Chs 29, 30 (GI & Hepatobiliary Function) Flashcards
Hiatal hernias can cause severe pain if the hernia is large. Gastroesophageal reflex is a common comorbidity of hiatal hernia, and, when this occurs, what might the hernia do?
a. Increase esophageal acid clearance
b. Retard esophageal acid clearance
c. Decrease esophageal acid clearance
d. Accelerate esophageal acid clearance
b. Retard esophageal acid clearance
Infants and children commonly have gastroesophageal reflex. Many times it is asymptomatic and resolves on its own. What are the signs and symptoms of gastroesophageal reflux in infants with severe disease?
a. Consolable crying and early satiety
b. Delayed satiety and sleeping after feeding
c. Tilting of the head to one side and arching of the back
d. Inconsolable crying and delayed satiety
c. Tilting of the head to one side and arching of the back
The stomach secretes acid to begin the digestive process on the food that we eat. The gastric mucosal barrier works to prevent acids secreted by the stomach from actually damaging the wall of the stomach. What are the factors that make up the gastric mucosal barrier? (Mark all that apply.)
a. An impermeable epithelial cell surface
b. Mechanisms for selective transport of bicarbonate and potassium loss
c. Characteristics of gastric mucus
d. Cell coverings that act as antacids
e. Mechanisms for selective transport of hydrogen and bicarbonate ions
a, c, e (Impermeable epithelial cell surface covering, characteristics of gastric mucus, mechanisms for selective transport of hydrogen and bicarbonate ions)
Helicobacter pylori has a prevalence of over 50% of American adults over the page of 50, which is thought to be caused by a previous infection when the client was younger. What can chronic gastritis caused by H. pylori cause?
a. Decreased risk of gastric adenocarcinoma
b. Decreased risk of low-grade B-cell gastric lymphoma
c. Duodenal ulcer
d. Gastric atrophy
d. Gastric atrophy
A 39-year-old white woman presents at the clinic with complaints of epigastric pain that is cramplike, rhythmic, and just below the xiphoid. She states that it wakes her up around 1 AM, and she is not sleeping well because of it. She further states that is the third episode of having this pain in the past year. The nurse suspects the client has a peptic ulcer and expects to receive what orders from the physician?
a. Schedule client for a complete metabolic panel and a complete blood count
b. Schedule client for laparoscopic examination
c. Schedule client for a swallow study
d. Schedule client for a lower gastrointestinal study
a
A client in a nursing home complains to her nurse that she is not feeling well. When asked to describe how she feels, the client states that she really is not hungry anymore and seems to have indigestion a lot. The nurse checks the client’s chart and finds that her vital signs are normal, but that she has lost weight over the past 2 months. She also notes that there is a family history of gastric cancer in the client’s family. The nurse notifies the physician and expects to receive what orders? (Mark all that apply.)
a. Schedule a barium radiograph and an endoscopy
b. Perform a Papanicolaou smear on the client’s gastric secretions
c. Order cytologic studies to be done during the endoscopy
d. Schedule a lower gastrointestinal study
e. Have a technician do an endoscopic ultrasound
a, c (schedule barium radiograph and endoscopy, order cytologic studies to be done during endoscopy)
Irritable bowel syndrome is thought to be present in 10% to 15% of the population in the United States. What is its hallmark symptom?
a. Nausea and abdominal pain unrelieved by defecation
b. Abdominal pain relieved by defecation with a change in consistency or frequency of stools
c. Diarrhea and abdominal pain unrelieved by defecation
d. Abdominal pain relieved by defecation and bowel impaction
b
Crohn disease is a recurrent inflammatory disease that can affect any area of the bowel. Characteristic of Crohn disease is granulomatous lesions that are sharply demarcated from the surrounding tissue. As the nurse caring for a client with newly diagnosed Crohn disease, you would know to include what in your teaching?
a. Definition of Crohn disease that includes that it is a recurrent disease that affects only the large intestine.
b. Information on which nonsteroidal anti-inflammatory drugs to take and how often to take them.
c. Information on sulfasalazine including dosage, route, frequency, and side effects of the drug.
d. Information on the chemotherapy that will be ordered to cure the disease.
c
Rotavirus is a common infection in children younger than 5 years of age. Like other diseases, rotavirus is most severe in children under 24 months of age. What is a symptom of rotavirus infection?
a. Mild to moderate fever that gets higher after the second day
b. Vomiting that lasts for the course of the disease
c. Fever that disappears after 7 days
d. Vomiting that disappears around the second day
d
Diverticulitis is the herniation of tissue of the large intestine through the muscularis layer of the colon. It is often asymptomatic and is found in approximately 80% of people over the age of 85. Diverticulitis is asymptomatic, but when symptoms do occur what is the most common complaint of the client?
a. Lower left quadrant pain with nausea and vomiting
b. Right lower quadrant pain with nausea and vomiting
c. Midepigastric pain with nausea and vomiting
d. Right lower quadrant pain with rebound tenderness on the left
a
Diarrhea is described as a change in frequency of stool passage to a point where it is excessively frequent. Diarrhea can be acute or chronic, inflammatory, or noninflammatory. What are the symptoms of noninflammatory diarrhea? (Mark all that apply.)
a. Small volume watery stools
b. Nonbloody stools
c. Periumbilical cramps
d. Nausea and/or vomiting
e. Large-volume blood stools
b, c, d (Nonbloody stools, periumbilical cramps, nausea and/or vomiting)
Peritonitis is an inflammatory condition of the lining of the abdominal cavity. What is one of the most important signs of peritonitis?
a. Vomiting of coffee-ground appearing emesis
b. The translocation of extracellular fluid into the peritoneal cavity
c. The translocation of intracellular fluid into the peritoneal cavity
d. Vomiting of bloody emesis
b
Celiac disease commonly presents in infancy as a failure to thrive. It is an inappropriate T-cell–mediated immune response and there is no cure for it. What is the treatment of choice for celiac disease?
a. Removal of protein from the diet
b. Removal of fat from the diet
c. Removal of gluten from the diet
d. Removal of sugar from the diet
c
One of the accepted methods of screening for colorectal cancer is testing for occult blood in the stool. Because it is possible to get a false-positive result on these tests, you would instruct the client to do what?
a. Eat lots of red meat for 3 or 4 days before the test is done.
b. Take 1000 mg of vitamin C in supplement form for 1 week prior to testing.
c. Eat citrus fruits at least 5 times a day for 2 days prior to testing.
d. Avoid nonsteroidal anti-inflammatory drugs for 1 week prior to testing.
d
The liver has many jobs. One of the most important functions of the liver is to cleanse the portal blood of old and defective blood cells, bacteria in the bloodstream, and any foreign material. Which cells in the liver are capable of removing bacteria and foreign material from the portal blood?
a. Kupffer cells
b. Langerhans cells
c. Epstein cells
d. Davidoff cells
a. Kupffer cells
