patho 2: E1

Ms. Johnson was just given the bad news that her 8 year old son Michael needs a liver transplant due to a rare disease that has destroyed his liver. Ms. Johnson would like to be considered to provide a donor piece of her liver for her son Michael. The nurse is right when she says the following to Ms. Johnson: a) the right lobe of your kidney will be used for donation. b) the left lobe of your kidney will be used for donation c) it does not really matter what area we take it from, we only need a little piece. d) only a small left lateral segment will be used for the donation.

* ANSWER: D. Children are smaller and only need the small lateral segment of the left lobe. Right lobe is not used for liver donation. The left lobe is the piece of the liver used for live donor donation.

Which condition may result from pressure exerted by a pituitary tumor? a. Hypothyroidism b. Hypercortisolism c. Diabetes Insipidus d. Insulin Hyposecretion

ANS: A If the tumor exerts sufficient pressure, then thyroid and adrenal hypofunction may occur because of lack of thyroid-stimulating hormone (TSH) and ACTH. These result in the symptoms of hypothyroidism and hypocortisolism. The remaining options are not associated with the pressure exerted by a pituitary tumor.

Which statement is false concerning the pathophysiologic process of alcoholic cirrhosis? A. Inflammation and damage leading to cirrhosis begin in the bile canaliculi. B. Alcohol is transformed to acetaldehyde, which promotes liver fibrosis. C. Mitochondrial function is impaired, decreasing oxidation of fatty acids. D. Acetaldehyde inhibits export of proteins from the liver.

ANS: A Rationale: Biliary cirrhosis differs from alcoholic cirrhosis in that the damage and inflammation leading to cirrhosis begin in bile canaliculi and bile ducts, rather than in the hepatocytes. The other options provide true information regarding the pathophysiologic process of alcoholic cirrhosis.

he nurse is giving a report to the night shift nurse, the patient was recently diagnosed with nonalcoholic fatty liver disease. What is the nurse going to mention when giving a report on this patient? A. This patient's diet should be balanced that includes more fruits vegetable and whole grains B. The patient can order whatever he/she wants to eat as long as blood glucose levels are monitored C. The patients' blood needs to drawn for hepatitis serology testing D. The patient is not being monitored for diabetes; this is not a risk with NAFLD

ANS: A Rationale: Improving the patients diet in order to promote a heart healthy lifestyle is the best treatment plan for patients with NAFLD, this can promote weight loss. Patients with NAFLD are at a high risk for diabetes and blood glucose levels should be monitored closely. NAFLD is not associated with hepatitis, however, they are both the two most common liver diseases in the US

What are the clinical manifestations of intestinal obstruction? -all that apply 1. Colicky pain 2. metabolic alkalosis 3. distention 4. hypovolemia 5. Vomiting

1,3,4,5. Metabolic alkalosis is incorrect, metabolic acidosis is a manifestation.

Where is bile formed and stored? A. liver; gallbladder B. liver; liver C. gallbladder; liver D. gallbladder; gallbladder

ANS: A. liver; gallbladder Rationale: The liver forms bile, which is used in the breakdown of fats and absorption of vitamins A, D, E, and K. The bile is then stored in the gallbladder. It is released into the small intestine when needed for digestion.

A patient has been diagnosed with reflux esophagitis (GERD). What instruction by the healthcare professional is most appropriate? A. Exercise soon after eating to increase gastric emptying. B. Try these proton-pump inhibitors for 2 weeks. C. You need to schedule an upper GI endoscopy soon. D. Over-the-counter antiemetics work well for this condition.

ANS: B Abnormalities in lower esophageal sphincter function, esophageal motility, and gastric motility or emptying can cause GERD. Delayed gastric emptying contributes to reflux esophagitis by (1) lengthening the period during which reflux is possible and (2) increasing the acid content of chyme. A treatment of choice for this condition is proton-pump inhibitors, so the healthcare professional would educate the patient on taking these medications. Increasing gastric motility may help GERD, but exercising soon after eating may promote vomiting and other GI distress. Antiemetics will not help in this condition. The takeaway here is, If GERD cannot be controlled through medication, movement or other integrative approaches, an endoscopy may be needed to refine the diagnosis and assess for cancerous changes.

H. pylori, high salt intake and nitrites are risk factors and/or linked to what GI Cancer? A. Esophageal Cancer B. Gastric Cancer C. Primary Liver Cancer D. Colon Cancer

ANS: B Infection with H. pylori causes chronic inflammation and significantly increases the risk of developing duodenal and gastric ulcer disease and gastric cancer. Alcohol and tobacco use as well as reflux are risk factors for esophageal cancer. Cirrhosis, chronic hepatitis B and C is a risk factor for primary liver cancer and also the liver is NOT part of the GI tract. Familial adenomatous polyposis coli is a risk factor for colon cancer.

The effects of the syndrome of inappropriate antiduretic hormone (SIADH) secretion include which solute? a. Sodium and water retention b. Sodium retention and water loss c. Sodium dilution and water retention d. Sodium dilution and water loss

ANS: C the symptoms of SIADH secretion are a result of dilutional hyponatremia and water retention. SIADH does not lead to sodium retention or water loss.

Hepatic fat accumulation is observed in which form of cirrhosis? A. Biliary B. Postnecrotic C. Metabolic D. Alcoholic

ANS: D Rationale: Alcoholic cirrhosis is a complex process that begins with fatty infiltration (hepatic steatosis). Fat deposition (deposition of triglycerides) within the liver hepatocytes is primarily caused by increased lipogenesis and decreased fatty acid oxidation by hepatocytes. This selection is the only option that accurately identifies the correct form of cirrhosis.

Cholecystitis is inflammation of the gallbladder wall usually caused by _____________________________. A. Accumulation of bile in the hepatic duct B. Obstruction of the cystic duct by a gallstone C. Accumulation of fat in the wall of the gallbladder D. Viral infection of the gallbladder

Answer: B - Obstruction of the cystic duct by a gallstone Rationale: Cholecystitis can be acute or chronic, but both forms are almost always caused by a gallstone lodged in the cysticduct. Accumulation of bile in the hepatic duct would not lead to cholecystitis, Neither the accumulation of fat nor a viral infection leads to cholecystitis.

1. Which of the cirrhosis's is considered autoimmune disease that has no cure? a. Nonalcoholic fatty liver disease b. Primary biliary cirrhosis c. Secondary biliary cirrhosis d. Primary sclerosing cholangitis.

Answer: B - primary biliary cirrhosis Rationale: Primary biliary cirrhosis is an autoimmune disorder because there is T lymphocyte-mediated and antibody-mediated destruction of the small intrahepatic bile ducts. Secondary biliary cirrhosis is an obstruction of the common bile duct due to a stone, tumor, clot. Primary sclerosing cholangitis is chronic inflammatory fibrotic disease of the hepatic blie duct that leads to secondary biliary cirrhosis. Lastly, nonalcoholic fatty liver disease is where there is infiltration of hepatocytes with fat, mainly triglycerides, that occurs in the absense of alcohol.

The colonoscopy is the gold standard for diagnosing colon cancer. It is recommended to get screened for colon cancer by receiving a colonoscopy at the age of ____. A. 45 B. 50 C. 40 D. 55

Answer: B. 50 Rational: Currently colonoscopy screenings are performed on people age 50 & up and are repeated depending on the findings. There are new guidelines being recommended by the United States Services Preventive Task Force to move the colonoscopy screening to age 45; however, this has not not been approved yet.

