Question 1

A 55-year-old man has been diagnosed with a gastroesophageal reflux disease (GERD), in which the function of his lower esophageal sphincter is compromised. Which of the following consequences of this condition is most likely to occur?

Accepted Answer

A)   Decreased absorption of ingested foods and fluids
B)   Impaired control of the gastric emptying rate
C)   Protrusion of the stomach or regurgitation of stomach contents into the esophagus
D)   Inappropriate release of gastric enzymes C

Question 2

Chronic anxiety and stress contribute to ulcers. Which of the following effects of the sympathetic nervous system is most responsible for this effect?

Accepted Answer

A)   Inhibition of the actions of Brunner glands
B)   Overstimulation of the oxyntic glands
C)   Suppression of cholecystokinin
D)   Inflammation of the parotid glands A

Question 3

Place the following components of the gastrointestinal tract in the chronological order that a bolus of food would pass through them. Use all the options.

Accepted Answer

A)   Ileum
B)   Pylorus
C)   Jejunum
D)   Hiatus
E)   Cecum F)  Duodenum D, B, F, C, A, E

Question 4

A 77-year-old woman has been admitted to hospital following several weeks of increasing fatigue. On observation, she is pale, and blood work indicates she has low hemoglobin and red cell counts. Stool tests for occult blood are positive, and following endoscopy, she has been diagnosed with an upper GI bleed that has been shown to originate in her stomach. She admits to regularly exceeding the recommended doses of nonsteroidal anti-inflammatory drugs (NSAIDs) in an effort to control her rheumatoid arthritis. Which of the following phenomena is most likely responsible for her present health problems?

Accepted Answer

A)   NSAIDs increase the gastric production of gastrin, increasing gastric secretions and lowering stomach pH.
B)   Drugs such as NSAIDs increase the H+ levels and thus decrease gastric pH, resulting in insult to the stomach lining.
C)   NSAIDs, aspirin, and other drugs increase prostaglandin synthesis, resulting in disruption of cellular structures lining the stomach.
D)   NSAIDs can disrupt the permeability of the gastric mucosa, causing hydrogen ions to accumulate in the mucosal cells of the lining.

Question 5

When the sympathetic nervous system is stimulated, the interstitial cells of Cajal, pacemaker cells of the GI tract, react by

Accepted Answer

A)   decreasing amplitude or abolishing the slow waves that control the spontaneous oscillations in membrane potentials.
B)   increasing the peristaltic motion of the GI tract, thereby causing explosive diarrhea.
C)   increasing the amount of secretions being entered into each segment of the intestinal tract.
D)   signaling the vagus nerve to slow down motility and increase absorption of water from the large intestine.

Question 6

A male infant is brought into the clinic because of colic-like symptoms. The mother states he acts like something is hurting. After eating, he vomits most of the feeding and then assumes a fetal position. He is also not gaining weight. The nurse practitioner is thinking that he is displaying clinical manifestations of obstruction and may have which of the following medical diagnoses?

Accepted Answer

A)   Duodenal ulceration
B)   Constipation
C)   Pyloric stenosis
D)   Erosive esophagitis

Question 7

Following a 14-day course of broad-spectrum antibiotics for the treatment of sepsis, a 60-year-old woman has developed watery diarrhea. Her care team attributes this to likely elimination of normal intestinal flora by the antibiotics. What other phenomena is most likely accompanying her low levels of normal flora?

Accepted Answer

A)   Decreased mineral and nutrient absorption; decreased carbohydrate metabolism
B)   Decreased pH of the stomach; increased pH of the lower GI tract
C)   Decreased fermentation of undigestible dietary residue; decreased vitamin absorption
D)   Proliferation of vitamin K; lower GI bleeding

Question 8

Which of the following medications used in the treatment of peptic ulcers and gastroesophageal reflux binds to H2 receptors and blocks the action of histamine on parietal cells?

Accepted Answer

A)   Cimetidine (Tagamet) 
B)   Levbid (hyoscyamine) 
C)   Lotronex (alosetron) 
D)   Nexium (esomeprazole)

Question 9

A male client complaining of chronic cramping, bloating, and diarrhea has been determined to have a deficiency in brush border enzymes within his small intestine. Which of the following meals or snacks high in carbohydrates and protein will likely exacerbate the client's signs and symptoms?

Accepted Answer

A)   Grapefruit and prunes
B)   Tossed salad with an oil and vinegar dressing
C)   Roast beef and a baked potato
D)   Tortilla chips and guacamole

Question 10

A speech therapist is performing a swallowing assessment on a 72-year-old man who has suffered a stroke 3 weeks ago. The man has been NPO (nothing by mouth) since his stroke, and the health care team is considering the introduction of oral food. The speech therapist is cueing the client to swallow to preclude either aspiration of food or pocketing of food in the sides of his mouth. The client most likely to have conscious control over which of the following processes listed below involved in swallowing?

