course point unit 7

Question 1

A client has experienced a stroke affecting the reticular formation of the medulla and lower pons. The nurse tells the client’s wife that care must be taken with eating to prevent:

Answer 1

Aspiration pneumonia

Question 2

A client takes 650 mg of aspirin every 4 hours daily for reports of joint pain. Which statement should be included in the client’s teaching plan?

Answer 2

“This medication can damage gastric mucosa.“

Question 3

An anatomy student explains that the funnel-shaped portion of the stomach that connects with the intestine is called which region?

Answer 3

Pyloric region

Question 4

The physiologic rationale for hanging normal saline (0.9% NS) or 5% dextrose in water (D5W) to a client who has been experiencing diarrhea includes:

Answer 4

Facilitating the absorption of osmotically active particles

Question 5

Which enzymes adhere to the border of the villus structures to allow access to carbohydrate and protein molecules?

Answer 5

Brush border

Question 6

A client with long-standing digestive problems is found to have a deficiency in pepsinogen. The client likely has dysfunction involving:

Answer 6

chief cells.

Question 7

Colonic microorganisms play a role in the synthesis of which vitamin?

Answer 7

K

Question 8

Which statement would help a nurse best explain an “incretin effect”?

Answer 8

“It is an increase in insulin release after ingestion of food.”

Question 9

The swallowing reflex is an entirely voluntary activity.

Answer 9

False

Question 10

Which carbohydrate is matched to its correct enzyme needed for digestion?

Answer 10

Sucrose and sucrase

Question 11

The gastrointestinal laboratory nurse is learning about small intestine secretions. Which explanation is most accurate?

Answer 11

“An extensive array of mucus-producing glands, called Brunner glands, is concentrated where contents from the stomach and secretions from the liver and pancreas enter the duodenum.”

Question 12

The nurse is providing medication teaching to a client that includes instructions to take the medication on an empty stomach. The client asks why so many medications are better taken on an empty stomach. Which is the nurse’s best response?

Answer 12

“Many medications rely on an acidic environment for better absorption.”

Question 13

A student is studying gallbladder function. Which gastrointestinal hormone stimulates contraction of the gallbladder?

Answer 13

Cholecystokinin

Question 14

Biopsy results reveal that a client has a deficient amount of parietal (oxyntic) cells in his stomach. The client asks the nurse to explain what this means. The nurse explains that parietal cells secrete HCl and intrinsic factor, which is needed for absorption of:

Answer 14

Vitamin B12

Question 15

A client is not able to absorb vitamin B12. The nurse determines that the client is deficient in:

Answer 15

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

Question 16

Serous fluid is contained in the:

Question 17

Which statement is true concerning gastric enterocytes?

Answer 17

They secrete enzymes that aid in digestion of proteins.

Question 18

A client is experiencing reflux of stomach contents into the esophagus. The nurse determines that the problem may result from:

Answer 18

Gastroesophageal sphincter

Question 19

Select the phase of swallowing that prevents food from entering the nasopharynx when a client is eating.

Answer 19

Pharyngeal

Question 20

The dietitian explains to the client that food is digested and absorbed in the:

Answer 20

Jejunum

Question 21

Which aspect of gastrointestinal function is performed by the brush border enzymes of the villus structures?

Answer 21

Digestion of carbohydrates

Question 22

During a lecture about the function of the intestine related to food digestion, the faculty mentions that when the students consume foods high in acid, the intestines will:

Answer 22

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

Question 23

A student is comparing the two patterns of contractions in the small intestine. Which statement is most accurate?

Answer 23

“Segmentation waves function mainly to mix the chyme with the digestive enzymes from the pancreas.”

Question 24

Which layer of the digestive tract consists of connective tissue and contains nerves, blood vessels, and structures for secreting the digestive juices?

Answer 24

Submucosal

Question 25

Where in the GI tract is food digested and absorbed?

Answer 25

The jejunum and the ileum

Question 26

The nurse is caring for a client who lacks an enzyme needed to create monosaccharides. For which manifestation of this disorder does the nurse assess the client?

Answer 26

diarrhea

Question 27

When discussing pathogens that can invade the gastrointestinal tract, the nurse will likely discuss which type of cell that signals the gastrointestinal immune system to attack pathogens to kill them before they can cause manifestations of an illness?

Answer 27

Cytotoxic T cells

Question 28

A 2-year-old boy is experiencing recurrent bouts of diarrhea. The volume of fluid that is lost in the stool creates a systemic dehydration. This child has an extracellular fluid deficit because:

Answer 28

water and electrolytes for digestive tract secretions are derived from the extracellular fluid compartment.

Question 29

The client chews an apple and starts the process of swallowing. As food enters the client’s esophagus, the nurse recognizes that which nerve innervates the sphincter in the lower esophagus?

Answer 29

Vagus nerve

Question 30

Absorption is a major function of the GI tract. How is absorption accomplished in the GI tract?