The nurse has to speak to the patient regarding the status of their liver and has to explain to their patient that it has progressed to NASH. The patient asks, "Is this reversible and if so how?" What is an appropriate response from the nurse? a. It is not reversible, so nothing you can do will help you at this point. b. It can be reversible. Eating a low carb diet exercise and weight loss can help reverse this process c. It can be reversible. Eating a high carb diet, and a sedentary lifestyle will help greatly.

Answer: B. It can be very difficult depending on if the patient is closer to cirrhosis or simple fat accumulation, but it is possible to reverse the process if patient has progressed to NASH. It is when the patient has progressed to Cirrhosis that the damage cannot be undone.

Which growth hormone disorder is seen in children and adolescents caused by increased secretion of growth hormone and excessive skeletal growth due to non-closure of epiphyseal plates? Multiple choice. A. Acromegaly B. GH replacement C. Gigantism D. Growth Hormone Deficiency

Answer: C Rationale: Acromegaly is seen in adults after the epiphyseal plates close with slow progression occurring in middle age men and women. Gigantism is increased secretion of GH seen in children and adolescents due to non-disclosure of epiphyseal plate. GH replacement Is a form of replacement therapy consistently been shown to have beneficial effects on body composition, bone turnover, cardiovascular risk factors, and quality of life. GH deficiency is a syndrome characterized by reduced lean body mass, increased fat mass, dyslipidemia, insulin resistance, vascular endothelial dysfunction, and results in impaired quality of life.

Which of the following describes dietary measures that be taken to prevent cancer of the stomach? a. high intake of salty foods b. high intake of pickled foods c. high intake of fruits and vegetables, d. high intake of meat

Answer: C Rationale: High intake of fruits and vegetables as well as vitamin C, carotenoids, and fiber are all dietary preventions for cancer of the stomach. High intake of salty foods, pickled foods, or meat- specifically red meat or processed meat, are risk factors for cancer of the stomach.

GERD occurs when there are issues with which part of the esophagus: a-Upper esophageal sphincter b-Cricopharyngeal muscle c-Lower esophageal sphincter d-Parotid

Answer: C Rationale: The lower esophageal sphincter is the barrier between the stomach and the esophagus that keeps stomach contents from regurgitating into the esophagus. Issues with the lower esophageal sphincter causes regurgitation of stomach acid into the lining of the esophagus, causing GERD.

The most common clinical manifestation of portal hypertension is ________ bleeding. A. Rectal B. Duodenal C. Esophageal D. Intestinal

Answer: C - Esophageal Rationale: Vomiting of blood from bleeding esophageal varices is the most common clinical manifestation of portal hypertension. Rectal, duodenal, and intestinal bleeding are NOT common clinical manifestations of portal hypertension.

Which of the following is considered a rare form of GI cancer? A. Colon Cancer B. Prostate Cancer C. Esophagus Cancer D. Pancreas Cancer

Answer: C. Esophagus cancer Rational: Colon cancer is the 3rd leading cause of cancer death in the United States. Prostate cancer is not a form of GI cancers. Esophagus cancer IS considered rare (More information: It has been reported that esophagus cancer has increased with human papillomavirus (HPV); according to the National Institute of Health in 2016 about 22.2% of esophageal cancer is related to HPV.) Pancreas cancer is the 4th cause of cancer death.

Which is not a true statement for Osteoporosis? A. Glucocorticoids could be a potential cause because it can increase RANKL expression B. Osteoporosis is an imbalance of bone resorption and formation C. Pain, bone deformity, fractures, and kyphosis are among clinical manifestations D. Thyroid Hormone is one of treatments

Answer: D Rationale: Estrogen, Bisphosphonates, Denosumba and Parathyroid hormone are among medical treatments for Osteoporosis.

What would NOT be considered a treatment option for ascites? A. Diuretic use B. Paracentesis C. Liver transplant D. Increased sodium intake in diet

Answer: D An increase in sodium intake in diet would not be considered a treatment option because water follow solute. The more sodium that is consumed the more the body will hold onto that extra fluid. The use of diuretics would be acceptable to help excrete out extra fluid. Parancetesis would be acceptable for a short time to help drain off some of the extra fluid in the belly. Lastly a liver transplant may be necessary in order to help restore liver function (albumin levels) so that fluid will not accumulate in the future.

A patient is suffering from pancreatitis and the nurse has discussed diet changes with the patient. Which of the following statements indicates that further teaching is needed? A. "If I am craving something sweet, I should have fruit such as blueberries." B. "Beans and lentils are good sources of protein that I can enjoy." C. "Cucumbers and hummus would be a great snack." D. "I know that I should avoid red meat, so when my family goes to McDonald's I will only get French fries"

Answer: D Rational: A diet for pancreatitis should focus on foods that are rich in protein, low in animal fats, and contain antioxidants. You should avoid or limit fried, fatty foods

Which type of osteoporosis is most likely to affect a 67 year old male? a. Perimenopausal Osteoporosis b. Idiopathic Juvenile Osteoporosis (IJO) c. Transient Regional Osteoporosis (TRO) d. Age-related bone loss

Answer: D Rationale: A. Perimenopausal osteoporosis is referring to osteoporosis that occurs to women during menopause due to an accelerated loss of estrogen; B. Idiopathic refers to diseases that have no known cause and it is a rare type of osteoporosis, but Idiopathic Juvenile Osteoporosis is known to usually affect children who have a history of being overweight before puberty; C. Transient Regional Osteoporosis is known to mainly affect the weight bearing joints of middle aged women and men, D. Age-related bone loss happens due to bone resorption occurring quicker than bone formation, and is associated with men and women after the age of 50.

How does a faulty negative-feedback mechanism result in a hormonal imbalance? A. Hormones are not synthesized in response to cellular and tissue activities B. Decreased hormonal secretion is a response to rising hormone levels C. Too little hormone production is initiated D. Excessive hormone production results from a failure to turn off the system

Answer: D Rationale: negative-feedback systems are important in maintain hormones within physiologic ranges. The lack of negative-feedback inhibition on hormonal release often results in pathologic conditions. Excessive hormone production, which is the result of the failure to turn off the system, can cause various hormonal imbalances and relate conditions.

1. A gastrectomy is performed on a client with gastric cancer. In the immediate postoperative period, the nurse notes bloody drainage from the nasogastric tube. Which of the following is the appropriate nursing intervention. A) Notify the physician B) Measure abdominal girth C) Irrigate the nasogastric tube D) Continue to monitor the drainage

Answer: D) Continue to monitor the drainage Rationale: Following gastrectomy, drainage from the nasogastric tube is normally bloody for 24 hours postoperatively with changes in color from brown to then yellow or clear. Bloody drainage is expected in the immediate postoperative period, the nurse should continue to monitor the drainage. The nurse does not have to notify the physician at this time. Measuring abdominal girth is performed to detect the development of distention. Following gastrectomy, a nasogastric tube should not be irrigated unless there are specific physician orders to do so.

An optimal teaching plan for an outpatient with stomach cancer receiving radiation therapy should include information about A) Cancer support groups B) Avitaminosis, ostomy care, and community resources C) Prosthetic devices, skin conductance and grief counseling D) Wound and skin care, nutrition, drugs, and community resources

Answer: D) Wound and skin care, nutrition, drugs, and community resources Rationale: Radiation therapy is used as an adjuvant to surgery or for palliation in stomach cancer treament. The nurse's role is to provide detailed instructions, to reassure the patient, and to ensure completion of the designated number of treatments. The nurse should start by assessing the patient's knowledge of radiation therapy. The nurse should teach the patient about skin care, the need for nutrition and fluid intake during therapy, and the appropriate use of antiemetic drugs.

