diarrhea

A patient being treated for hepatic encephalopathy could be expected to receive a(n) ________diet. a.low-protein and high-fiber b.high-protein and high-carbohydrate c.high-sodium d.unrestricted

a.low-protein and high-fiber

Premature infants are at greater risk for developing a.necrotizing enterocolitis. b.pseudomembranous colitis. c.appendicitis. d.diverticular disease.

a.necrotizing enterocolitis.

The blood urea nitrogen (BUN) level is affected by (Select all that apply.) a.protein intake. b.fat intake. c.fluid intake. d.catabolism. e.renal function.

a.protein intake. c.fluid intake. d.catabolism. e.renal function.

An important sign of glomerular basement membrane dysfunction is a.proteinuria. b.hematuria. c.glycosuria. d.urinary casts.

a.proteinuria

Normal bile is composed of a.water, electrolytes, and organic solutes. b.proteins. c.bile acids. d.phospholipids.

a.water, electrolytes, and organic solutes.

The pain associated with chronic pancreatitis is generally described as ________ in nature. a.sharp and constant b.steady and boring c.intermittent and burning d.intermittent and stabbing

b.steady and boring

Patients who may be at risk for development of cholesterol gallstones include (Select all that apply.) a.high spinal cord injuries. b.patients receiving total parenteral nutrition. c.patients receiving chemotherapy. d.patients with rapid weight loss. e.pregnant women.

a.high spinal cord injuries. b.patients receiving total parenteral nutrition. d.patients with rapid weight loss. e.pregnant women.

Confusion, subtle behavioral changes, no liver flap

Grade 1

Drowsy, clear behavioral changes, liver flap present

Grade 2

Stuporous, able to follow commands, marked confusion, slurred speech, liver flap present

Grade 3

Coma, no liver flap

Grade 4

Celiac sprue is a malabsorptive disorder associated with a.inflammatory reaction to gluten-containing foods. b.megacolon at regions of autonomic denervation. c.ulceration of the distal colon and rectum. d.deficient production of pancreatic enzymes.

a.inflammatory reaction to gluten-containing foods.

The most common causes of prehepatic jaundice are ________ and ineffective erythropoiesis. a.hemolysis b.metabolism c.fibrosis d.canalicular bilirubin transport

a.hemolysis

A patient receiving chemotherapy may be at greater risk for development of a.gastroesophageal reflux. b.stomatitis. c.esophageal varices. d.Mallory-Weiss syndrome.

b.stomatitis.

A patient with chronic gastritis would likely be tested for a.Helicobacter pylori. b.occult blood. c.lymphocytes. d.herpes simplex.

a.Helicobacter pylori.

What is a pathophysiologic mechanism involved in the development of diarrhea? (Select all that apply.) a.Osmotic diarrhea b.Excessive flatus c.Secretory diarrhea d.Exudative diarrhea e.Motility disturbances

a.Osmotic diarrhea c.Secretory diarrhea d.Exudative diarrhea e.Motility disturbances

Crohn disease is associated with what complications? (Select all that apply.) a.Perianal fissures b.Fistulae c.Green stool d.Abscesses e.Rectal pain

a.Perianal fissures b.Fistulae d.Abscesses

Hormones that increase sodium reabsorption from the tubular fluid include (Select all that apply.) a.aldosterone. b.atrial natriuretic peptide. c.antidiuretic hormone. d.urodilatin. e.angiotensin II.

a.aldosterone. e.angiotensin II.

Acute right lower quadrant pain associated with rebound tenderness and systemic signs of inflammation are indicative of a.appendicitis. b.peritonitis. c.cholecystitis. d.gastritis.

a.appendicitis.

18. Chronic cholecystitis can lead to (Select all that apply.) a.biliary sepsis. b.calcified gallbladder. c.porcelain gallbladder. d.cirrhosis. e.diabetes mellitus.

a.biliary sepsis. b.calcified gallbladder. c.porcelain gallbladder.

Ulcerative colitis is commonly associated with a.bloody diarrhea. b.malabsorption of nutrients. c.fistula formation between loops of bowel. d.inflammation and scarring of the submucosal layer of the bowel.

a.bloody diarrhea.

