Chapter 28: Structure and Function of the Gastrointestinal System

A client asks the nurse to explain the digestive tract layers because the client is experiencing upper GI problems. When talking about the mucosa layer, the nurse will emphasize that the roles/functions of this layer consist of: Select all that apply. -production of mucus to protect and lubricate the inner lining. -beginning of the digestive process by secreting enzymes to break down food. -contracting of smooth muscles to propel food forward. -supporting the abdominal viscera with its connective tissue.

-production of mucus to protect and lubricate the inner lining. -beginning of the digestive process by secreting enzymes to break down food.

The bottom two-thirds (2/3) of the esophagus is comprised of how many GI wall structure layers? 4 3 2 5 All other answers

4

A parent reports that the child comes home with a stomachache and then a bout of diarrhea every time she has ice cream out with friends. Which conclusion by the nurse is likely most accurate for this child? -Anxiety about eating too many calories -A deficiency of lactase -Gallbladder disease -Premature peptic ulcer formation

A deficiency of lactase

A client tells the nurse that he experiences diarrhea after eating ice cream or cheese. The nurse tells the client he may have a deficiency of: -Amylase -Trypsin -Lactase -Pepsin

Lactase

Which nerve plexus controls the motility along the length of the gut? -Myenteric -Submucosal -Mechanoreceptors -Intramural plexuses

Myenteric

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

Steatorrhea

Which hormones identified as having an incretin effect account for about 90% of this effect? Select all that apply. -Glucagon-like peptide-1 (GLP-1) -Glucose-dependent insulinotropic polypeptide (GIP) -Ghrelin -Gastrin -Secretin

-Glucagon-like peptide-1 (GLP-1) -Glucose-dependent insulinotropic polypeptide (GIP)

Which anatomical structures are contained in the lower gastrointestinal (GI) tract? -Ileocecal valve -Appendix -Ileum -Sigmoid colon -Pyloric sphincter

-Ileocecal valve -Appendix -Sigmoid colon

The dental hygienist explains the purposes of saliva to the client. The hygienist knows that the client understands when stating which as a function of saliva? Select all that apply. -Saliva lubricates food as it passes through the mouth. -Saliva cleans the mouth. -Saliva initiates digestion of dietary proteins. -Saliva has antimicrobial action. -Saliva contains intrinsic factor.

-Saliva lubricates food as it passes through the mouth. -Saliva cleans the mouth. -Saliva has antimicrobial action.

A hospitalized client has developed anorexia. The nurse is aware that this may result from which factors? Select all that apply. -Smells -Fear -Anxiety -Medication -Depression -Happiness

-Smells -Fear -Anxiety -Medication -Depression

The client chews an apple and starts the swallowing process. As the food bolus enters the back of the mouth and swallowing is initiated, the nurse knows that the client's motor impulses are being carried out by which cranial nerves? Select all that apply. -Trigeminal (V) -Vagus (X) -Hypoglossal (XII) -Abducens (VI)

-Trigeminal (V) -Vagus (X) -Hypoglossal (XII)

Which of the following are major functions of colonic microorganisms? Select all that apply. -Vitamin synthesis -Absorption of calcium -Absorption of magnesium -Absorption of potassium

-Vitamin synthesis -Absorption of calcium -Absorption of magnesium

Place the following steps relating to swallowing in order in which they occur. a. The tongue moves the food to the back of the mouth. b. The food is lifted to the posterior wall of the pharynx. c. The soft palate is pulled upward and the nasopharynx is blocked. d. The pharynx uses involuntary, constrictive movements to move the food. e. The walls of the esophagus are stretched. f. Local and central nervous system reflexes initiate peristalsis. 1a, 2c, 3b, 4d, 5e, 6f 1a, 2b, 3c, 4d, 5e, 6f 1a, 2b, 3d, 4c, 5e, 6f 1a, 2c, 3b, 4d, 5f, 6e 1a, 2b, 3c, 4e, 5d, 6f

1a, 2b, 3c, 4d, 5e, 6f

A client has experienced a stroke affecting the reticular formation of the medulla and lower pons. The nurse tells the client's wife that care must be taken with eating to prevent: -Aspiration pneumonia -Duodenal ulcers -Gastric atony -Steatorrhea

Aspiration pneumonia

Nausea and vomiting can be side effects of many drugs as well as physiologic disturbances within the body. What is a common cause of nausea? -Distention of the stomach -Distention of the cecum -Distention of the jejunum -Distention of the duodenum