Which structure synthesizes clotting factors and the vitamin K necessary for hemostasis? a. Colon b. Spleen c. gallbladder d. Liver

Answer: D, Liver Rationale: The liver performs many hemostatic functions, including synthesis of clotting factors and vitamin K. These are not synthesized in the colon, spleen, or gallbladder.

Which is not a cause of Osteoporosis? A. Decreased levels of estrogen and testosterone B. Decreased activity level C. Inadequate vitamin D, calcium or magnesium D. Family history E. Inadequate mineralization

Answer: E Rationale: Inadequate mineralization is a cause of Osteomalacia

2) Elevated_______________ levels can signal obstruction of the biliary tree. a) ablumin b)Prothrombin time (PT) c)AST d)ALT e) Alk phos

Answer: E. Alk phos. Alkaline phosphate is mainly present in the bile ducts. Elevated alk phosphate can signal obstruction of the biliary tree and can also be seen with bone breakdown. AST /ALT are liver enzymes involved in metabolic reactions. PT measures function in part of the clotting cascade. Albumin assesses the liver function, it is a serum protein that is synthesized by the liver.

What types of viral hepatitis's are sourced from blood transmission? A. Hep A B. Hep B C. Hep C D. Hep D E. Hep E F. B,C,D E. A,E

Answer: F Hepatitis B, C, and D are usually exposed through the blood or blood derived body fluids. Hepatitis A and E are usually sourced from feces and the route of transmission is typically the fecal- oral route. Hepatitis A and E are typically more prevalent in 3rd world countries and is due to contaminated water sources and contaminated food. Hepatitis B, C, and D are more prevalent in the United States as many transmissions occur through sharing of needles.

What type of GI diagnostic test provides a biopsy channel for tissue sampling and provides direct visualization of the GI tract?

Answer: Fiberoptic endoscopy Rationale: Fiberoptic endoscopy is a GI diagnostic test that uses flexible endoscopes allowing direct visualization of GI tract, provide a biopsy channel for tissue sampling, and provide means for suction to remove gastrointestinal secretions or blood. X-rays with contrast, such as barium or iodine, outline the gastrointestinal lumen, biliary tree and pancreatic ducts, fistulae, and arteriovenous systems. Computed tomography is used to diagnose intestinal lesions and pancreatic or hepatic tumors or cysts. Ultrasounds are used to detect gallstones and intraabdominal masses, particularly abscesses

Chromaffin cell tumors of the adrenal medulla are called _________. (Short answer, one word)

Answer: Pheochromocytomas Rationale: Pheochromocytomas are rare tumors of the chromaffin cells. They cause hyperfunction of the adrenal medulla and they continuously secrete catecholamines. About 10% are malignant. Clinical manifestations include: hypertension, headache, pallor, diaphoresis, tachycardia, and palpitations.

What is the difference between up-regulation and down-regulation? (short answer)

Answer: Up-regulation occurs when there are small amounts of hormones. The amount of receptors increase to give the target cell a better chance of "catching" the released hormone. Down-regulation occurs when there are large amounts of hormones. The amount of receptors decrease because the target cell does not need to work as hard to "catch" the hormone if there are several in the area. Both mechanisms are used to adjust the sensitivity of the target cell to the amount of hormones present.

During what phase of swallowing is the bolus transported to the stomach by the contraction and relaxation of the layers of the smooth muscle? a. oropharyngeal phase b. pharyngeal phase c. voluntary phase d. esophageal phase

Answer: d. esophageal phase Rationale: Esophageal phase occurs when the bolus is transported to the stomach by the motions of the outer longitudinal and inner circular layers of the smooth muscle. The repeated waves of the contraction push the food along, this is the last phase of swallowing. Oropharyngeal is the first phase which is where the food is segmented into the bolus by the tongue. Then the next phase is the pharyngeal, this is where the swallowing center and the respiratory center provide coordinated intervention. The oropharyngeal phase is voluntary, while the esophageal phase is involuntary.

What types of gastric secretions stimulate hydrochloric acid?

Answers: Acetylcholine, Caffeine, Calcium, Gherlin, Gastrin, Histamine Rationale: Acetylcholine, Caffeine, Calcium, Gherlin, Gastrin, and Histamine stimulate hydrochloric acid. They are not to be confused with the gastric secretions that inhibit hydrochloric acid—Atrial natriuretic peptide, Cholecystokinin, Glucagon-like peptide-1, Somatostatin, Secretin, and Prostaglandins.

When gathering a health history on a patient recently admitted with acute pancreatitis what specifically is the nurse going to be looking for? A. Surgical history (abdominal or non-abdominal) B. Social history including drug and alcohol use/consumption C. Any abnormal moles or lumps found from self-examination D. All the above E. A and C only F. A and B only

ANS: F (A and B only) Rationale: Any patient with a surgical history is at increased risk for pancreatitis, there is an increased risk for infection with surgery. Alcohol abuse is the most common cause for acute pancreatitis. Mole and lumps would not present with acute pancreatitis, but the signs and symptoms include abdominal pain that radiates to the back, fever, nausea and vomiting

Which stage of colon cancer is also referred to as Dukes A colon cancer? a. Stage 0 b. Stage I c. Stage VI d. Stage II

ANS: b. Stage I Rationale: Stage 0 (carcinoma in situ): involves only the mucosal lining; also known as carcinoma in situ Stage I: extension of cancer to the middle layers of the colon wall, no spread to lymph nodes; stage I colon cancer is sometimes called Dukes A colon cancer Stage II: extension beyond the colon wall to nearby tissues around the colon or rectum, and/or through the peritoneum; stage II colon cancer is sometimes called Dukes B colon cancer Stage III: spread beyond the colon into lymph nodes and nearby organs and/or through the peritoneum; stage III colon cancer is sometimes called Dukes C colon cancer Stage IV: spread to nearby lymph nodes and has spread to other parts of the body, such as the liver or lungs; stage IV colon cancer is sometimes called Dukes D colon cancer

Known as the Whipple Procedure is the most common procedure for which type of cancer of the GI tract? a. Cancer of the Liver b. Cancer of the Gallbladder c. Cancer of the Small Intestine d. Cancer of the Pancreas

ANS: d. Cancer of the Pancreas Rationale: Pancreaticoduodenectomy (Whipple procedure) is the most common procedure performed to decompress duct obstruction. Some surgeons recommend a total pancreatectomy because cancer of the pancreas seldom consists of a single lesion.

Explain how X-ray is used for the diagnosis of esophagus cancer?

An esophagram is a series of X-rays of the esophagus which are taken after the patient swallows a barium solution which coats the inside of the esophagus and allows the physician to observe for changes in the shape of the esophagus.

The following are pairs of the salivary gland except A) Sublingual B) Submucosal C) Submandibular D) Parotid

Answer is B Rationale: The three pairs of the salivary glands are the Submandibular, Sublingual and the Parotid while submucosal is an histological part of the gastrointestinal tract.

Which risk factor(s) below are associated with Gastrointestinal Cancers? Select all that apply. 1. Use of Tabaco chewing, or smoking. 2. Persistent exposure to areas of heavily concentrated radioactivity. 3. High alcohol consumption 4. Heavy consumption of junk food and not healthier food options.