Chronic pancreatitis may lead to a.diabetes mellitus. b.Crohn disease. c.gallstones. d.celiac sprue.

a.diabetes mellitus.

A disorder of the esophageal smooth muscle function where dysphagia is a symptom is (Select all that apply.) a.esophageal stricture. b.achalasia. c.esophageal tumors. d.Mallory-Weiss syndrome. e.hiatal hernia.

a.esophageal stricture. b.achalasia. c.esophageal tumors.

Steatohepatitis is caused by an accumulation of ________ in the liver cells. a.fat b.bile c.acetaminophen d.ferritin

a.fat

Factors that increase the glomerular filtration rate include a.fluid volume excess. b.increased hydrostatic pressure in the Bowman's capsule. c.high oncotic pressure in glomerular capillary blood. d.obstruction in the renal tubules.

a.fluid volume excess.

Untreated acute cholecystitis may lead to ________ of the gallbladder wall. a.gangrene b.infection c.distention d.inflammation

a.gangrene

The primary selectivity barrier for glomerular filtration is the a.glomerular basement membrane. b.endothelial tight junctions. c.epithelial fenestra. d.mesangial cells.

a.glomerular basement membrane.

Which digestive enzyme is secreted from the intestinal mucosa during a meal? (Select all that apply.) a.Amylase b.Cholecystokinin c.Trypsinogen d.Lecithin e.Lipase f.Secretin

b.Cholecystokinin f.Secretin

What laboratory data would support a diagnosis of hemochromatosis? a.Deficient protease inhibitor b.Elevated ferritin c.Elevated urine copper d.Positive antinuclear antibody

b.Elevated ferritin

Which symptom suggests the presence of a hiatal hernia? a.Nausea b.Heartburn c.Diarrhea d.Abdominal cramps

b.Heartburn

What form of viral hepatitis is likely to be transmitted sexually? a.Hepatitis A b.Hepatitis B c.Hepatitis C d.Hepatitis E

b.Hepatitis B

________ disease is a rare autosomal recessive disorder in which excessive amounts of copper accumulate in the liver. a.Kayser-Fleischer b.Wilson c.Reye d.Byler

b.Wilson

Liver transaminase elevations in which aspartate aminotransferase (AST) is markedly greater than alanine aminotransferase (ALT) is characteristic of a.viral hepatitis. b.alcohol-induced injury. c.cirrhosis. d.acetaminophen toxicity.

b.alcohol-induced injury.

A patient who should be routinely evaluated for peptic ulcer disease is one who is a.taking 6 to 8 tablets of acetaminophen per day. b.being treated with high-dose oral glucocorticoids. c.experiencing chronic diarrhea. d.routinely drinking alcoholic beverages.

b.being treated with high-dose oral glucocorticoids.

Most gallstones are composed of a.bile. b.cholesterol. c.calcium. d.uric acid salts.

b.cholesterol.

Fecal leukocyte screening would be indicated in a patient with suspected a.lactose intolerance. b.enterocolitis. c.laxative abuse. d.giardiasis.

b.enterocolitis

The underlying mechanism which directly results in glycosuria is a.filtration of glucose from the glomerulus. b.exceeding the threshold for glucose reabsorption. c.secretion of glucose into the distal tubule. d.the mechanism is unknown.

b.exceeding the threshold for glucose reabsorption.

The main driving force for glomerular filtration is a.oncotic pressure in the Bowman's capsule. b.hydrostatic pressure in glomerular capillaries. c.permeability of the glomerular membrane. d.solute content of the blood in the glomerular capillaries.

b.hydrostatic pressure in glomerular capillaries.

The finding of hypotension, rigid abdomen, and absent bowel sounds in a patient with pancreatitis a.is an expected finding and requires no specific intervention. b.indicates peritonitis with substantial risk for sepsis and shock. c.requires immediate surgical intervention. d.is an unusual finding in pancreatitis and indicates misdiagnosis.

b.indicates peritonitis with substantial risk for sepsis and shock.

It is true that gallstones are a.a minimal risk for Native Americans. b.more common in women. c.more common in men. d.at highest risk among Asians.

b.more common in women.