Distention of the duodenum

A client has been told he has abdominal adhesions due to an old appendix infection. Knowing the structures of the abdominal cavity, the nurse will explain about which structure that can form bands of fibrous scar tissue to wall off the infection, preventing it from spreading to other parts of the body? -Mesentery -Greater omentum -Haustration -Peritoneum

Greater omentum

Ghreli produced in the mucosal layer of the stomach has a role in regulation of which hormone that contributes to the regulation of weight? -Gastric acid fluid -Growth hormone -Biliary bicarbonate -Pancreatic enzyme

Growth hormone

A client has just been treated for constipation and the nurse is providing health education. What statement best describes the nature of movements in the colon? -The internal and external anal sphincters control the movement of feces into and through the colon. -Haustrations move the colon contents along with 2- to 3-minute rest periods between movements. -Segmentation waves ensure that all surfaces of the feces are exposed to the colon surface. -Large segments of the colon contract as a unit for around 30 seconds, which aids with defecation.

Large segments of the colon contract as a unit for around 30 seconds, which aids with defecation.

When caring for a client with cancer experiencing chemotherapy-induced nausea and vomiting, which medication works to delay this nausea and vomiting by acting on the CNS to block the activation of the NK-1 receptors? -Ondansetron, a serotonin (5-hydroxytyramine) antagonist -Anastrozole, an aromatase inhibitor -Promethazine, a neuroleptic medication -Prochlorperazine, a dopamine (D2) receptor antagonist

Ondansetron, a serotonin (5-hydroxytyramine) antagonist

Some smooth muscle cells in the GI tract serve as pacemakers. What are the cells called that display rhythmic spontaneous oscillations in membrane potentials ? -Peristalsis -Intestinal spasms -Slow waves -Rapid contractility

Slow waves

When explaining absorption to a client, the nurse mentions that a number of substances require a specific carrier or transport system. An example the nurse could use relates to the transport of amino acids and glucose, which requires the presence of which electrolyte for absorption to occur? -Potassium -Phosphate -Sodium -Calcium

Sodium

The intestinal absorption of glucose and galactose, an amino acid, is facilitated by which transport system? -Bile salt micelles -Fat emulsification -Sodium linked (SGLT-1) -Brush border enzyme

Sodium linked (SGLT-1)

Fat that is not absorbed in the intestine is excreted in the stool. Which term is used to describe fatty stools? -Chyme -Steatorrhea -Diarrhea -Clay-colored stools

Steatorrhea

The production of chyme occurs in which organ? - Stomach -Esophagus -Small intestine -Pancreas

Stomach

Which layer of the digestive tract consists of connective tissue and contains nerves, blood vessels, and structures for secreting the digestive juices? -Mucosal -Peritoneum -Submucosal -Circular muscle

Submucosal

Motility along the length of the GI tract, controlling the function of each segment of the GI tract and integrating signals for absorption of nutrients, primarily is innervated by which portion of the enteric nervous system? -Submucosal plexus -Vasovagal -Sympathetic -Preganglionic

Submucosal plexus

A nursing student is observing an autopsy. The pathologist is exposing the intestines of the deceased to check for abnormalities. The student asks why there is so much of the small intestine that it has to be coiled. Which response is best? -The small intestine must be as long as it is to give the pancreas time to expel enzymes. -The small intestine must be as long as it is to insure that the nutrients will all get exposed to the gastric mucosa. -The small intestine must be as long as it is because different areas absorb different nutrients. -There is no specific reason for the small intestine to be as long as it is.

The small intestine must be as long as it is to insure that the nutrients will all get exposed to the gastric mucosa.

A serous-type fluid secreted by special cells in the intestinal mucosal layer performs which function? -Vehicle for absorption -Enzyme that splits sugars -Protection from acid content -Parasympathetic stimulation

Vehicle for absorption

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

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

A 2-year-old boy is experiencing recurrent bouts of diarrhea. The volume of fluid that is lost in the stool creates a systemic dehydration. This child has an extracellular fluid deficit because: -electrolytes accumulate in tissues during fluid loss, resulting in an elevated concentration and creating relative dehydration. -water loss in diarrhea is from intracellular stores, resulting in lower cellular volume. -water and electrolytes for digestive tract secretions are derived from the extracellular fluid compartment. -the child is losing large amounts of free water while retaining electrolytes.

water and electrolytes for digestive tract secretions are derived from the extracellular fluid compartment.

Which statement would help a nurse best explain an "incretin effect"? -"It is an elevation in blood glucose caused by ingestion of food." -"It is an increase in insulin release after ingestion of food." -"It is a decrease in gastric motility after ingestion of food." -"It is an increase in blood glucose when no food is ingested."