Answer(s): Numbers 1,2,3. Rationale: Number 1 is correct; Use of Tabaco chewing, or smoking is a risk factor of conceiving gastrointestinal Cancer because it can lead to the inflammation of esophageal lining leading to esophageal adenocarcinoma Number 2 is correct. Although not specifically stated in the text, one of the listed risk factors are "environmental irritants", which correlates well with consistent exposure to radioactivity. Such exposure can cause basal and squamous cell hyperplasia Number 3 is correct. High alcohol consumption is apparent in gastroesophageal reflux disease which transforms normal squamous epithelium to abnormal columnar in the esophagus area Number 4 is incorrect. No where in the text does it state that unhealthy foods or diet will directly lead to Gastrointestinal Cancer(s).

Which of the following cells is associated with the pancreatic hormone insulin? 1. Alpha cells 2. Beta cells 3. Delta cells 4. F cells

Answer- 2. Rationale- Each of the cells listed are found in the Islets of Langerhans and play an important role in pancreatic function. Beta cells are associated with insulin. Alpha cells are associated with glucagon. Delta cells are associated with somatostatin and gastrin. Lastly, f cells are associated with pancreatic polypeptide.

Which of the following is NOT a hormone synthesized in the adrenal glands? 1. Mineralcorticoids 2. Glucocorticoids 3. Androgens 4. Oxytocin

Answer- 4. Rationale- Mineralcorticoids, glucocorticoids, and androgens are synthesized in the adrenal glands and play a vital role in maintaining homeostasis. Oxytocin is found in the posterior pituitary gland.

What are Hormones and their function within the Endocrine System? A. They are antibodies that fight off disease within the Endocrine system. B. They are chemical messengers that communicate the feedback system. C. They are plasma components that assist with coagulation. D. They are toxins excreted from the body while under stress

Answer- B Rationale- Hormones are chemical messengers that bind to receptors attached to cells throughout the body. They facilitate communication of the feedback systems.

What type of Hormone must use a membrane receptor to gain access within a cell?

Answer- Water-soluble hormones Rationale- Lipid-soluble hormones can travel through the lipid bi-layer. Water-soluble hormones must use a membrane receptor to move through the lipid bi-layer and into the cell. This is due to the hydrophobic tails within the cell membrane.

Which viral factor is associated with the cancer of the stomach? 1) H. Pylori 2) Corona virus 3) Streptococcus Pyogenes 4) Staphylococcus Areas

Answer: 1) Rationale: Is the correct answer choice because although only 1% of individuals infected with the H- Pylori virus develop Gastric Cancer. Individuals infected still run a great risk of cell proliferation being stopped which can cause poorly differentiated, unorganized cell growth or severe chronic gastritis. These manifestations then could lead to gastric and duodenal carcinoma. 2, 3, or 4 were the incorrect answers because they are not consistent viruses that would lead or cause development of stomach cancer.

Identify the clinical manifestations associated with an adrenal adenoma that causes hypersecretion of androgens in a woman: 1. Polydipsia, nocturia, polyuria, hypernatremia, increased plasma osmolality, large volume of dilute urine. 2. Tachycardia, diaphoresis, tremor, pallor, confusion, decreased level of consciousness, perhaps seizure. 3. Virilization: lack of breast development, hirsutism, increased muscle bulk. 4. Polydipsia, nocturia, polyuria, increased appetite, weight loss, hyperglycemia, glycosuria.

Answer: 3. Virilization: lack of breast development, hirsutism, increased muscle bulk. Rationale: The correct answer is choice number 3, because hypersecretion of androgens in a woman results in virilization (the development of male sex characterisitcs). The other choices were all incorrect. Clinical manifestations listed in choice 1 are associated with Diabetes Insipidus. Clinical manifestations listed in choice 2 are associated with Hypoglycemia. Clinical manifestations listed in choice 4 are associated with Type 1 Diabetes Mellitus.

Which of the following phases of swallowing occur when food is segmented into a bolus and forced posteriorly toward the pharynx as the tongue pushes upward against the hard palate? A. Oropharyngeal phase B. Pharyngeal phase C. Esophageal phase D. Lower esophageal sphincter phase

Answer: A Rationale: In the oropharyngeal phase, food is segmented into bolus and forced posteriorly toward the pharynx as the tongue pushes upward against the hard palate. Next, the pharyngeal phase occurs, where the swallowing center and respiratory center work together to prevent food from getting into the nasopharynx. During this phase, respiration is inhibited and the epiglottis folds downwards to prevent the bolus from entering the respiratory pathway and the tongue and pharyngeal constrictors work together to propel the food into the esophagus. In the esophageal phase, the outer longitudinal and inner circular layers of smooth muscle push the food down the esophagus into the stomach by coordinated sequential contraction and relaxation of the muscles.

Glucagon is produced by __________ A. Alpha Cells and some cells lining GI tract B. Beta Cells and cells lining the stomach C. Delta Cells D. All of the above

Answer: A Rationale: Produced by alpha cells and cells lining GI tract. Glucagon functions as an antagonist of insulin. It is released with low blood glucose levels, acts primarily in liver to stimulates glycogenolysis, gluconeogenesis, lipolysis.

All of the following are true of icterus except? a. Clinical manifestations of organ discoloration, fever, chills, itchiness, pain b. Yellow or green discoloration of skin and sclera c. Accumulation of bile pigment in body fluids and tissue d. Another name for Jaundice

Answer: A Rationale: The clinical manifestations are Yellow discoloration not orange discoloration, fever, chills, pain, pruritus (itchiness). The other answer choices are all true about icterus, aka jaundice.

The nurse is aware that a patient with a positive Chvostek's sign indicates what abnormality? A) hypocalcemia B) hyponatremia C) hypokalemia D) hypermagnesemia

Answer: A Rationale: Chvostek's sign is elicited by tapping the client's face lightly over the facial nerve, just below the temple. If the client's facial muscles twitch, it indicates hypocalcemia. Hyponatremia is indicated by weight loss, abdominal cramping, muscle weakness, headache, and postural hypotension. Hypokalemia causes paralytic ileus and muscle weakness. Clients with hypermagnesemia exhibit a loss of deep tendon reflexes, coma, or cardiac arrest.

What are the clinical manifestations of osteoporosis? a. Spine malformations, height loss, back pain. b. Bone pain or tenderness, and swelling. c. Pain and stiffness in the weightbearing joints. d. Fever, fatigue, inflammation, and weight loss.

Answer: A Rationale: The correct set of clinical manifestations for Osteoporosis is A. Spine malformations, height loss, and back pain; B. Bone pain or tenderness and swelling are clinical manifestations of Osteosarcoma; C. Pain and stiffness in the weightbearing joints is usually the first symptom of Osteoarthritis; And D. Fever, fatigue, inflammation, and weight loss are some of many clinical manifestations that are associated with Rheumatoid Arthritis (RA).

Which part of the GI system contains the highest concentration of bacteria? a-Large intestine b-Stomach c-Jejunum d-Duodenum

Answer: A Rationale: The large intestine contains the highest concentration of bacteria in the GI system. The stomach has the lowest concentration as it is primarily sterile, and the jejunum and duodenum have low concentrations.

Which of the following is NOT a possible symptom of colorectal cancer? a. increased appetite b. constipation c. abodominal distention and pain d. chronically narrow pencil thin stool

Answer: A Rationale: some of the possible symptoms of colorectal cancer include: Stools become narrow and pencil shaped; progressive abdominal distention, pain, vomiting, constipation, need for laxatives, cramps, and bright blood on the surface of the stool. Increased appetite is not a known finding in patients with any type of GI cancer.

