Chapter 36: Structures and Function of the GI Tract

Place the components to the gastrointestinal tract in descending order, describing the route food would take through the body. - Esophagus - Duodenum - Pyloric region - Mouth - Rectum - Stomach

1. Mouth 2. Esophagus 3. Stomach 4. Pyloric region 5. Duodenum 6. Rectum

What percentage of stool is water?

75%

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

A. "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 has been diagnosed with a defect in the pyloric sphincter. How will the nurse explain the likely consequence of a dysfunctional pyloric sphincter? A. Contents from the small intestine may flow back into the stomach. B. Intestinal motility will be slowed and you may have constipation. C. Food may have trouble entering the stomach from the esophagus. D. Decreased control of defecation could lead to fecal incontinence.

A. Contents from the small intestine may flow back into the stomach.

A pathophysiology student is differentiating digestion from absorption. Which explanation is most accurate? A. Digestion is the process of dismantling foods into their constituent parts. B. Absorption requires hydrolysis, enzyme cleavage, and fat emulsification. C. Digestion takes place mainly in the stomach. D. The absorptive function of the large intestine focuses mainly on nutrient absorption.

A. Digestion is the process of dismantling foods into their constituent parts.

The common bile duct opens into which part of the gastrointestinal tract? A. Duodenum B. Jejunum C. Cecum D. Ileum

A. Duodenum

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: A. Facilitating the absorption of osmotically active particles B. Activation of the ATP channels C. Activating the pancreatic enzymes of trypsin and elastase D. Emulsification of fats

A. Facilitating the absorption of osmotically active particles

Which substance necessary for vitamin B12 absorption is produced by the parietal cells in the stomach? A. Intrinsic Factor B. Hydrochloric Acid C. Carbonic Anhydrase D. Pepsinogen

A. Intrinsic Factor

Which are functions of the digestive system? Select all that apply. A. Nutrients are absorbed B. Wastes are collected C. Wastes are eliminated D. Insulin is produced E. RBCs are produced F. Vitamins are synthesized

A. Nutrients are absorbed B. Wastes are collected C. Wastes are eliminated F. Vitamins are synthesized

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

A. Protein digestion begins in the stomach.

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? A. Stomach and duodenum B. Esophagus and stomach C. Rectum and anus D. Small intestine and colon

A. Stomach and duodenum

The nurse is teaching a new mother about the need for supplemental vitamin K due to the lack of normal flora in the intestinal track of the newborn. Which factor(s) will the nurse explain because they influence the process by which normal flora colonizes the gastrointestinal tract of newborns? Select all that apply A. Stress B. Immunologic Status C. Mother's age at time of birth D. Passage through birth canal E. Diet

A. Stress B. Immunologic Status D. Passage through birth canal E. Diet

Which statement is true concerning gastric enterocytes? A. They secrete enzymes that aid in digestion of proteins. B. They secrete lubrication for the gastrointestinal tract. C. They digest enterobacteria. D. They provide binding sites for insulin.

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

Which substance is broken down by the emulsification process? A. Triglycerides B. Proteins C. Lactose D. Starch

A. Triglycerides

Which of the following are major functions of colonic microorganisms? Select all that apply. A. Vitamin Synthesis B. Absorption of Calcium C. Absorption of magnesium D. Absorption of potassium

A. Vitamin Synthesis B. Absorption of Calcium C. Absorption of magnesium

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

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

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

Active transport and diffusion

Which function is performed by saliva? A. Antimicrobial protection B. Promotion of intestinal flora C. Catalysis of brush border enzymes D. Buffering of gastric secretions

Antimicrobial protection

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

B. "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 statement is most accurate? A. "Peristaltic movements drive the contents forward and backward." B. "Segmentation waves function mainly to mix the chyme with the digestive enzymes from the pancreas." C. "The frequency of segmenting activity decreases after a meal." D. "Peristaltic movements begin in the cecum."

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

An older adult client has been diagnosed with pernicious anemia as a result of the aging process. Which nursing intervention is appropriate to treat pernicious anemia? A. Increasing green, leafy vegetables in the diet B. Administering an intramuscular injection of cobalamin, a form of B12. C. Discussing ways to give liquid forms of iron supplement D. Greatly reducing intake of antacids and laxatives

B. Administering an intramuscular injection of cobalamin, a form of B12.

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

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

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

B. Fermentation of undigestible dietary residue

A pharmacology student is studying gastrointestinal medications. The student explains that proton pump inhibitors (PPIs) are used to inhibit secretion of: A. Pepsin B. Gastric Acid C. Intrinsic Factor D. Lysozyme

B. Gastric Acid

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

B. Peritoneum

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

B. Pharyngeal phase

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

B. Stimulation of gastric acid secretion by parietal cells

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: A. Vitamin A B. Vitamin B12 C. Vitamin K D. Vitamin D3

B. Vitamin B12

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

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

Which enzymes adhere to the border of the villus structures to allow access to carbohydrate and protein molecules? A. Chymotrypsin B. Activated trypsin C. Bile Salts D. Brush borders

Brush border

A student identifies enterocytes on a microscope slide of tissue. The student explains that these cells secrete: A. Gastrin B. Mucus C. Brush border enzymes D. HCl

