ch 28-29

A 71 year-old male has been recently diagnosed with a stage III tumor of colorectal cancer, and is attempting to increase his knowledge base of his diagnosis. Which of the following statements about colorectal cancer demonstrates a sound understanding of the disease? a) "While diet is thought to play a role in the development of colorectal cancer, the ultimate causes are largely unknown." b) "A large majority of patients who have my type of colon cancer survive to live many more years." c) "If accurate screening test for this type of cancer existed, it could likely have been caught earlier." d) "The NSAIDs and aspirin that I've been taking for many years probably contributing to my getting cancer."

A. "While diet is thought to play a role in the development of colorectal cancer, the ultimate causes are largely unknown."

The nurse is reviewing the medical history of four clients. The nurse determines that the client at greatest risk for developing peptic ulcer disease is: a) A client with a prior diagnosis of Helicobacter pylori and refused treatment b) A client diagnosed with arthritis who takes acetaminophen (Tylenol) twice per day c) A client who has a history of a ruptured appendix d) A client who overeats excessive amounts of fatty foods

A. A client with a prior diagnosis of Helicobacter pylori and refused treatment

A nurse practitioner is examining an obese patient. The practitioner asks which of the following structures can contain considerable amounts of fat? a) Greater omentum b) Mesentery c) Lesser omentum d) Peritoneum

A. Greater omentum

Digestion of starch begins in which of the following structures? a) Mouth b) Small intestine c) Large intestine d) Stomach

A. Mouth

A nurse is completing an abdominal assessment on a patient suspected to have appendicitis. When the nurse applies and then releases pressure in the patient's right lower quadrant, the patient experiences tenderness. The nurse is documenting the presence of which of the following? a) Rebound tenderness b) Referred tenderness c) Periumbilical tenderness d) Peforated appendix

A. Rebound tenderness

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? a) Small intestine b) Ileocecal valve c) Upper region of the stomach d) Internal anal sphincter

A. Small intestine

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: a) stimulate the release of secretin which then inhibits release of gastrin. b) inhibit the release of glucose-dependent insulinotropic peptide to slow gastric emptying. c) stimulate the release of glucagon-like peptide 1 to lower blood glucose levels. d) stimulate pancreatic enzymes to release more insulin.

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

Parents of a 20-month-old infant report that he refuses food or eats poorly and that he grimaces when he swallows. He also is irritable and cries a lot. The mother is worried that he ate something inappropriate this morning, because he vomited something that looked like coffee grounds. Which of the following health problems would the care team first suspect? a) Hirschsprung's disease b) Esophagitis from gastrointestinal reflux c) Rotavirus infection d) Appendicitis

B. Esophagitis from gastrointestinal reflux

A nurse is teaching a client diagnosed with Crohn disease about potential complications. The most appropriate information for the nurse to include would be: a) Difficulty swallowing b) Fistula formation c) Excessive weight gain d) Chronic constipation

B. Fistula formation

In the balance of secretions in the gastric mucosa by the parietal cells, which of the following ions is produced to buffer the production of hydrochloric acid? a) OH- b) HCO3- c) K+ d) H2O

B. HCO3-

A 22 year-old student has developed a fever and diarrhea while on a backpacking trip in Southeast Asia. His oral temperature is 101.40 F. The diarrhea is bloody, frequent, and small in volume. These clinical manifestations are sufficiently distressing that he/she is visiting a local medical clinic in the area. Which of the following diagnoses best characterizes this health problem? a) Noninflammatory diarrhea b) Inflammatory diarrhea c) Factitious diarrhea d) Secretory diarrhea

B. Inflammatory diarrhea

Crohn's disease not only affects adults but also can occur in children. The nurse assesses for which of the following major manifestations in children with Crohn's disease? a) Dental caries b) Malnutrition c) Halitosis d) Weight gain

B. Malnutrition

Which of the following statements is true concerning food digestion? a) Pepsin helps to digest food in the small intestine. b) Protein digestion begins in the stomach. c) Monosaccharides cannot be absorbed. d) Proteins are broken down by carbohydrates.