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

A student is explaining the enteric and autonomic nervous systems in the gastrointestinal (GI) tract. A faculty member knows the student has mastered this information when he or she makes which statement? -"Sympathetic innervation to the stomach, small intestine, cecum, and ascending and transverse colon occurs through the vagus nerve." -"The Meissner plexus is concerned mainly with motility along the length of the gut." -The Auerbach plexus is concerned with controlling the secretions, absorption, and contraction of each segment of the intestinal tract." -"Sympathetic innervation controls the extent of mucus secretion by the mucosal glands."

"Sympathetic innervation controls the extent of mucus secretion by the mucosal glands."

The gastrointestinal laboratory nurse is learning about small intestine secretions. Which explanation 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." -"The Brunner glands secrete large amounts of acidic mucus." -"Ulcers are more likely to occur in the stomach than in the duodenum." -"Sympathetic stimulation causes a marked increase in mucus production."

"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."

A client with diabetes mellitus states, "I can eat as many carbohydrates as I want and it will not affect my blood sugar." What is the nurse's best response? -"Carbohydrates are broken down into monosaccharides before being absorbed." -"You are correct." -"Carbohydrates do not affect blood glucose." -"Clients with diabetes cannot eat carbohydrates."

"Carbohydrates are broken down into monosaccharides before being absorbed."

Following a 14-day course of broad-spectrum antibiotics for the treatment of sepsis, a client develops watery diarrhea attributed to the elimination of normal intestinal flora. What other phenomena are most likely accompanying the low levels of normal flora? -Decreased mineral and nutrient absorption; decreased carbohydrate metabolism -Decreased pH of the stomach; increased pH of the lower gastrointestinal tract -Decreased fermentation of undigestible dietary residue; decreased vitamin absorption -Proliferation of vitamin K; lower gastrointestinal bleeding

Decreased fermentation of undigestible dietary residue; decreased vitamin absorption

Select the phase of swallowing that prevents food from entering the nasopharynx when a client is eating. -Pharyngeal -Oral -Anal -Esophageal

Pharyngeal

The swallowing reflex is an ordered sequence of events. In which phase is the epiglottis moved so that it covers the larynx? -Pharyngeal phase -Oral phase -Esophageal stage -Voluntary stage

Pharyngeal phase

What is the primary purpose of the mucosal barrier in the gastrointestinal tract? -Food digestion -Muscle stimulation -Lubrication of stool -Protection from acid secretion

Protection from acid secretion

Which statement is true concerning food digestion? -Protein digestion begins in the stomach. -Pepsin helps to digest food in the small intestine. -Proteins are broken down by carbohydrates. -Monosaccharides cannot be absorbed.

Protein digestion begins in the stomach.

Saliva contains which enzyme that initiates the digestion of dietary starches? -Ptyalin -Lipase -Mucous -Bile

Ptyalin

While explaining digestion and absorption of nutrients to a client, the nurse mentions that the brush border enzymes would facilitate absorption of which food? -Ice cream -Green, leafy vegetables -Garlic toast -Fried catfish

Garlic Toast

A client is experiencing reflux of stomach contents into the esophagus. The nurse determines that the problem may result from: -Gastroesophageal sphincter -Pharyngoesophageal sphincter -Upper esophageal sphincter -Pyloric sphincter

Gastroesophageal sphincter

A student is comparing the actions of the gastrointestinal hormones. Which hormone acts as an appetite-stimulating signal? -Ghrelin -Gastrin -Secretin -Glucagon-like peptide 1 (GLP-1)

Ghrelin

While assessing a client who is experiencing diarrhea caused by Clostridium difficile, the nurse should anticipate hearing: -Normal bowel sounds -Hypoactive bowel sounds -Absence of bowel sounds -Hyperactive bowel sounds

Hyperactive bowel sounds

A client asks the nurse what part of the brain regulates appetite. Which is the best response by the nurse? -Hypothalamus -Medulla -Midbrain -Cerebellum

Hypothalamus

A student is comparing the two patterns of contractions in the small intestine. Which statement is most accurate? -"Peristaltic movements drive the contents forward and backward." -"Segmentation waves function mainly to mix the chyme with the digestive enzymes from the pancreas." -"The frequency of segmenting activity decreases after a meal." -"Peristaltic movements begin in the cecum."

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

Which would be considered the results of damage to the gastric mucosa from medications such as aspirin and nonsteroidal anti-inflammatory drugs? Select all that apply. -Local ischemia -Vascular stasis -Tissue necrosis -Gastric hypermotility

-Local ischemia -Vascular stasis -Tissue necrosis

Which are functions of the digestive system? Select all that apply. -Nutrients are absorbed. -Wastes are collected. -Wastes are eliminated. -Vitamins are synthesized. -Insulin is produced. -Red blood cells are produced.