It is true that glucose reabsorption in the tubules a.occurs passively. b.occurs in the proximal convoluted tubule. c.is unlimited. d.simply does not occur.

b.occurs in the proximal convoluted tubule.

A patient admitted with bleeding related to esophageal varices could be expected to receive a continuous intravenous infusion of a.glucose. b.octreotide acetate. c.anticoagulants. d.proton pump inhibitors.

b.octreotide acetate.

Barrett esophagus is a a.gastrin secreting lesion. b.preneoplastic lesion. c.benign condition. d.gastrin-secreting tumor.

b.preneoplastic lesion.

Patients with acute pancreatitis are generally made NPO and may require continuous gastric suctioning in order to a.prevent abdominal distention. b.remove the usual stimuli for pancreatic secretion. c.prevent hyperglycemia associated with loss of insulin secretion. d.prevent mechanical obstruction of the intestine.

b.remove the usual stimuli for pancreatic secretion.

what clinical finding would suggest an esophageal cause of a client's report of dysphagia? a.Nasal regurgitation b.Airway obstruction with swallowing c.Chest pain during meals d.Coughing when swallowing

c.Chest pain during meals

An early indicator of colon cancer is a.rectal pain. b.bloody diarrhea. c.a change in bowel habits. d.jaundice.

c.a change in bowel habits.

An urgent surgical consult is indicated for the patient with acute abdominal pain and a.vomiting. b.CVA tenderness. c.absent bowel sounds. d.borborygmi.

c.absent bowel sounds.

The most common cause of mechanical bowel obstruction is a.volvulus. b.intussusception. c.adhesions. d.fecal impaction.

c.adhesions

More than half of the initial cases of pancreatitis are associated with a.trauma. b.stones. c.alcoholism. d.high cholesterol.

c.alcoholism.

Hepatitis B is usually transmitted by exposure to a.hepatitis vaccine. b.feces. c.blood or semen. d.contaminated food.

c.blood or semen.

Epigastric pain that is relieved by food is suggestive of a.pancreatitis. b.cardiac angina. c.gastric ulcer. d.dysphagia.

c.gastric ulcer.

A patient with pancreatitis may experience muscle cramps secondary to a.alkalosis. b.hyperglycemia. c.hypocalcemia. d.hypermagnesemia.

c.hypocalcemia

Renin is released from a.the posterior pituitary gland. b.the liver. c.juxtaglomerular cells. d.macula densa cells.

c.juxtaglomerular cells.

Brain injury secondary to high serum bilirubin is called a.hepatic encephalopathy. b.hepatic meningitis. c.kernicterus. d.encephalitis.

c.kernicterus.

Jaundice is a common manifestation of a.malabsorption syndromes. b.anemia. c.liver disease. d.cholecystitis.

c.liver disease.

Serum creatinine may be increased by a.carbohydrate intake. b.fat intake. c.muscle breakdown. d.fluid intake.

c.muscle breakdown.

Elevated serum lipase and amylase levels are indicative of a.gallbladder disease. b.appendicitis. c.pancreatitis. d.peritonitis.

c.pancreatitis.

Esophageal varices represent a complication of ________ hypertension. a.primary b.pregnancy-induced c.portal d.secondary

c.portal

The primary function of the vasa recta is to a.secrete renin. b.reabsorb NaCl. c.reabsorb interstitial fluid. d.secrete urea.

c.reabsorb interstitial fluid.

Excess potassium is excreted from the body by the renal system primarily via a.glomerular filtration based on blood level of potassium. b.reabsorption based on blood level of potassium. c.secretion based on aldosterone level. d.an unknown mechanism.

c.secretion based on aldosterone level.

Narcotic administration should be administered carefully in patients with acute pancreatitis related to potential for a.respiratory depression. b.narcotic dependency. c.sphincter of Oddi dysfunction. d.allergic reaction.

c.sphincter of Oddi dysfunction.