Brush border enzymes

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

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

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

C. Cholecystokinin

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

C. Ghrelin

Which nerve plexus controls the motility along the length of the gut? A. Mechanoreceptors B. Intramural plexuses C. Myenteric D. Submucosal

C. Myenteric

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: A. The stomach, with its hydrochloric acid production B. The duodenum, with common bile duct secretions C. The mouth, with ptyalin and amylase breaking down starches D. The jejunum, where peristaltic waves begin

C. The mouth, with ptyalin and amylase breaking down starches

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? A. Green, stringy emesis B. Bright red, bloody emesis C. Thick, brownish, foul-smelling emesis D. Clear mucous-looking emesis

C. Thick, brownish, foul-smelling emesis

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

C. a complex microbial system that contains hundreds of different species

A nurse documents that the client has "steatorrhea." What did the nurse most likely assess? A. hard, black stools B. Incontience C. Fatty stools D. Foul-smelling urine

C. fatty stools

Which carbohydrate is matched to its correct enzyme needed for digestion? A. lactose and sucrose B. starch and alpha dextrinase C. sucrose and sucrase D. starch and lactase

C. sucrose and sucrase

A client with long-standing digestive problems is found to have a deficiency in pepsinogen. The client likely has dysfunction involving: A. Chief cells B. Crypts of Lieberkuhn C. epithelial cells of gastric pits D. epithelial cells of the esophagus

Chief cells

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

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

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

D. Cholecystokinin

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

D. Gastroesophageal sphincter

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? A. Incomplete digestion of starches B. Impaired glucose metabolism C. Inadequate gastric acid production D. Impaired digestion of fats

D. Impaired digestion of fats

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

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

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

D. Pyloric Region

The circular layer of smooth muscle that lies between the stomach and the small intestine is called: A. The cardiac orifice B. The antrum C. Cardiac sphincter D. Pyloric sphincter

D. Pyloric sphincter

Which statement describes peristalsis in the esophagus? A. Primary peristalsis is partially mediated by smooth muscle fibers in the esophagus. B. The pressure in the lower esophageal sphincter normally is less than that in the stomach. C. The pharyngoesophageal sphincter is innervated by the vagal nerve. D. The hormone gastrin increases constriction of the lower esophageal sphincter.

D. The hormone gastrin increases constriction of the lower esophageal sphincter.

Excessive intestinal secretion or impaired absorption can lead to which extracellular problem? A. Acidosis B. Dehydration C. Hypotonicity D. Hypervolemia

Dehydration

Which aspect of gastrointestinal function is performed by the brush border enzymes of the villus structures? A. Fat metabolism B. Vitamin A synthesis C. Digestion of carbohydrates D. 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? A. Initiation of the second defecation reflex B. Increase in the amplitude of slow waves C. Increased GI motility D. Dry mouth

Dry mouth

What is the condition that is characterized by the rapid emptying of highly acidic and hyperosmotic gastric secretions into the duodenum and jejunum? A. Hypertrophic pyloric stenosis B. PUD C. Dumping syndrome D. IBS

Dumping syndrome

The dietitian explains to the client that food is digested and absorbed in the: A. Stomach B. Jejunum C. Cecum D. Colon

Jejunum

Which structure in the gastrointestinal (GI) tract has absorptive function focusing mainly on water resorption? A. Large Intestine B. Stomach C. Small Intestine D. Ileum

Large intestine

Which action initiates defecation? A. Mass movement B. Haustral churning C. Peristaltic movements D. Segmentation waves

Mass movement

Serous fluid is contained in the: A. Stomach B. Small Intestine C. Peritoneal Cavity D. large intestine

Peritoneal cavity

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

Pharyngeal

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

Pyloric sphincter

Villi are anatomic features that contribute to the enlarged surface area of the: A. Large intestine B. Small intestine C. Stomach D. Esophagus

Small intestine

Which type of nervous system response can cause a marked decrease in mucous production, leaving the area susceptible to irritation, thereby causing ulcer development in the duodenum? A. Parasympathetic inhibition B. Sympathetic stimulation C. CNS increase D. PNS inhibition

Sympathetic stimulation

Which enzymes are responsible for the breakdown of protein? A. Ptyalin and mucus B. Pepsin and bile C. Amylase and lipase D. Trypsin and elastase

Trypsin and elastase

Which nerve controls the esophageal phase of swallowing? A. Glossopharyngeal B. Hypoglossal C. Vagus D. Trigeminal

Vagus

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? A. Upper region of the stomach B. Ileorecal valve C. Small Intestine D. Internal anal sphincter

small intestine

The production of chyme occurs in which organ? A. Stomach B. Esophagus C. Small Intestine D. Pancreas

stomach

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: A. Fluid volume deficit B. Hypotonic GI motility C. Fatigue D. Metabolic acidosis

Fluid volume deficit

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? A. Mesentery B. Greater omentum C. Haustration D. Peritoneum

Greater omentum

Ghrelin produced in the mucosal layer of the stomach has a role in regulation of which hormone that contributes to the regulation of weight? A. Gastric acid B. Growth hormone C. Biliary bicarbonate D. Pancreatic enzymes

Growth Hormones