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

What is true regarding the process of absorption? Select all that apply. -It is the process by which nutrients are moved through the GI tract. -The process involves active transport. -The process involves diffusion. -The reabsorption of water occurs mainly in the small intestines. -The transport of amino acids requires the presence of the intrinsic factor.

-It is the process by which nutrients are moved through the GI tract. -The process involves active transport. -The process involves diffusion.

Saliva has more than one function. What are the functions of saliva? Select all that apply. -Protection -Lubrication -Antibacterial -Initiate digestion of starches -Initiate digestion of protein

-Protection -Lubrication -Antibacterial -Initiate digestion of starches

Each day, approximately how much total fluid (in mL) is secreted into the gastronintestal tract (GI) tract from all forms of secretions (round up or down to the nearest thousand)? 7000 3200 3000 2000 All other answers

7000

Absorption is a major function of the GI tract. How is absorption accomplished in the GI tract? -Osmosis and diffusion -Active transport and osmosis -Active transport and diffusion -Diffusion and inactive transport

Active transport and diffusion

Which enzyme is found in the mouth and is the first to initiate the breakdown of starches? -Amylase -Bile -Pepsin -Trypsin

Amylase

Which function is performed by saliva? -Antimicrobial protection -Promotion of intestinal flora -Buffering of gastric secretions -Catalysis of brush border enzymes

Antimicrobial protection

Serous fluid is contained in the: -Stomach -Small intestine -Large intestine -Peritoneal cavity

Peritoneal cavity

A client who has had his gallbladder (GB) removed asks the nurse, "Why do I feel sick every time I go to a fast-food restaurant and order burgers and fries?" The nurse bases the response knowing that: -The restaurant may have "bad" grease in its fryer. -Without a GB, the size of the client's stomach has been decreased. -Bile from the GB is needed to break down lipids. -When the GB is removed, the pancreatic duct is also removed.

Bile from the GB is needed to break down lipids.

Select the enzyme that is secreted by the small intestine to facilitate the digestion of carbohydrates and proteins. -Brush border -Bile salts -Activated trypsin -Chymotrypsin

Brush border

Which enzymes adhere to the border of the villus structures to allow access to carbohydrate and protein molecules? -Brush border -Bile salts -Activated trypsin -Chymotrypsin

Brush border

A student identifies enterocytes on a microscope slide of tissue. The student explains that these cells secrete: -Brush border enzymes -Hydrochloric acid (HCl) -Mucus -Gastrin

Brush border enzymes

Which layer of the digestive tract constitutes the outer wall of the intestine and contains a serous fluid between its two layers? -Mesentery -Omentum -Haustration -Peritoneum

Peritoneum

Which of the following has a surface area approximately equal to that of the skin? -Peritoneum -Submucosal layer -Mucosal layer -Muscularis mucosae

Peritoneum

Which statement is true concerning the digestion of carbohydrates? -Carbohydrates must be digested in the large intestines. -Carbohydrates are broken down into monosaccharides before being absorbed. -Carbohydrates require hydrochloric acid to be absorbed. -Carbohydrates are excreted without being digested.

Carbohydrates are broken down into monosaccharides before being absorbed.

A nurse explains to an older adult client that production of intrinsic factor in the stomach decreases with aging. The nurse encourages the client to increase intake of which food? -Chicken -Citrus fruits -Green leafy vegetables -Apples

Chicken

A client with a history of chronic nausea and vomiting but an insatiable appetite has the symptoms attributed to an enzyme deficiency. Which enzyme deficiency is primarily responsible for the large appetite and lack of control of food intake? -Cholecystokinin -Ghrelin -Gastrin -Secretin

Cholecystokinin

A student is studying gallbladder function. Which gastrointestinal hormone stimulates contraction of the gallbladder? -Cholecystokinin -Ghrelin -Secretin -Gastrin

Cholecystokinin

A nurse is concerned about a client's continual use of nonsteroidal anti-inflammatory drugs (NSAIDs). Which problematic occurrence is the nurse concerned about? -Damage to the gastric mucosa -Increase in the proton pump -Decrease in the production of intrinsic factor -Increase in gastrin secretion

Damage to the gastric mucosa

Excessive intestinal secretion or impaired absorption can lead to which extracellular problem? -Acidosis -Dehydration -Hypotonicity -Hypervolemia

Dehydration

The physiologic rationale for hanging normal saline (0.9% NS) or 5% dextrose in water (D5W) to a client who has been experiencing diarrhea includes: -Facilitating the absorption of osmotically active particles -Activation of the ATP channels -Activating the pancreatic enzymes of trypsin and elastase -Emulsification of fats

Facilitating the absorption of osmotically active particles

True or False: The swallowing reflex is an entirely voluntary activity.