Serious renal impairment generally does not occur until ____ of the total nephrons have been damaged a.20% b.40% c.60% d.80%

d.80%

A biliary cause of acute pancreatitis is suggested by an elevation in which serum laboratory results? a.Lipase b.Amylase c.Glucose d.Alkaline phosphatase

d.Alkaline phosphatase

What finding should prompt further diagnostic testing in a child presenting with diarrhea? a.Periumbilical discomfort b.Greenish, watery diarrhea c.Frequent, large-volume diarrhea d.Blood and mucus in the stools

d.Blood and mucus in the stools

What finding would rule out a diagnosis of irritable bowel syndrome in a patient with chronic diarrhea? a.Negative stool leukocytes b.Intermittent constipation c.Abdominal pain and distention d.Bloody stools

d.Bloody stools

Which finding on urinalysis should prompt further evaluation? a.pH 4.5 b.Red blood cells 2 per high-power field c.Specific gravity of 1.015 d.White blood cells 20 per high-power field

d.White blood cells 20 per high-power field

A viral hepatitis screen with positive hepatitis B surface antigen (HBsAg) should be interpreted as ________ hepatitis B. a.recovered from b.immunity to c.chronic active d.acute

d.acute

An infusion of mannitol would be prescribed to treat a.varices. b.encephalopathy. c.peritonitis. d.cerebral edema.

d.cerebral edema.

The definitive treatment for cholecystitis is a.lithotripsy of stones. b.chemical dissolution of stones. c.antibiotics and anti-inflammatories. d.cholecystectomy.

d.cholecystectomy.

Proton pump inhibitors may be used in the management of peptic ulcer disease to a.increase gastric motility. b.inhibit secretion of pepsinogen. c.neutralize gastric acid. d.decrease hydrochloric acid (HCl) secretion.

d.decrease hydrochloric acid (HCl) secretion.

A silent abdomen 3 hours after bowel surgery most likely indicates a.peritonitis. b.mechanical bowel obstruction. c.perforated bowel. d.functional bowel obstruction.

d.functional bowel obstruction.

Dumping syndrome is commonly seen after __________ procedures. a.appendectomy b.intestinal biopsy c.colonoscopy d.gastric bypass

d.gastric bypass

A patient with a history of alcoholism presents with hematemesis and profound anemia. The expected diagnosis is a.ascites. b.cerebral edema. c.hepatic encephalopathy. d.gastroesophageal varices.

d.gastroesophageal varices.

An increased urine bilirubin is associated with a.an increased indirect serum bilirubin. b.hemolytic reactions. c.Gilbert syndrome. d.hepatitis.

d.hepatitis.

Hepatic encephalopathy is associated with a.hyperbilirubinemia. b.hyperuricemia. c.toxic effects of alcohol on brain cells. d.increased blood ammonia levels.

d.increased blood ammonia levels.

Constipation in an elderly patient can be best treated by a.maintaining a low-fiber diet. b.maintaining the current level of activity. c.fecal disimpaction. d.increasing fiber in the diet.

d.increasing fiber in the diet.

The glucose transporter in the proximal tubule a.has no transport maximum. b.does not depend on sodium reabsorption. c.is ATP dependent. d.may be saturated at high filtered glucose loads.

d.may be saturated at high filtered glucose loads.

Rupture of esophageal varices is a complication of cirrhosis with portal hypertension and carries a high ________ rate. a.cure b.morbidity c.insurance d.mortality

d.mortality

The most challenging aspect of treatment for chronic pancreatitis is a.pancreatectomy. b.strict dietary avoidance of fats. c.abstinence from alcohol. d.pain control.

d.pain control.

Pathophysiologically, esophageal varices can be attributed to a.elevated bilirubin. b.diminished protein metabolism. c.fluid accumulation. d.portal hypertension.

d.portal hypertension.

Approximately two-thirds of the water and electrolytes filtered by the kidney are reabsorbed by the a.loop of Henle. b.collecting tubule. c.distal tubule. d.proximal tubule.

d.proximal tubule.

The glomerular filtration rate is most accurately reflected in the a.blood urea nitrogen level. b.urinary output. c.serum osmolality. d.serum creatinine level.

d.serum creatinine level.

it is true that biliary cancer a.is most often cured by surgery. b.respond well to chemotherapy. c.are identifiable and treatable when diagnosed early. d.tend to be asymptomatic and progress insidiously.

d.tend to be asymptomatic and progress insidiously.