living a CHSLD for a few years. Over the past three days, the LPN has noted that the beneficiary has had diarrhea and rectal bleeding. Her incontinence briefs have needed to be changed 10 to 12 times a days. The LPN also observes irritation of the bottom and applies a protective ointment to this area. She notifies the RN to asses the irritation and her observations in the TPN. The doctor suspects ulcerative colitis. Which of the following clinical manifestations relates to the beneficiary’s condition? *