False

The dietitian explains to the client that food is digested and absorbed in the: -Stomach -Jejunum -Cecum -Colon

Jejunum

Colonic microorganisms play a role in the synthesis of which vitamin? D K C E

K

Which action initiates defecation? -Mass movements -Haustral churning -Peristaltic movements -Segmentation waves

Mass movements

Digestion of starch begins in which structure? -Mouth -Stomach -Small intestine -Large intestine

Mouth

Select the correct structural sequence of the GI tract. -Mouth, esophagus, stomach, duodenum, jejunum, ileum, cecum, colon, rectum -Mouth, esophagus, stomach, jejunum, ileum, duodenum, cecum, colon, rectum -Mouth, esophagus, stomach, ileum, duodenum, jejunum, cecum, colon, rectum -Mouth, esophagus, stomach, duodenum, jejunum, ileum, colon, cecum, rectum -Mouth, esophagus, stomach, jejunum, duodenum, ileum, cecum, colon, rectum

Mouth, esophagus, stomach, duodenum, jejunum, ileum, cecum, colon, rectum

The layer of the gastrointestinal (GI) tract that facilitates movement of contents in the GI tract is known as: -Muscularis externa -Muscularis mucosae -Lamina propria -Serosal layer

Muscularis externa

A client is admitted to the hospital for further evaluation of problems experienced with gastrointestinal digestion and absorption. The nurse anticipates the health care provider will further assess the: -Small intestine -Sigmoid colon -Intestinal lumen -Large bowel

Small intestine

A nurse explains to her client 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 organ? -Small intestine -Ileocecal valve -Upper region of the stomach -Internal anal sphincter

Small intestine

Villi are anatomic features that contribute to the enlarged surface area of the: -Small intestine -Large intestine -Stomach -Esophagus

Small intestine

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 antibiotics were not specific enough, and C. difficile was allowed to survive. -The current infection is unrelated and was coincidental to the time of the previous infection. -The client's antibiotics disrupted the microbial balance and allowed overgrowth. -C. difficile is part of the normal flora and rebounded after antibiotic therapy.

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

Which statement regarding the defecation process is most accurate? -The external sphincter is a circular thickening of smooth muscle, several centimeters in length, that lies inside the anus. -The internal sphincter is composed of striated voluntary muscle. -The external sphincter is controlled by nerve fibers in the pudendal nerve. -To prevent involuntary defecation from occurring, the internal anal sphincter is under the conscious control of the cortex.

The external sphincter is controlled by nerve fibers in the pudendal nerve.

Where in the GI tract is food digested and absorbed? -The colon and the ileum -The jejunum and the ileum -The stomach and the jejunum -The jejunum and the colon

The jejunum and the ileum

When discussing digestion with a group of nursing students, the instructor asks, "Where does the digestion of our food begin?" The most accurate student response would be: -The stomach, with its hydrochloric acid production -The duodenum, with common bile duct secretions -The mouth, with ptyalin and amylase breaking down starches -The jejunum, where peristaltic waves begin

The mouth, with ptyalin and amylase breaking down starches

Which statement is true concerning gastric enterocytes? -They secrete enzymes that aid in digestion of proteins. -They secrete lubrication for the gastrointestinal tract. -They digest entero bacteria. -They provide binding sites for insulin.

They secrete enzymes that aid in digestion of proteins.

A client has been diagnosed with an incompetent pyloric sphincter. This client is experiencing a lot of abdominal pain and nausea. When this client vomits, the nurse should expect what type of secretions will be in the basin? -Green, stringy emesis -Bright red, bloody emesis -Thick, brownish, foul-smelling emesis -Clear mucous-looking emesis

Thick, brownish, foul-smelling emesis

Which colon section forms the left colic (splenic) flexure? -Transverse -Sigmoid -Ascending -Appendix

Transverse

Which substance is broken down by the emulsification process? -Triglycerides -Proteins -Lactose -Starch

Triglycerides

Which enzymes are responsible for the breakdown of protein? -Trypsin and elastase -Amylase and lipase -Pepsin and bile -Ptyalin and mucus

Trypsin and elastase

A client is not able to absorb vitamin B12. The nurse determines that the client is deficient in: -parietal (oxyntic) cells, which secrete HCl and intrinsic factor. -mucous neck cells, which secrete mainly mucus. -peptic (chief cells), which secrete pepsinogen. -S cells, which secrete secretin.