A patient has been diagnosed with gastric cancer: Which of the following is NOT a symptom that the patient may expect to experience following this diagnosis? A. Weight gain B. Fatigue C. Abdominal pain D. Fatigue or weakness

Answer: A Rational: Patients can expect to experience loss not weight gain. This can be due to a combination of factors including side effects from treatment, malabsorption issues, and tumor growth may give a feeling of "fullness" causing the patient to consume less food.

Food Enters the stomach via which orifice or sphincter? a. Cardiac b. Upper esophageal c.Gastric d. Fundal

Answer: A, Cardiac. Rationale: Each end of the esophagus is opened and closed by a sphincter. The upper esophageal sphincter prevents entry of air into the esophagus during respiration. The lower esophageal sphincter prevents regurgitation from the stomach. The lower esophageal sphincter is located near the esophageal hiatus- the opening in the diaphragm where the esophagus ends at the stomach. The gastric sphincter controls the release of food from the stomach to the smalll intestine and is also known as the pyloric sphincter. The fundal sphincter is not a structure in the GI system.

Which of the following are hormones of the posterior pituitary? A. Antidiuretic hormone B. ACTH C. Growth hormone D. Oxytocin

Answer: A, D Rationale: The hormones of the posterior pituitary are synthesized in the nuclei of the hypothalamus. Stored and secreted by the posterior pituitary. -Antidiuretic hormone (ADH, arginine vasopressin) Controls plasma osmolality Causes water reabsorption into the blood Is released when plasma osmolality is increased or intravascular volume is decreased -Oxytocin Causes uterine contractions and milk ejection in lactating women Acts on uterus to stimulate contractions

What are the 6 hormones of the anterior pituitary gland that Dr. Devries wants us to know? (short answer)

Answer: Adrenocorticotropic hormone (ACTH), Thyroid-stimulating hormone (TSH), Follicle-stimulating hormone (FSH), Luteinizing hormone (LH), Growth hormone (GH), and Prolactin. **There are 3 more listed on slide 20 of the Endocrine PPT, but were not listed as ones we need to know**

When all 5 functions of the endocrine system are not functioning correctly, what is seen as a result? Short answer, one word.

Answer: Alterations Rationale: In order for the endocrine system to function properly: differentiation of the reproductive and central nervous systems in the developing fetus, stimulation of sequential growth and development during childhood and adolescence, coordination of the male and female reproductive systems, maintenance of an optimal internal environment, and initiation of corrective and adaptive responses when emergency demands occur should all be present. If one of any of the 5 components is not functioning correctly, an alteration of the endocrine system will be present.

Which of the following secretions function to break down protein-forming polypeptides in the stomach? A. Lipase B. Pepsin C. Cholecystokinin (CCK) D. Gastric hydrochloric acid

Answer: B Rationale: Pepsin is an enzyme that breaks down protein-forming polypeptides in the stomach and is stimulated by acetylcholine and inactivated by the alkaline environment of the duodenum. Lipase aids in the digestion of fat whereas Cholecystokinin inhibits food intake, reduces gastric motility and decreases gastric emptying. Gastric hydrochloric acid works to dissolve food fibers, acts as a bactericide against swallowed organisms, and converts pepsinogen to pepsin.

Which of the following is NOT true of bile? A. It is an alkaline, bitter-tasting yellowish-green fluid. B. It aids in the digestion of glucose. C. The liver secretes 700-1200 mL of bile per day. D. It contains bile salts, cholesterol, bilirubin, electrolytes, and water.

Answer: B Rational: Bile salts aid in the digestion of fats, not glucose. The rest are true.

The nurse receives a cell culture of a patient's liver to assess the progression of non-alcoholic fatty liver disease. The results shows fat accumulation in the liver and that fat pus has begun to cause inflammation to the hepatocytes. What would be the appropriate stage of the liver? a. non-alcoholic fatty liver disease (NAFD) b. nonalcoholic steatohepatitis (NASH) c. cirrhosis

Answer: B Rationale: For NAFD it only shows that fat is beginning to accumulate in liver. For NASH, the fat pus begins to show inflammation and damage to to the hepatocytes. Cirrhosis is when scar tissue begins to replace damaged hepatocytes.

A nurse should suspect a patient with hypothyroidism to report which health concerns? A) Increase appetite and weight loss B) Puffiness of the face and hands C) nervousness and tremors D) thyroid gland swelling

Answer: B Rationale: Hypothyroidism causes facial puffiness, extremity edema, and weight gain. Signs and symptoms of hyperthyroidism (Graves' disease) include an increased appetite, weight loss, nervousness, tremors, and thyroid gland enlargement (goiter).

Most protein hormones are transported in the bloodstream are: A. Bound to a lipid-soluble carrier B. Free in an unbound, water-soluble form C. Bound to a water-soluble binding protein D. Free because of their lipid-soluble chemistry

Answer: B Rationale: Peptide or protein hormones, such as insulin, pituitary, hypothalamic, and parathyroid, are water soluble and circulation in free (unbound) forms.

Patient has hypervolemia, weight gain without peripheral edema present, lethargy, and muscle twitching. What alteration in the posterior pituitary gland should the nurse suspect? A. Diabetes Insipidus B. Graves' disease C. SIAD D. Addison's Disease

Correct Answer: C Rationale: SIAD is a disorder in which there is high levels of ADH is secreted by the pituitary gland. This leads to enhanced renal water retention and low serum Na. The water retention leads to weight gain and hypervolemia. The hyponatremia can cause lethargy and muscle twitching. Diabetes insipidus is a disorder of the pituitary gland but is a result of low ADH and excessive water loss. Graves' disease is a disorder associated with hyperthyroidism, and Addison's disease is associated with the adrenal insufficiency.

Crushing Disorder is associated with which hormone alteration? A. Excessive secretion of aldosterone B. Hypersecretion of adrenal estrogens C. Absence of the production of insulin D. Overproduction of pituitary ACTH

Correct Answer: D Rationale: Crushing disease is caused from the overproduction of ACTH leading to excess production of cortisol and loss of the feedback control of ACTH secretion. Excessive secretion of aldosterone related to primary hyperaldosteronism or Conn disease. Hypersecretion of adrenal estrogens is related to feminization. Absence of the production of insulin is related to Diabetes type 1.

Which is true about the location of the hypothalamus? A) It is located at the base of the brain B) Is connected to the posterior pituitary by the portal blood vessel C) Is connected to the anterior pituitary by the hypothalamohypophysial nerve tract D) Produces Oxytocin

Correct answer: A Rationale: It is connected to the posterior pituitary by the hypothalamohypophysial nerve tract. It is connected to the anterior pituitary by the portal blood vessel. The posterior pituitary produces oxytocin. The hypothalamus is located at the base of the brain.

Which is not a function of the endocrine system? A) Stimulation of sequential growth and development B) Maintenance of internal environment C) Producing enterokinase which prevents the pancreas from eating itself D) Initiating adaptive and corrective measures during an emergency

Correct answer: C Rational: The endocrine system is a chemical response system. It produces hormones in feedback loops. While the pancreas is part of the endocrine system it is also part of the GI tract. The exocrine pancreas is responsible for producing the enzyme enterokinase, which prevents the pancreas from eating itself.

In Binge-Eating/Purging eating disorder self-starvation is associated with: a: not eating to help control weight b: not being bothered about weight gain c: regularly engaging in purging activities to help control weight gain d: eating only certain types of food

Correct answer: C Rationale: Binge- eating is consuming large amounts of food followed by purging in order not to gain weight which makes C the correct answer. A is not correct because it describes anorexia nervosa and b is not correct bc people with binge-eating disorder are concerned about weight gain. Binge eating disorder is not related to only eating certain types of food so d is also incorrect.

