Chapter 42

Question 1

Where in the brain is the vomiting center located?
a. Hypothalamus
b. Medulla oblongata
c. Pons
d. Midbrain

Answer 1

b. Medulla oblongata

Question 2

Antiemetic agents, such as domperidone and metoclopramide, are antagonists for which
receptors?
a. 5-Hydroxytryptamine (5-HT) serotonin
b. Histamine-2
c. Acetylcholine
d. Dopamine

Answer 2

d. Dopamine

Question 3

A patient in the clinic reports projectile vomiting without nausea or other gastrointestinal
symptoms. What action by the healthcare professional is most appropriate?
a. Provide antiemetic medications.
b. Arrange a brain scan.
c. Administer intravenous hydration.
d. Schedule a GI consultation.

Answer 3

b. Arrange a brain scan.

Question 4

A patient reports feeling constipated. When assessing this patient, how often should the patient
report bowel movements to be considered within the normal range?
a. Once a day
b. Once every 2 days
c. Once a week
d. Once every 2 weeks

Answer 4

c. Once a week

Question 5

How many stools per day are considered the upper limits of normal?
a. Two
b. Three
c. Five
d. Seven

Answer 5

b. Three

Question 6

The adult intestine processes approximately how many liters of luminal content per day?
a. 3
b. 6
c. 9
d. 12

Answer 6

c. 9

Question 7

A person who has cholera (Vibrio cholerae) would be expected to have which type of diarrhea?
a. Osmotic
b. Secretory
c. Small volume
d. Motility

Answer 7

b. Secretory

Question 8

What type of diarrhea is a result of lactase deficiency?
a. Motility
b. Osmotic
c. Secretory
d. Small-volume

Answer 8

b. Osmotic

Question 9

A professor has taught the students about the pathogenesis of abdominal pain. Which statement
by a student indicates the professor needs to review the material?
a. Chemical mediators, such as histamine, bradykinin, and serotonin, produce
abdominal pain.
b. Edema and vascular congestion produce abdominal pain by stretching.
c. Ischemia, caused by distention of bowel obstruction or mesenteric vessel
thrombosis, produces abdominal pain.
d. Low concentrations of anaerobes, such as Streptococci, Lactobacilli,
Staphylococci, Enterobacteria, and Bacteroides, produce abdominal pain.

Answer 9

d. Low concentrations of anaerobes, such as Streptococci, Lactobacilli,
Staphylococci, Enterobacteria, and Bacteroides, produce abdominal pain.

Question 10

How can abdominal pain that is visceral in nature best be described?
a. Diffuse, vague, poorly localized, and dull
b. It travels from a specific organ to the spinal cord.
c. The pain lateralizes from only one side of the nervous system.
d. Associated with the peristalsis of the gastrointestinal tract

Answer 10

a. Diffuse, vague, poorly localized, and dull

Question 11

A patient asks the healthcare professional to describe the cause of gastroesophageal reflux
disease (GERD). What response by the professional is best?
a. Excessive production of hydrochloric acid
b. Zone of low pressure of the lower esophageal sphincter
c. Presence of Helicobacter pylori in the esophagus
d. Reverse muscular peristalsis of the esophagus

Answer 11

b. Zone of low pressure of the lower esophageal sphincter

Question 12

A patient has frank bleeding of the rectum. How does the healthcare professional document this
finding?
a. Melena
b. Hematochezia
c. Occult bleeding
d. Hematemesis

Answer 12

b. Hematochezia

Question 13

What is the cause of functional dysphagia?
a. Intrinsic mechanical obstruction
b. Extrinsic mechanical obstruction
c. Tumor
d. Neural or muscular disorders

Answer 13

d. Neural or muscular disorders

Question 14

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.

Answer 14

b. Try these proton-pump inhibitors for 2 weeks.

Question 15

By what mechanism does intussusception cause an intestinal obstruction?
a. Telescoping of part of the intestine into another section of intestine
b. Twisting the intestine on its mesenteric pedicle
c. Loss of peristaltic motor activity in the intestine
d. Fibrin and scar tissue that attaches to the intestinal omentum

Answer 15

a. Telescoping of part of the intestine into another section of intestine

Question 16

A patient has been admitted for a possible small intestinal obstruction. What is the first sign the
healthcare professional assesses for that would indicate the presence of this condition?
a. Vomiting
b. Dehydration
c. Electrolyte imbalances
d. Distention

Answer 16

d. Distention

Question 17

An intestinal obstruction at the pylorus or high in the small intestine causes metabolic alkalosis
by causing which outcome?
a. Gain of bicarbonate from pancreatic secretions that cannot be absorbed
b. Excessive loss of hydrogen ions normally absorbed from gastric juices
c. Excessive loss of potassium, promoting atony of the intestinal wall
d. Loss of bile acid secretions that cannot be absorbed

Answer 17

b. Excessive loss of hydrogen ions normally absorbed from gastric juices.