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

A client with long-standing digestive problems is found to have a deficiency in pepsinogen. The client likely has dysfunction involving: -parietal cells. -chief cells. -epithelial cells of gastric pits. -epithelial cells of the esophagus.

parietal cells.

A hospitalized older adult asks the nurse how he acquired Clostridium difficile while taking an antibiotic medication. Which is the best response by the nurse? -"The administration of broad-spectrum antibiotics can disrupt the normal microbial balance and allow overgrowth of species." -"It is a consequence of being older and having health issues." -"All clients in the hospital are at risk for developing the problem." -"It is the result of using a generic medication in place of your home medication."

"The administration of broad-spectrum antibiotics can disrupt the normal microbial balance and allow overgrowth of species."

A gastroenterologist is teaching a group of students about the enteric nervous system in preparation for a consult with a client who has experienced a spinal cord injury. Which teaching point is most accurate? -"The myenteric plexus is responsible for controlling the function of each segment of the intestinal tract." -"The enteric nervous system is made up of the myenteric and submucosal plexuses; these are located in the wall of the gastrointestinal (GI) tract." -"Sympathetic innervation of much of the gastrointestinal (GI) tract occurs by way of the vagus nerve." -"Parasympathetic stimulation blocks the release of the excitatory neuromediators and inhibits gastrointestinal (GI) motility."

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

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

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

A student is studying the esophagus. Which statement made by this student to a faculty member is a correct one? -"The lower sphincter, known as the pharyngoesophageal sphincter, lies just above the area where the esophagus joins the stomach." -"The gastroesophageal sphincter keeps air from entering the esophagus and stomach during breathing." -"The upper esophageal sphincter passes through an opening, or hiatus, in the diaphragm." -"The smooth muscle layers provide the peristaltic movements needed to move food along the length of the esophagus."

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

A client takes 650 mg of aspirin every 4 hours daily for reports of joint pain. Which statement should be included in the client's teaching plan? -"This medication can damage gastric mucosa." -"You should have your partial thromboplastin time assessed." -"This medication will not assist with joint pain." -"You should have your hemoglobin and hematocrit checked weekly."

"This medication can damage gastric mucosa."

A client is diagnosed with pernicious anemia and asks, "Why is my body not able to absorb vitamin B12?" Which response by the nurse is most accurate? -"You have too many ulcers in your stomach." -"More than likely, you were born with deficient vitamin B12 stores." -"Your stomach is not secreting a substance known as intrinsic factor, which is needed to absorb vitamin B12." -"Your daily intake of high saturated fats is interfering with the stomach's ability to absorb the nutrients that it needs, especially vitamin B12."

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

During a lecture discussing nausea and vomiting, the nurse reviews the role of the chemoreceptor trigger zone which may be stimulated (causing vomiting) by which factors? Select all that apply. -Daily intake of baby aspirin -Chemotherapeutic agents -Salmanella food poisoning -Intake of carbohydrate beverages -Increased intracranial pressure

-Chemotherapeutic agents -Salmanella food poisoning -Increased intracranial pressure

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 intestines -Destruction of mucus -Suppression of digestion -Decreased absorption of nutrients

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

An adult has been diagnosed with gastroesophageal reflux disease, in which the function of the lower esophageal sphincter is compromised. Which consequence of this condition is most likely? -Decreased absorption of ingested foods and fluids. -Impaired control of the gastric emptying rate. -Protrusion of the stomach or regurgitation of stomach contents into the esophagus. -Inappropriate release of gastric enzymes.

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

Which statements best describe peristaltic movements? Select all that apply. -They are rhythmic, propulsive movements. -They force intraluminal contents forward. -They move chyme from the small to large intestine. -They occur when the smooth muscle layer dilates. -They begin in the cecum.

-They are rhythmic, propulsive movements. -They force intraluminal contents forward. -They move chyme from the small to large intestine.