Which of the following is a diagnostic criterion for anorexia nervosa in DSM-IV-TR? a. a refusal to maintain a minimal body weight by extreme calorie restriction b. a pathological fear of gaining weight c. a distorted body image in which, even when clearly emaciated, sufferers continue to insist they are d. all of the above

Correct answer: D Rationale: Anorexia nervosa is diagnosed by meeting the criteria of answers A, B, and C therefore making D the correct answer. People with anorexia nervosa are typically underweight due to calorie restriction, have an extreme fear of gaining weight, as well as suffer from distorted body image also known as body dysmorphia.

Which of the following is not a symptom of right-sided colon cancer? a. Palpable mass in the right lower quadrant b. Narrow, pencil-shaped stools c. Fatigue d. Dark red blood in the stool

Correct answer: b Rationale: Narrow, pencil-shaped stools are a common finding in those with left-descending colon cancer. Characteristics of right-sided colon cancer include the patient evolving to the pain, mass in the right lower quadrant, anemia, fatigue, and mahogany-colored blood mixed with stool.

Which of the following statements are true in regard to cancer of the gallbladder? (select all that apply) A. Cancers in the gallbladder are common and easily treated B. Common clinical manifestations include intermittent left upper quadrant pain for a year, nausea, vomiting, and diarrhea C. Cancers of the gallbladder are rare but lethal D. Common clinical manifestation is steady right upper quadrant abdominal pain for approximately 2 months E. Early stages are asymptomatic.

Correct answers: c, d, and e Rationale: Cancer of the gallbladder is rare and not caught easily. It is lethal and difficult to treat because it is asymptomatic in the early stages. Pain is localized in the right upper quadrant because that is where the gallbladder is located. Treatment includes removal of the gallbladder.

How many stages of osteoarthritis are there? A. 3 stages B. 4 stages C. 2 stages D. 5 stages

ANS B: There are four stages of osteoarthritis. Stage 1 is minor, stage 2 is mild, stage 3 is moderate, and stage 4 is severe. In the minor stage there is minimum disruption and 10% cartilage loss. In the mild stage there is joint space narrowing and the cartilage begins to breakdown with the occurrence of osteophytes. In the moderate stage there is moderate joint space reduction and there are gaps in the cartilage that can expand until they reach the bone. In the 4th stage - severe, the joint space is greatly reduced and 60% of the cartilage is already lost which occurs along with large osteophytes.

Which section of the gastrointestinal tract is the most sterile? A. Duodenum B. Jejunum C. Large intestine D. Stomach

ANS: D. Stomach Rationale: The stomach has the smallest concentration of bacteria and is a relatively sterile environment in the digestive tract. This because the highly acidic gastric juices make the environment inhospitable to microorganisms.

A Nurse practitioner is looking after a patient with elevated calcitonin. The electrolyte most likely to not be balanced In the body is A. Calcium B. Selenium C. Riboflavin D. Sodium

ANSWER: A RATIONALE: Calcitonin only impacts calcium. Thyrocalcitonin made by Parafollicular cells, creates calcitonin.

An APRN is looking after a patient taking a prescription medication to block hormone receptor sites. Which result would come about due to the medication? A. Decreased hormone activity B. Elevated hormone activity C. Increased blood pressure D. Decreased blood pressure

ANSWER: A RATIONALE: When receptor sites are connected to different substances that stop hormone attachment, the cell responds the same way as when the level of the hormone is lowered.

Which of the following are clinical manifestations of HHNKS? A. Serum glucose > 400, high blood volume, severe dehydration, high perfusion B. Serum glucose> 400, severe dehydration, low blood volume, low perfusion C. Serum glucose >500, severe dehydration, low blood volume, low perfusion D. Serum glucose > 500, high blood volume, severe dehydration, high perfusion

ANSWER: C Rational: Hyperosmolar Hyperglycemic Nonketotic Syndrome is life threatening and more common with DM 2. It is a lack of ketosis. The clinical manifestations are Serum glucose > 500 mg/ dL or higher, severe dehydration, low blood volume, and low perfusion.

1. What is the most common cause of jaundice in neonates? A. Immature liver B. Infection C. Enzyme deficiency D. Bruising at birth or other internal bleeding

Although these are all causes of newborn jaundice, the correct answer is A. The most common cause is due to newborns having an immature liver. Jaundice is also more common in newborns than adults.

Which of the following is not an accessory organ? A) Salivary gland B) Liver C) Gallbladder D) Exocrine Pancreas E) Mouth

Answer is E Rationale: All others are accessory organs which only take parts in digestion except mouth which is an organ of digestion because digestion of carbohydrates starts from the mouth

Dr. Devries discussed the importance of the hypothalamus and it's special neurosecretory cells. What are the key functions of the special neurosecretory cells and how do they relate to the posterior pituitary? (Short answer)

Answer: Special neurosecretory cells synthesize and secrete hypothalamus releasing hormones. These regulate and release hormones from the anterior pituitary. They also synthesize antidiuretic hormone and oxytocin, which are then stored and released from the posterior pituitary. Rational: This is an example of hormones being made in one location and stored/ released from another location.

Select the following that is associated with a lower GI bleed: 1. Melena 2. Mallory-weiss tear 3. Esophageal or gastric varices 4. Inflammatory bowel disease 5. Occult bleeding

Answer: 1, 4, 5, Rationale: An upper GI bleed causes hematemesis from a Mallory-weiss tear at the esophageal-gastric junction from severe retching, cancer, peptic ulcers, NSAIDs, etc., and an esophageal or gastric varices rupture caused by portal hypertension.

Which of the following is NOT a process of the gastrointestinal tract? 1. Secretion of mucus, water, and enzymes 2. Production and storage of bile for digestion 3. Chemical digestion of food particles 4. Elimination of waste products by defecation

Answer: 2

Parietal cells of the GI tract function to secrete what substance(s)? A. hydrochloric acid B. pepsinogen C. gastrin D. all of the above

Answer: A Rationale: The parietal cells secrete hydrochloric acid, gastroferrin, and intrinsic factor. Pepsinogen is secreted by chief cells and gastrin is secreted by G cells.

Which of the following is associated with elevated ACTH and a lack of production of both cortisol and aldosterone? A. Cushing syndrome B. Addison's Disease C. Myxedema D. Graves Disease

Answer: B Rationale: Addison's Disease, also called primary adrenal insufficiency, is a disorder in which the adrenal glands fail to produce enough cortisol and aldosterone. This is caused by an autoimmune response where the immune system attacks the outer portion of the adrenal glands (where aldosterone and cortisol are made).

Most endocrine hormones are regulated by a ___________ feedback system? A- positive B-negative C- neutral D- high affinity

Answer: B-Negative Rationale: A negative feedback system occurs when a chaging chemical, neural, or endocrine response decreases the subsequent synthesis and secretion of a hormone.

Which disease is often associated with the use of IV drugs and human immunodeficiency viral (HIV) infection? A. Hepatitis A B. Hepatitis C C. Hepatitis B D. Hepatitis E

Answer: B. Hepatitis C Rationale: Hepatitis A is often found in feces, bile and sera of infected individuals. Hepatitis B is transmitted paternally or sexually. Hepatitis C is transmitted through IV drug use or HIV infection. Hepatitis E is transmitted fecal to oral.