B. Protein digestion begins in the stomach.

Which of the following statements is true concerning gastric enterocytes? a) They digest entero bacteria. b) They secrete enzymes that aid in digestion of proteins. c) They secrete lubrication for the gastrointestinal tract. d) They provide binding sites for insulin.

B. They secrete enzymes that aid in digestion of proteins.

A patient is admitted with a peptic ulcer. The nurse's priority on admission is to assess for which of the following? Select all that apply. a) Pain assessment b) Smoking history c) Family history d) dietary history e) Alcohol usage

B. • Smoking history C. • Family history E. • Alcohol usage

A student is comparing the different parts of the gastrointestinal (GI) tract. Which of the following statements demonstrates understanding? a) "The jejunum serves as a storage channel for the elimination of waste." b) "The esophagus is where most of the absorptive processes occur." c) "The mouth is the receptacle where initial digestive processes take place." d) "The cecum is where most digestive and absorptive processes occur."

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

The nurse is teaching her patient with hepatobiliary disease about her diet. She tells her that she may have steatorrhea, which is the malabsorption of which dietary component? a) Protein b) Starch c) Fat d) Calcium

C. Fat

The incidence of stomach cancer has significantly decreased in the United States, yet it remains the leading cause of death worldwide. The nurse understands the reason for the high mortality rate in stomach cancer is because of which of the following reasons? a) Diagnostic testing is not available for detection of the disease. b) The progression of the disease is rapid. c) Patients have few early symptoms of the disease. d) Patients are afraid to talk about their symptoms.

C. Patients have few early symptoms of the disease.

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? a) Grapefruit and prunes. b) Tortilla chips and guacamole. c) Roast beef and a baked potato. d) Tossed salad with an oil and vinegar dressing.

C. Roast beef and a baked potato.

A client is admitted to the hospital with a suspected diagnosis of strangulated bowel. The nurse anticipates the client will need: a) Insertion of a nasogastric tube b) Low fiber diet for 24 hours c) Surgery to release the bowel d) Lower abdominal massage

C. Surgery to release the bowel

Symptoms of gastric cancer include vague epigastric pain, which makes early detection difficult. The nurse would expect a patient to undergo which of the following diagnostic examinations to determine the location of the gastric cancer? a) Blood test b) Occult blood c) Chemotherapy d) Barium x-ray

D. Barium x-ray

A nurse reading a sigmoidoscopy report notes that a patient was found to have skip lesions. The nurse interprets this as an indication of which of the following? a) Peptic ulcer b) Zollinger-Ellison syndrome c) Ulcerative colitis d) Crohn's disease

D. Crohn's disease

A patient asks the nurse what part of the brain regulates appetite. Which is the best response by the nurse? a) Medulla b) Cerebellum c) Midbrain d) Hypothalamus

D. Hypothalamus

Colonic microorganisms play a role in the synthesis of which of the following vitamins? a) C b) D c) E d) K

D. K

A patient is not able to absorb vitamin B12. The nurse determines that the patient is deficient in: a) S cells, which secrete secretin b) Peptic (chief cells), which secrete pepsinogen c) Mucous neck cells, which secrete mainly mucus d) Parietal (oxyntic) cells, which secrete HCl and intrinsic factor

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

A client has developed a ruptured appendix. The nurse is aware the client is at high risk for: a) Vomiting b) Diarrhea c) Gastritis d) Peritonitis

D. Peritonitis

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? a) Opioid receptors b) Acetylcholine receptors c) Dopamine d) Serotonin

D. Serotonin

The results of a patient's 24-hour stool specimen indicate 20 g or more of fat. The nurse would interpret this as: a) Hyperlipidemia b) Clostridium difficile c) Diarrhea d) Steatorrhea

D. Steatorrhea

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.