Which would be considered the function of secretory glands in the gastrointestinal tract? Select all that apply. -To produce mucus to lubricate the wall of the gastrointestinal tract -To secrete fluid and enzymes to aid in digestion -To release gas from carbohydrate metabolism -To increase gastric motility through muscle contraction

-To produce mucus to lubricate the wall of the gastrointestinal tract -To secrete fluid and enzymes to aid in digestion

Place the components to the gastrointestinal tract in descending order, describing the route food would take through the body. a. Mouth b. Esophagus c. Stomach d. Pyloric region e. Duodenum f. Rectum 1a, 2b, 3c, 4d, 5e, 6f 1a, 2b, 3c, 4e, 5d, 6f 1a, 2b, 3d, 4c, 5e, 6f 1a, 2b, 3e, 4c, 5d, 6f 1% 1a, 2b, 3d, 4e, 5c, 6f

1a, 2b, 3c, 4d, 5e, 6f

When maltose is not broken down into two glucose molecules in the gastrointestinal tract, which of the following may occur? -Diarrhea -Decrease in insulin production -Reduction in gastric secretions -Reduction in fat absorption

Diarrhea

Which aspect of gastrointestinal function is performed by the brush border enzymes of the villus structures? -Fat metabolism -Vitamin A synthesis -Digestion of carbohydrates -Maintenance of fluid and electrolyte balance

Digestion of carbohydrates

The client tells the nurse that she is very anxious and that her pulse is racing. What will the nurse expect to see? -Dry mouth -Increased GI motility -Increase in the amplitude of slow waves =Initiation of the second defecation reflex

Dry Mouth

The common bile duct and the pancreatic duct release their products into which section of the intestines? -Ileum -Antrum -Jejunum -Duodenum

Duodenum

The common bile duct opens into which part of the gastrointestinal tract? -Duodenum -Jejunum -Ileum -Cecum

Duodenum

The colon is home to between 300 and 500 different species of bacteria. What is their main metabolic function? -Digestion of insoluble fiber -Fermentation of undigestible dietary residue -Compaction of metabolic waste prior to leaving the body -Absorption of calcium

Fermentation of undigestible dietary residue

While planning care for a client with irritable bowel syndrome, knowing the client has an increased amount of secretions with impaired GI absorption, the priority nursing diagnosis would be: -Fluid volume deficit -Hypotonic GI motility -Fatigue -Metabolic acidosis

Fluid volume deficit

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

Ghrelin

A nurse practitioner is examining an obese client. Which structure can contain considerable amounts of fat? -Greater omentum -Lesser omentum -Mesentery -Peritoneum

Greater omentum

A client has been diagnosed with cholecystitis (gallbladder inflammation) that has impaired the normal release of bile. Which gastrointestinal consequence is this client likely to experience? -Incomplete digestion of starches -Impaired glucose metabolism -Inadequate gastric acid production -Impaired digestion of fats

Impaired digestion of fats

A resident of a long-term care facility has contracted Clostridium difficile with frequent diarrhea and hyperactive bowel sounds. What process in the small intestine is most likely accompanying the current status? -Pathogenic microorganisms are causing dilation of the small intestine, increasing motility. -Segmentation waves have become more frequent as a result of the infection. -Intestinal stasis brought on by infection is preventing the small intestine from sufficiently slowing the rate of motility. -Inflammation is accompanied by an increase in peristaltic movements of the small intestine.

Inflammation is accompanied by an increase in peristaltic movements of the small intestine.

A client with a stressful job is admitted to hospital reporting abdominal pain. He admits that he vomited earlier and there was blood present. What effect of the sympathetic nervous system is most responsible for the client's symptoms? -Inhibition of the actions of Brunner glands -Overstimulation of the oxyntic glands -Suppression cholecystokinin -Inflammation of the parotid glands

Inhibition of the actions of Brunner glands

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 holds organs in place. -It attaches the jejunum and ileum to the abdominal wall. -It has substantial mobility and moves around in the peritoneal cavity with peristaltic movements. -It is mainly there to prevent any noxious substance from entering into the gut.

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

Which statement best communicates the nature of movements in the colon? -The internal and external anal sphincters control the movement of feces into and through the colon. -Haustrations move the colon contents along with 2- to 3-minute rest periods between movements. -Segmentation waves are local events involving only 0.5 to 1.5 in (1.25 to 3.75 cm) of the intestine. -Large segments of the colon contract as a unit for around 30 seconds.

Large segments of the colon contract as a unit for around 30 seconds.

A speech therapist is performing a swallowing assessment on a client who had a stroke, because the health care team is considering the introduction of oral food. The client will most likely have conscious control over which process? -Initiation of primary peristalsis -Moving the epiglottis back to cover the larynx -Moving a bolus to the posterior wall of the pharynx -Moving the bolus backwards in the esophagus

Moving a bolus to the posterior wall of the pharynx

A nurse is teaching a client about the difference between digestion and absorption. Which action should the nurse describe as absorption? -Hydrolysis of compounds to make them into smaller molecules -Emulsification of fats to make them water soluble -Cleavage of proteins into peptides and amino acids -Moving nutrients from the external environment of the GI tract into the internal environment