A patient diagnosed with hypoparathyroidism presents the following symptoms: muscle spasms, hyperreflexia, and tonic-clonic convulsions. What irregularity should the nurse expect to find in their lab report? A. Increased serum phosphate B. Increased serum calcium C. Decreased serum calcium D. Decreased serum phosphate

Answer: C Rationale: Muscle spasms, hyperreflexia, and tonic-clonic convulsions are all signs of hypocalcemia; a clinical manifestation of hypoparathyroidism. When experiencing hypocalcemia, labs would show decreased serum calcium levels.

Examples of Lipid soluble hormones. A. Estrogen B. Testosterone C. Epinephrine D. A and B E. All of the above

Answer: D Rationale: Estrogen and Testosterone are both lipid soluble hormones, but epinephrine is water soluble

Where does the process of digestion begin? A. stomach B. esophagus C. small intestine D. mouth

Answer: D Rationale: The process of digestion begins in the mouth with the breakdown of carbohydrates by salivary α-amylase.

Which prevention techniques are suggested for hepatitis E? A. exposure immunization B. blood donor screenings C. vitamins D. ensure safe drinking water

Answer: D. Ensure safe drinking water Rationale: Hepatitis A and B are prevented by exposure immunizations. Hepatitis C is prevented by blood donor screenings and risk behavior modification. Hepatitis D is prevented by exposure immunization and risk behavior modification. Hepatitis E is prevented by ensuring safe drinking water

What organ in the GI system is the major site for digestion and the absorption of food?

Answer: small intestine Rationale: In the small intestine there are contractions with segmentations that create a forward and backward movement which helps break things down and allows for more digestion. There is also mixing with digestive enzymes. In the long muscles of the small intestine there is rhythmic movements, aiding more in the movement of foods and the breakdown and absorption.

Which of the following is FALSE regarding Secondary Osteoporosis A. It is bone loss due to a clinical defined disorder B. It is bone loss due to aging C. It may be reversible D. It can be due to adverse medication effects

B - secondary osteoporosis is osteoporosis due to a clinically defined disorder and is not due to ageing. Primary osteoporosis is due to aging. Secondary osteoporosis can also be reversed or due to adverse medication effects.

Women who are perimenopausal or postmenopausal have an increased chance of osteoporosis due to what? A. Decrease in acetylcholine B. Decrease in estrogen C. Increase in Vitamin A D. Increase in Vitamin D

B. is the correct answer- lack of estrogen can cause excessive bone resorption.

Mr. Thomas, a butcher, says "Every time I see a gallbladder, I wonder if bile has any good purpose? Can you tell me?"

Bile is important and useful. It helps process dietary fats in the intestines so that the animal or the person gets the benefit from eating the fats. Bile is made by the liver and stored in the gallbladder until it goes into the intestines when the animal or person eats fats.

Which is NOT a potential risk factor for Osteoporosis A. Sex B. Age C. Caffeine intake D. Changes in hormones

C - Potential risk factors for osteoporosis include: age (older), sex (female), race (Caucasian and Asian women at greater risk), body size(slender small body frame), family history(broken bones or osteoporosis), medications(glucocorticoids and other medications), lifestyle (physically inactive), diet (low in calcium and vitamin D), and changes in hormones(love levels of estrogen and testosterone and high levels of PTH).

There are four stages to osteoarthristis, in which stage there is obvious erosion to the cartilage surface between bones and fibrillation narrows the gap between the bones. A) Stage 1 B) Stage 2 C) Stage 3 D) Stage 4

C) Stage 3, "moderate", where there is obvious erosion to the cartilage surface between bones, fibrillation narrows the gap between the bones and the bones develop spurs at the joints as it becomes rougher.​ There is obvious joint inflammation which causes frequent pain when walking, running, squatting, extending or kneeling. Along with joint stiffness, there may be popping or snapping sounds when walking. In stage 1 there is very minor wear & tear and bone spur growths at the end of the knee joints. However, at this stage it is unlikely you will feel pain or discomfort. In stage 2, diagnostic images or X-rays of knee joints will show more bone spur growth, and though the space between the bones appear normal, people will begin experiencing symptoms of joint pain. Typically, the area around the knee joints will feel stiff and uncomfortable. ​​In stage 4 (severe) the joint space between the bones are considerably reduced, causing the cartilage to wear off, leaving the joint stiff. The breakdown of cartilage leads to a chronic inflammatory response, with decreased synovial fluid that causes friction, greater pain and discomfort when walking or moving the joint.​ The advanced stage of the disease shows development of more spurs causing excruciating pain, which makes even everyday chores, including walking and descending stairs a challenge.​

What diagnosis is possible for a protrusion of part of the stomach through the esophageal diaphragm? A. Pyloric Stenosis, B. GERD C. Hiatal Hernia D. Gastritis

C. Hiatal hernia, can also be called esophageal or diaphragmatic hernia.

Which of the following are a risk factor of osteoporosis? A. Smoking B. Family History C. Low physical activity D. All of the above

D. is the correct answer- smoking, family history, and low physical activity can all increase the chances of osteoporosis in a person.

Hormones cause 2 general effects, direct and permissive. Explain the difference between these effects. (short answer)

Direct effects have a direct and noticeable effect on the target cell. Permissive effects are less obvious. Rational: Hormones have three routes that stimulate effects. Some effects are more noticeable than others. These three routs include: 1. acting on preexisting channel-forming proteins to alter membrane channel permeability, 2. activating preexisting proteins through a second messenger system (water soluble) and, 3. activating genes to cause protein synthesis.

NAFLD is more prevalent in men than women mostly because of the levels of...

Estrogen In studies estrogen is commented to be a "protective factor". Estrogen is able to help break down fatty acids toward ketone body production instead of becoming a low density lipoprotein (LDL, aka "bad" cholesterol).

Describe the difference between negative feedback and positive feedback

Negative feedback occurs when the end result of hormone action on target cells suppresses secretion of that hormone and positive feedback occurs when the end result of hormone action on target cells increases secretion of that hormone. The example Dr. Devries gave for negative feedback is the furnace in our homes; once we set our thermostat to a certain temperature the furnace will cut on to obtain that temperature and once it has reached that, it will cut off. Negative feedback is more common than positive feedback.

All of the following are bodily mechanisms that promote insulin resistance EXCEPT: A. alteration in the production of adipokines by adipose tissue, or leptin resistance B. anorexia-induced insulin resistance C. reduced insulin-stimulated mitochondrial activity D. release of inflammatory cytokines from adipose tissue

Rationale: All of the answer choices except (b) work to reduce glucose uptake and metabolism in patients who are type 2 diabetics. Anorexia can not induce insulin, unlike Obesity.

As we age, levels of this particular hormone decrease, which leads to a decrease in bone and muscle mass: A. Aldosterone B. Cortisol C. Growth Hormone D. Melatonin

Rationale: As we age, levels of Growth Hormone decrease, which leads to a decrease in bone and muscle mass. Aldosterone functions as a part of the renin-angiotensin-aldosterone system (RAAS) by causing water retention. Cortisol plays a role in the body's response to stress, while melatonin helps regulate our sleep-wake cycles.

Cancer that is facilitated by chronic inflammation and dysplasia caused by GERD and long term exposure to irritants. A. Stomach cancer B. Esophageal cancer C. Diaphragm cancer D. Small intestines cancer

Rationale: The correct answer is B. The clinical manifestations are chest pain, dysphagia, and back pain. Treatment is removal of primary lesion and local lymph nodes.