Accepted Answer

A)   Initiation of primary peristalsis
B)   Moving the epiglottis back to cover the larynx
C)   Moving a bolus to the posterior wall of the pharynx
D)   Moving the bolus backward in the esophagus

Question 11

A gastroenterologist is teaching a group of medical students about the enteric nervous system in preparation for a consult on client who has suffered a spinal cord injury. Which of the physician's teaching points is most accurate?

Accepted Answer

A)   "The myenteric plexus is responsible for controlling the function of each segment of the intestinal tract."
B)   "The enteric nervous system is made up of the myenteric and submucosal plexuses; these are located in the wall of the GI tract."
C)   "Sympathetic innervation of much of the GI tract occurs by way of the vagus nerve."
D)   "Parasympathetic stimulation blocks the release of the excitatory neuromediators and inhibits GI motility."

Question 12

Which of the following statements best communicates the nature of movements in the colon?

Accepted Answer

A)   The internal and external anal sphincters control the movement of feces into and through the colon.
B)   Haustrations move the colon contents along with 2- to 3-minute rest periods between movements.
C)   Segmentation waves ensure that all surfaces of the feces are exposed to the colon surface.
D)   Large segments of the colon contract as a unit for around 30 seconds.

Question 13

The instructor asks a group of nursing students to explain the function of the omentum. The students will respond based on which pathophysiologic principle?

Accepted Answer

A)   It holds organs in place.
B)   It attaches the jejunum and ileum to the abdominal wall.
C)   It has lots of mobility and moves around in the peritoneal cavity with peristaltic movements.
D)   It is mainly there to prevent any noxious substance from inner into the gut.

Question 14

Which of the following statements best captures an aspect of the process of fat digestion and absorption?

Accepted Answer

A)   Ingested triglycerides are broken down into absorbable form by gastric lipase.
B)   Triglycerides are digested with the aid of bile salts.
C)   Long-chain fatty acids are absorbed directly into the portal blood.
D)   Stool is not excreted until all fat is absorbed.

Question 15

A science teacher is talking to a group of fifth graders about the role of "spit." During the course of the discussion, the teacher asks the students which of the following are functions of saliva?

Accepted Answer

A)   Good protection device if someone is being attacked
B)   Will have more saliva production when anxious, such as right before a test
C)   Has antibacterial action to help keep the mouth clean
D)   Secretes acid to chemically break down fatty foods like French fries
E)   Secretes the enzyme pepsin

Question 16

A mom asks her neighbor, a nurse, why every time she takes her daughter (10 years old) out for ice cream she comes home with a stomachache and then experiences a bout of diarrhea. The nurse is thinking that this girl is experiencing

Accepted Answer

A)   anxiety about increasing too many calories.
B)   a deficiency of lactase.
C)   gallbladder disease.
D)   premature peptic ulcer formation.

Question 17

A 42-year-old female client with a long-standing history of chronic nausea and vomiting but a near-insatiable appetite has had her symptoms attributed to an enzyme deficiency. Further diagnostic testing indicates that she has inadequate pancreatic enzyme levels and that her large appetite is due to a lack of enzyme control of food intake inhibition. In which of the following enzymes is the woman most likely deficient?

Accepted Answer

A)   Cholecystokinin
B)   Ghrelin
C)   Gastrin
D)   Secretin

Question 18

While explaining to a group of nursing students what the function of the first mucosal layer of the lower two thirds of the esophagus, the pathophysiology instructor mentions which of the following functions? Select all that apply.

Accepted Answer

A)   Secretion of mucus to lubricate and protect the inner surface of the alimentary canal
B)   Smooth muscle cells that facilitate movement of contents of the GI tract
C)   Holding the organs in place and storage of fats
D)   Barrier to prevent the entry of pathogenic organisms
E)   A cushioning to protect against injury from sports or car accidents

Question 19

A patient has just been diagnosed with pernicious anemia. The patient asks the nurse why his body is not able to absorb vitamin B12. The nurse responds,

Accepted Answer

A)   "You have too many ulcers in your stomach."
B)   "More than likely, you were born with deficient vitamin B12 stores."
C)   "Your stomach is not secreting a substance known as intrinsic factor, which is needed to absorb vitamin B12."
D)   "Your daily intake of high saturated fats is interfering with the stomach's ability to absorb the nutrients that it needs, especially vitamin B12."

Question 20

A 79-year-old male resident of a long-term care facility has contracted Clostridium difficile and is experiencing consequent diarrhea. Auscultation of the man's abdomen indicates hyperactive bowel sounds. What process in the man's small intestine is most likely accompanying his current status?

Accepted Answer

A)   Pathogenic microorganisms are causing dilation of his small intestine, increasing motility.
B)   Segmentation waves have become more frequent as a result of his infection.
C)   Intestinal stasis brought on by infection is preventing his small intestine from sufficiently slowing the rate of motility.
D)   Inflammation is accompanied by an increase in peristaltic movements of his small intestine.

Exam 42: Structure and Function of the Male Reproductive System

A 55-year-old man has been diagnosed with a gastroesophageal reflux disease (GERD) , in which the function of his lower esophageal sphincter is compromised. Which of the following consequences of this condition is most likely to occur?