Answer 30

Active transport and diffusion

Question 31

The colon is home to between 300 and 500 different species of bacteria. What is their main metabolic function?

Answer 31

Fermentation of undigestible dietary residue

Question 32

A rare condition caused by gastrin-secreting tumors most commonly found in the small intestine or pancreas is called:

Answer 32

Zollinger-Ellison syndrome

Question 33

A nurse administering a client’s medication tells the client that a proton pump inhibitor has been added. When the client asks the purpose of the medication, the nurse responds that it is to prevent:

Answer 33

Stress ulcer

Question 34

A client is admitted to the hospital with a suspected diagnosis of strangulated bowel. The nurse anticipates the client will need:

Answer 34

surgery to release the bowel.

Question 35

Crohn disease is recognized by sharply demarcated, granulomatous lesions that are surrounded by normal-appearing mucosal tissue. The nurse recognizes these lesions to be defined by which description?

Answer 35

Cobblestone

Question 36

The incidence of stomach cancer has significantly decreased in the United States, yet it remains the leading cause of death worldwide. The nurse understands the reason for the high mortality rate in stomach cancer is because of which reason?

Answer 36

Clients have few early symptoms of the disease.

Question 37

The cause of gastric carcinomas has been influenced by which factors? Select all that apply.

Question 38

A teenager has been diagnosed with failure to thrive possibly due to malabsorption syndrome. In addition to having diarrhea and bloating, the client more than likely has what hallmark manifestation of malabsorption?

Answer 38

Fatty, yellow-gray, foul-smelling stools

Question 39

Diarrhea is described as a change in frequency of stool passage to a point where it is excessively frequent. What are the symptoms of non-inflammatory diarrhea? Select all that apply.

Answer 39

Nausea and/or vomiting, Periumbilical cramps, and Nonbloody stools

Question 40

Which meal choice is most likely to exacerbate an individual’s celiac disease?

Answer 40

Spaghetti with meatballs and garlic bread

Question 41

A client is admitted with chronic gastritis. The nurse expects which invasive test to be performed to establish the presence of Helicobacter pylori (H. pylori)?

Answer 41

Endoscopic biopsy

Question 42

A client is admitted with an abrupt onset of referred pain to the epigastric area, with an episode of nausea. On the nurse’s initial assessment, the client is lying still and taking shallow breaths, with a rigid abdomen. Which problem is the client experiencing?

Answer 42

Peritonitis

Question 43

A client who is diagnosed with Zollinger-Ellison syndrome will exhibit which symptoms?

Answer 43

Diarrhea with fat deposits

Question 44

Pharmacologic treatment for peptic ulcers has changed over the past several decades. The nurse knows that the goal for pharmacologic treatment is focused on:

Answer 44

Eradicating Helicobacter pylori (H. pylori)

Question 45

An older adult client has been placed on a broad-spectrum antibiotic for a recurrent urinary tract infection. Which potential problem would the nurse anticipate in this client?

Answer 45

Colonization of Clostridioides difficile

Question 46

Which client likely faces the greatest risk of a gastrointestinal bleed?

Answer 46

A client who takes aspirin with each meal to control symptoms of osteoarthritis

Question 47

A health care provider suspects a client has celiac disease after the client reports sickness every time after eating something made with wheat, barley, and/or rye. The provider will further assess the client for which potential manifestations to confirm the diagnosis? Select all that apply.

Answer 47

Iron deficiency, Diarrhea, Abdominal pain

Question 48

An older adult client presents with loose mucus-filled stools. The nurse suspects the client has Clostridioides difficile. What is a priority assessment for the nurse?

Question 49

In the balance of secretions in the gastric mucosa by the parietal cells, which ion is produced to buffer the production of hydrochloric acid?

Answer 49

HCO3–

Question 50

Good hand-washing techniques are important in health care. The nurse knows that bacterial infections can be prevented by good hand washing techniques. Which route of transmission is most common for Clostridioides difficile?

Answer 50

Fecal–oral transmission

Question 51

A client with quadriplegia adheres to a regular bowel protocol. Which action performed by the client’s caregiver is likely to promote defecation?

Answer 51

Digital stimulation of the client’s rectum

Question 52

Crohn disease has a distinguishing pattern in the gastrointestinal (GI) tract. The surface has granulomatous lesions surrounded by normal-appearing mucosal tissue. A complication of the pattern includes:

Answer 52

fistula formation

Question 53

A young client presents reporting diarrhea, fecal urgency, and weight loss. The stool is light-colored and malodorous, and it tends to float and be difficult to flush. The client has also noted tender, red bumps on the shins and reports pain and stiffness in the elbows and knees. Sigmoidoscopy reveals discontinuous, granulomatous lesions; no blood is detected in the stool. Which diagnosis would his care team first suspect?