Question 18

A patient has been admitted to the hospital with a possible bowel obstruction. Which assessment
finding would alert the healthcare professional that the obstruction is in the small vs. large
intestine?
a. Profuse vomiting of clear gastric fluids
b. Vague dull hypogastric pain without vomiting
c. Colicky pain caused by distention, followed by vomiting
d. Excruciating pain, vomiting, and fever

Answer 18

c. Colicky pain caused by distention, followed by vomiting

Question 19

A patient has chronic gastritis. What treatment does the healthcare professional educate the
patient on?
a. Antibiotic therapy
b. Corticosteroids
c. Vitamin B12 injections
d. Pancreatic enzyme replacement

Answer 19

a. Antibiotic therapy

Question 20

A peptic ulcer may occur in all of these areas except which?
a. Stomach
b. Duodenum
c. Jejunum
d. Esophagus

Answer 20

c. Jejunum

Question 21

A class of students has learned about contributing factors to duodenal ulcers. What statement
indicates to the professor that the students need a review?
a. Bleeding from duodenal ulcers causes hematemesis or melena.
b. Gastric emptying is slowed, causing greater exposure of the mucosa to acid.
c. The characteristic pain begins 30 min to 2 hours after eating
d. Duodenal ulcers occur with greater frequency than other types of peptic ulcers.

Answer 21

b. Gastric emptying is slowed, causing greater exposure of the mucosa to acid.

Question 22

After a partial gastrectomy or pyloroplasty, clinical manifestations that include increased pulse,
hypotension, weakness, pallor, sweating, and dizziness are the results of which mechanism?
a. Excessive relaxation of gastric and vascular smooth muscles
b. Postoperative hemorrhage
c. Concentrated food bolus, causing hyperglycemia
d. Rapid gastric emptying

Answer 22

d. Rapid gastric emptying

Question 23

A patient reports dumping syndrome after a partial gastrectomy. What does the healthcare
professional teach this patient?
a. Eat small, frequent high-protein meals.
b. This will need surgical correction.
c. Take antacids 30 min before meals.
d. Drink plenty of water with your meals.

Answer 23

a. Eat small, frequent high-protein meals.

Question 24

The most common clinical manifestation of portal hypertension is what type of bleeding?
a. Rectal
b. Duodenal
c. Esophageal
d. Intestinal

Answer 24

c. Esophageal

Question 25

A patient has portal hypertension-induced splenomegaly. Which lab value would the healthcare
professional associate with this condition?
a. Low white blood cell count
b. Low platelet count
c. High red cell count
d. High hemoglobin and hematocrit

Answer 25

b. Low platelet count

Question 26

A professor has taught the students about the sources of increased ammonia in patients with
hepatic encephalopathy. What statement by a student indicates the professor should review this
material?
a. End products of intestinal protein digestion are sources of increased ammonia.
b. Digested blood leaking from ruptured varices is a source of increased ammonia.
c. Accumulation of short-chain fatty acids are a source of increased ammonia.
d. Ammonia-forming bacteria in the colon are sources of increased ammonia.

Answer 26

c. Accumulation of short-chain fatty acids are a source of increased ammonia.

Question 27

Hepatic fat accumulation is observed in which form of cirrhosis?
a. Biliary
b. Metabolic
c. Postnecrotic
d. Alcoholic

Answer 27

d. Alcoholic

Question 28

A student asks the healthcare professional to explain the pathophysiologic process of alcoholic
cirrhosis. What statement by the professional would not be consistent with complete knowledge
about this process?
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.

Answer 28

a. Inflammation and damage leading to cirrhosis begin in the bile canaliculi.

Question 29

A student learns what information about acute pancreatitis?
a. Autoimmune process with IgG attacking pancreatic acinar cells
b. It is usually a severe disease with a high mortality rate.
c. Pancreatic enzymes autodigest pancreatic cells and tissues.
d. Oversecretion of pancreatic enzymes and malnutrition

Answer 29

c. Pancreatic enzymes autodigest pancreatic cells and tissues.

Question 30

The mutation of which gene is an early event associated with the pathogenetic origin of
esophageal cancer?
a. KRAS
b. TP53
c. myc
d. HER2

Answer 30

b. TP53