What is the 3rd most common cause of cancer death in the US for men and women? A. Pancreatic cancer B. Stomach cancer C. Colorectal cancer D. Liver cancer

Rationale: The correct answer is C. This cancer develops from adenomatous polyps which is a mass arising from the intestinal mucosal epithelium.

A patient is admitted with hepatic encephalopathy secondary to cirrhosis. Which meal option selection below should be avoided with this patient? A. Beef tips and broccoli rabe B. Pasta noodles and bread C. Cucumber sandwich with a side of grapes D. Fresh salad with chopped water chestnuts

The answer is A. Patients who are experiencing hepatic encephalopathy are having issues with toxin build up in the body, specifically ammonia. Remember that ammonia is the byproduct of protein breakdown, and normally the liver can take the ammonia from the protein breakdown and turn it into urea (but if the cirrhosis is severe enough this can't happen). Therefore, the patient should consume foods LOW in protein until the encephalopathy subsides. Option A is very high in protein while the others are low in protein. Remember meats, legumes, eggs, broccoli rabe, certain grains etc. are high in protein.

A client has undergone a laparoscopic cholecystectomy. Which of the following instructions should the nurse include in the discharge teaching? A. Empty the bile bag daily B. Breathe deeply into a paper bag when nauseated C. Keep adhesive dressings in place for 6 weeks D. Report bile-colored drainage from any incision

The answer is D. There should be no bile colored drainage coming from any of the incisions postoperatively. A laparoscopic cholecystectomy does not involve a bile bag. Breathing into a paper bag will prevent a person from passing out due to hyperventilation; it does not alleviate nausea. If the adhesives have not already fallen off, they are removed by the surgeon in 7-10 days, not 6 weeks.

What substance, supplied by oral ingestion, is necessary for the synthesis of thyroid hormone(s) T3 & T4? A. Creatinine B. Iodine C. Phosphorus D. Cortisol

The correct answer is B. Iodine is necessary for the synthesis of the thyroid hormones, because the thyroid gland actually uses iodine to make the thyroid hormones T3 - tri iodine and T4 - 4 iodine molecules). This is essential for the body as the thyroid hormones are important for the repair of damaged cells, supporting a healthy metabolism and for helping control growth.

A nurse says, "All of our cirrhosis patients have low albumin. How does cirrhosis cause hypoalbuminemia?"

The hepatocytes in a well functioning liver synthesize albumin and put it into the blood. In cirrhosis, many of the hepatocytes have been destroyed or are not working well, so the liver is not able to synthesize enough albumin to keep the blood levels normal.

Name two functions of the Endocrine System

There are five functions of the Endocrine System and any of these would have worked. 1) differentiation of the reproductive and central nervous systems in the developing fetus 2) Stimulation of sequential growth and development during childhood and adolescence 3) Coordination of the male and female reproductive systems 4) Maintenance of an optimal internal environment 5) Initiation of corrective and adaptive responses when emergency demands occur

A patient has been told that she has elevated liver enzymes caused by nonalcoholic fatty liver disease (NAFLD). The nursing teaching plan should include A. Having genetic testing done. B. Recommending a heart-healthy diet. C. The necessity to reduce weight rapidly. D. Avoiding alcohol until liver enzymes return to normal.

answer: B A heart healthy diet is recommended. Weight loss can improve insulin sensitivity and reduce liver enzyme levels

Which condition is NOT a known cause of cirrhosis? a) Obesity b) Alcoholic consumption c) Hepatitis C d) All are known causes of cirrhosis

answer: D Obesity, excessive alcohol consumption, and hepatitis C are all causes of cirrhosis.

What is the most common form of cancer in bones? A. Ewing sarcoma B. Chondrosarcoma C. Osteosarcoma D. Fibrosarcoma

ANS C: Osteosarcoma is the most common form of bone cancer making up 1/3 of cases. Chondrosarcoma is the second most common form of bone cancer making up about ¼ of primary bone cancer cases. Ewing sarcoma makes up about 15% of primary bone cancers. Fibrosarcoma is rare.

Tom, a 60 year old male, presents to the Emergency Room with the following symptoms: upper abdominal pain, vomiting (including blood),and current changes in bowel habits. When the clinician goes into the room to see Tom, the clinician asks Tom about his lifestyle habits. Tom tells the clinician he eats a cold ham and turkey sandwich with mustard, cheese, and pickles and a bag of chips with a soda everyday for lunch. For dinner, Tom states that we runs through a fast food joint on the way home. Tom reports smoking 1/2 to 1 pack of cigarettes daily for the past 15 years along with consuming at least a 6 pack of beer per week. Tom states he normally weighs 80kg, but his weight measured today is charted as 76kg. As Tom's nurse you suspect which of the following? A. Cancer of the stomach B. Cancer of the small intestine C. Cancer of the pancreas D. Cancer of the colon

ANSWER: A RATIONALE: There are many environmental risk factors associated with cancer of the stomach. For Tom, the applicable environmental factors are (1) dietary contributors and (2) lifestyle habits such as alcohol consumption and cigarette smoking. A high salt intake, food additives, and a low intake of fruit and vegetables increase the changes of stomach cancer. The diet that Tom listed is a combination of all three of these factors. The consumption of alcohol and smoking cigarettes also increase the chances of stomach cancer. Additional environmental factors that were not applicable to Tom are infection with H. pylori and chronic atrophic gastritis. Tom's symptoms also should give an insight to his diagnosis. Clinical manifestations of cancer of the stomach include weight loss, upper abdominal pain, vomiting, hematemesis, anemia, and a change in bowel habits.

When an HgA1C has been ordered, the Nurse identifies that the diagnostic test is to test for which pancreatic disorder? A. DM 2 B. DM 1 C. Metabolic Syndrome D. Cancer

ANSWER: A. DM 2 Rational: Hemoglobin A1C reflects average glucose exposure over the life of a red blood cell over a three month span. Diabetes Mellitus 2 is not a complete loss of insulin, but an insufficient amount.

Colorectal cancer is the 3rd most common cause of cancer death in the US for men and women. Of the following, which is NOT a current treatment option for this type of cancer? A. Surgery B. Monoclonal antibody C. Possible colostomy D. Blood Transfusion E. Radiation/Chemotherapy

ANSWER: D RATIONALE: Treatment options for colorectal cancer include: surgery, possible colosotmy, radiation, chemotherapy, and monoclonal antibody. A blood transfusion was not listed among the treatment options. Treatment options are selected and modified on an individual basis based upon stages of the cancer, spread of the cancer, etc.

Which of the following is not a main diagnostic characteristic of anorexia nervosa? A. Restriction of calorie intake leading to low body weight for age/sex/height. B. Extreme fear of gaining weight C. Having a body weight normal or around normal. D. Disturbance in the way one views their body shape/image.

The correct answer is C. Having a body weight normal or around normal identifies with Bulimia Nervosa. Patient's with anorexia nervosa have a 25-30% loss of ideal body weight.

After consuming a slice of cake and a scoop of ice cream for your cousin Angelo's 9th birthday, which hormone would you expect to have increase in your body? A. Glucagon B. PTH C. Insulin D. Prolactin

The correct answer is C. Understanding that ice cream and cake are both made of sugary ingredients, this is going to cause the blood glucose to become elevated, hyperglycemia. When the blood sugar of the body becomes elevated, the beta cells of the pancreas are going to be stimulated, releasing the hormone insulin which is going to aid in bringing our blood sugar down to a regular level