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

An older adult is reporting increasing fatigue and dark stools. On assessment, the nurse notes pale mucous membranes, low hemoglobin and red cell counts, and upper gastrointestional bleed in the stomach via endoscopy. Questioning reveals excess nonsteroidal anti-inflammatory drug (NSAID) usage to control rheumatoid arthritis pain. Which phenomenon is responsible for the present health problems? -NSAIDs increase the gastric production of gastrin, increasing gastric secretions and lowering stomach pH. -Drugs such as NSAIDs increase the H+ levels and thus decrease gastric pH, resulting in insult to the stomach lining. -NSAIDs, aspirin, and other drugs increase prostaglandin synthesis, resulting in disruption of cellular structures lining the stomach. -NSAIDs can disrupt the permeability of the gastric mucosa, causing hydrogen ions to accumulate in the mucosal cells of the lining.

NSAIDs can disrupt the permeability of the gastric mucosa, causing hydrogen ions to accumulate in the mucosal cells of the lining.

Defecation is controlled by both an internal and an external sphincter. What nerve controls the external sphincter? -Vagus nerve -Femoral nerve -Phrenic nerve -Pudendal nerve

Pudendal nerve

An anatomy student explains that the funnel-shaped portion of the stomach that connects with the intestine is called which region? -Pyloric region -Cardiac region -Body -Fundus

Pyloric region

Regurgitation of bile salts and duodenal contents can lead to gastric ulcers. Which structure prevents this from happening? -Pyloric sphincter -Cardiac orifice -Pharyngoesophageal sphincter -Gastroesophageal sphincter

Pyloric sphincter

The circular layer of smooth muscle that lies between the stomach and the small intestine is called: -Pyloric sphincter -Cardiac sphincter -The antrum -The cardiac orifice

Pyloric sphincter

A client reports chronic cramping, bloating, and diarrhea and is diagnosed with a deficiency in brush border enzymes within the small intestine. Which meal/snack, high in carbohydrates and protein, will likely exacerbate the client's signs and symptoms? -Grapefruit and prunes -Tossed salad with an oil and vinegar dressing -Roast beef and a baked potato -Tortilla chips and guacamole

Roast beef and a baked potato

When acidic chyme enters the duodenum, it stimulates secretion of which hormone? -Secretin -Gastrin -Ghrelin -Glucagon-like peptide 1 (GLP-1)

Secretin

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 -Dopamine -Acetylcholine receptors -Opioid receptors

Serotonin

Gastrin production, a task that is performed by the stomach, results in which effect? -Stimulation of pancreatic enzyme secretions -Stimulation of gastric acid secretion by parietal cells -Conversion of polysaccharides to monosaccharides -Release of insulin in response to glucose load

Stimulation of gastric acid secretion by parietal cells

A client has been diagnosed with an incompetent pyloric sphincter. The nurse educating the client mentions that this is due to abnormal communication between which components of the gastrointestinal tract? -Stomach and duodenum -Esophagus and stomach -Rectum and anus -Small intestine and colon

Stomach and duodenum

Which statement 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. -Each day approximately 2000 mL of fluid is secreted into the GI tract. -Secretory activity is increased with sympathetic stimulation. -The secretions are mainly albumin with sodium and potassium.

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

The client chews an apple and starts the process of swallowing. As food enters the client's esophagus, the nurse recognizes that which nerve innervates the sphincter in the lower esophagus? -Phrenic nerve -Vagus nerve -Hypoglossal nerve -Trigeminal nerve

Vagus nerve

Biopsy results reveal that a client has a deficient amount of parietal (oxyntic) cells in his stomach. The client asks the nurse to explain what this means. The nurse explains that parietal cells secrete HCl and intrinsic factor, which is needed for absorption of: Vitamin A Vitamin K Vitamin B12 Vitamin D3

Vitamin B12

Which statement best captures an aspect of the process of fat digestion and absorption? -Ingested triglycerides are broken down into absorbable form by gastric lipase. -Triglycerides are digested with the aid of bile salts. -Long-chain fatty acids are absorbed directly into the portal blood. -Stool is not excreted until all fat is absorbed.

Triglycerides are digested with the aid of bile salts.

Which nerve controls the esophageal phase of swallowing? -Vagus -Hypoglossal -Glossopharyngeal -Trigeminal

Vagus

While reviewing the colonic absorption and role of flora in the GI system, the instructor will stress that the large intestine contains: -only a few species of bacterial species, primarily aerobic in nature. -a high percentage of acidic secretions that limit bacterial invasion. -a complex microbial system that contains hundreds of different species. -a few species of anaerobic bacteria and no aerobic bacteria.

a complex microbial system that contains hundreds of different species.