Patho PrepU Chp 28

The gastrointestinal laboratory nurse is learning about small intestine secretions. Which of the following explanations is most accurate? `

"An extensive array of mucus-producing glands, called Brunner glands, is concentrated where contents from the stomach and secretions from the liver and pancreas enter the duodenum."

Which of the following would help a nurse best explain an "incretin effect"?

"It is an increase in insulin release after ingestion of food."

A student is comparing the two patterns of contractions in the small intestine. Which of the following statements is most accurate?

"Segmentation waves function mainly to mix the chyme with the digestive enzymes from the pancreas."

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?

"The enteric nervous system is made up of the myenteric and submucosal plexuses; these are located in the wall of the GI tract."

A student is comparing the different parts of the gastrointestinal (GI) tract. Which of the following statements demonstrates understanding?

"The mouth is the receptacle where initial digestive processes take place."

While studying the esophagus, a student is able to correctly state which of the following to a faculty member?

"The smooth muscle layers provide the peristaltic movements needed to move food along the length of the esophagus."

A patient takes 650 mg of aspirin every 4 hours daily for complaints of joint pain. Which of the following statements should be included in the patient's teaching plan?

"This medication can damage gastric mucosa."

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

"Your stomach is not secreting a substance known as intrinsic factor which is needed to absorb vitamin B12."

The human body secretes approximately 2000ml of intestinal secretions and 1200ml of salivary secretions. What is the total amount of daily gastronintestal tract secretions (round up or down to the nearest 1000ml)?

7000

A mom asks her neighbor, a nurse, why every time they take their 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:

A deficiency of lactase.

Which enzyme is found in the mouth and is the first to initiate the breakdown of starches?

Amylase

A patient has experienced a stroke affecting the reticular formation of the medulla and lower pons. The nurse tells the patient's wife that care must be taken with eating to prevent which of the following?

Aspiration pneumonia

Select the enzyme that is secreted by the small intestine to facilitate the digestion of carbohydrates and proteins.

Brush border

Which enzymes adhere to the border of the villus structures to allow access to carbohydrate and protein molecules?

Brush border

A student is studying gallbladder function. Which of the following gastrointestinal hormones stimulates contraction of the gallbladder?

Cholecystokinin

A nurse is concerned about a patient's continual use of nonsteroidal anti-inflammatory drugs (NSAIDs). Which of the following is the nurse concerned about?

Damage to the gastric mucosa

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 are most likely accompanying her low levels of normal flora?

Decreased fermentation of undigestible dietary residue; decreased vitamin absorption

The common bile duct opens into which of the following parts of the gastrointestinal tract?

Duodenum

The swallowing reflex is an entirely voluntary activity.

False

The colon is home to between 300 and 500 different species of bacteria. What is their main metabolic function?

Fermentation of undigestible dietary residue

The stomach secretes two important hormones in the GI tract. One is gastrin. What is the second hormone secreted by the stomach?

Ghrelin

A nurse practitioner is examining an obese patient. The practitioner asks which of the following structures can contain considerable amounts of fat?

Greater omentum

A patient asks the nurse what part of the brain regulates appetite. Which is the best response by the nurse?

Hypothalamus

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.

Ileum Pylorus Jejunum Hiatus Cecum Duodenum

Which substance necessary for vitamin B12 absorption is produced by the parietal cells in the stomach?

Intrinsic factor

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

It has lots of mobility and moves around in the peritoneal cavity with peristaltic movements.

The dietitian explains to the patient that food is digested and absorbed in which of the following?

Jejunum

Colonic microorganisms play a role in the synthesis of which of the following vitamins?

K

Which of the following actions initiate defecation?

Mass movements

Digestion of starch begins in which of the following structures?

Mouth

A nurse is teaching a client about the difference between digestion and absorption. Which action should the nurse describe as absorption?

Moving nutrients from the external environment of the GI tract into the internal environment

Which of the following are functions of the digestive system? Select all that apply.

Nutrients are absorbed. Wastes are collected. Wastes are eliminated. Vitamins are synthesized.

A patient is not able to absorb vitamin B12. The nurse determines that the patient is deficient in:

Parietal (oxyntic) cells, which secrete HCl and intrinsic factor

Serous fluid is contained in which of the following?

Peritoneal cavity

The swallowing reflex is an ordered sequence of events. In which of the following phases is the epiglottis moved so that it covers the larynx?

Pharyngeal phase

Which of the following is the primary purpose of the mucosal barrier in the gastrointestinal tract?

Protection from acid secretion

Which functions apply to gastrointestinal secretions? Select all that apply.

Protection of the mucosal layer Secretion of enzymes and fluids Reabsorption of fluid in the small and large intestine

Which of the following statements is true concerning food digestion?

Protein digestion begins in the stomach.

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?

Protrusion of the stomach or regurgitation of stomach contents into the esophagus.

An anatomy student is studying the stomach. The student explains that the funnel-shaped portion that connects with the intestine is which of the following?

Pyloric region

Regurgitation of bile salts and duodenal contents can lead to gastric ulcers. Which of the following structures prevents this from happening?

Pyloric sphincter

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 carbs and protein will likely exacerbate the client's signs and symptoms?

Roast beef and a baked potato.

Which of the following are accessory organs that also aid in digestion? Select all that apply.

Salivary glands Liver Pancreas

Several neurotransmitters have been identified with nausea and vomiting. In this capacity, they act as neuromediators. What neuromediator is thought to be involved in the nausea and vomiting that accompanies chemotherapy?

Serotonin

A nurse explains to her patient that food is moved along the gastrointestinal (GI) tract with intermittent contractions that mix the food and move it along. These movements are found in which of the following organs?

Small intestine

Villi are anatomic features that contribute to the enlarged surface area of which of the following?

Small intestine

Fat that is not absorbed in the intestine is excreted in the stool. Which of the following terms is used to describe fatty stools?

Steatorrhea

The results of a patient's 24-hour stool specimen indicate 20 g or more of fat. The nurse would interpret this as:

Steatorrhea

The production of chyme occurs in which of the following organs?

Stomach

Which layer of the digestive tract contains the blood vessels, nerves, and other structures responsible for secreting digestive enzymes?

Submucosal

A client with a systemic infection has been given strong doses of broad-spectrum antibiotics for a period of 10 days. The infection recedes and he is taken off the antibiotic therapy. Two days later he presents with a Clostridium difficile infection. How should the nurse best interpret this situation?

The client's antibiotics disrupted the microbial balance and allowed overgrowth.

Which of the following statements most accurately describes the function of the secretory glands in the gastrointestinal (GI) tract?

The secretory glands produce mucus to lubricate and protect the mucosal layer of the GI tract wall.

Which of the following statements is true concerning gastric enterocytes?

They secrete enzymes that aid in digestion of proteins.

Which of the following substances is broken down by the emulsification process?

Triglycerides

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

Triglycerides are digested with the aid of bile salts.

Which enzymes are responsible for the breakdown of protein?

Trypsin and pepsin

A patient asks the nurse why he experiences vomiting after eating pieces of expired sandwich meat and drinking six beers. Which is the best response by the nurse?

Vomiting limits the possibility of damage from ingested noxious agents.

While reviewing the colonic absorption and role of flora in the GI system, the instructor will stress that the large intestine contains:

a complex microbial system that contains hundreds of different species.

During a lecture about the function of the intestine related to food digestion, the faculty mentions that when the students consume foods high in acid, the intestines will:

stimulate the release of secretin which then inhibits release of gastrin.