Answer 53

Crohn disease

Question 54

Inflammatory bowel disease (IBD) is used to designate two related inflammatory intestinal disorders: Crohn disease and ulcerative colitis. The nurse recognizes the difference between the distribution pattern between Crohn disease and ulcerative colitis. Which pattern describes Crohn’s disease?

Answer 54

Skip lesions

Question 55

A client with a history of peptic ulcer disease presents to the emergency department with the following symptoms: early satiety, feeling of epigastric fullness and heaviness after meals, weight loss, and vomiting. The nurse suspects that the peptic ulcer has caused which problem?

Answer 55

Obstruction

Question 56

Caregivers of a toddler report poor oral intake and grimacing when swallowing. The caregivers also describe the toddler as having difficulty with sleep and wheezing being heard when breathing. The nurse focuses initial assessments based on which likely cause of the symptoms?

Answer 56

gastrointestinal reflux disease

Question 57

Irritable bowel syndrome is thought to be present in 10% to 15% of the population in the United States. What is its hallmark symptom?

Answer 57

Abdominal pain relieved by defecation with a change in consistency or frequency of stools

Question 58

A client who ate a large meal and then went to weightlifting class states “feeling very uncomfortable” and reports gastric reflux. What is the nurse’s best response to the client?

Answer 58

“There is backward movement of gastric contents into the esophagus that occurs soon after eating.”

Question 59

Which clinical manifestations would lead the nurse to suspect the postoperative client has developed a mechanical bowel obstruction? Select all that apply.

Answer 59

Increased abdominal distention, Extreme restlessness, High-pitched bowel sounds

Question 60

A college student goes to the campus health office complaining of diarrhea, lower right abdominal pain, and weight loss. Suspecting Crohn disease, the nurse will assess for which complication associated with this diagnosis?

Answer 60

Urine that has the look and smell of feces

Question 61

A 40-year-old client tells the nurse that a parent died of gastric cancer and that the client wants to do everything one can do to avoid the disease. Which recommendation should the nurse provide?

Answer 61

Avoid smoked and preserved foods.

Question 62

A 68-year-old man who has smoked for at least 50 years reports that lately he feels as though food is “getting stuck” in his throat. At first this was a problem just with dry food, but now his morning oatmeal is getting stuck. On questioning, he reports drinking at least five alcoholic beverages nearly every day. His problem is most likely:

Answer 62

squamous cell carcinoma of the esophagus.

Question 63

A client is admitted with an exacerbation of Crohn disease and has been experiencing a weight loss of 20 pounds in 2 weeks. The client is unable to absorb nutrients from the intestine. The nurse would expect which type of diet to be ordered for this client?

Answer 63

Total parenteral nutrition

Question 64

A client diagnosed with ulcerative colitis has been experiencing more than six bloody stools daily with evidence of toxicity. The nurse should question which order from the physician?

Answer 64

Colonoscopy

Question 65

The client who has experienced third-degree burns is susceptible to which specific type of gastrointestinal (GI) ulceration?

Answer 65

Stress

Question 66

The nurse is reviewing laboratory results of a client who has liver failure. Which finding would place the client at increased risk for bleeding?

Answer 66

Increased prothrombin time

Question 67

When caring for the client with Laennec cirrhosis, the nurse recognizes which pathophysiologic finding to be an expected etiology of jaundice?

Answer 67

Impaired uptake of bilirubin

Question 68

A client is diagnosed with choledocholithiasis and acute suppurative cholangitis and is being rushed to surgery to prevent which possible complication?

Answer 68

The accumulation of purulent bile, which can cause sepsis.

Question 69

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?

Answer 69

Kupffer cells

Question 70

A client’s long-standing diagnosis of congenital hemolytic anemia often manifests itself with jaundice. What type of jaundice does this client most likely experience?

Answer 70

Prehepatic

Question 71

A client with persistent, recurring episodes of epigastric and upper left quadrant pain and anorexia, nausea, vomiting, constipation, and flatulence has been diagnosed with chronic pancreatitis. What is the cause of the symptoms of chronic pancreatitis?

Answer 71

Destruction of both the endocrine and exocrine pancreas

Question 72

The nurse is caring for a client with advanced liver disease who has ascites. Which treatment will the nurse anticipate being used for the daily management of ascites?

Answer 72

diuretics

Question 73

When teaching a group of nursing students about the liver, the nurse relates that Kupffer cells function to remove harmful substances or cells from the portal blood and venous sinusoids through which process?

Answer 73

Phagocytosis

Question 74

Which individual likely faces the highest risk of developing chronic pancreatitis?

Answer 74

A woman who has 6 to 8 alcoholic beverages each evening

Question 75

The client has right upper quadrant pain caused by acute choledocholithiasis. The health care provider suspects the common bile duct is obstructed, based on which flowing lab value?

Answer 75

Bilirubin 15 mg/dL (256.56 µmol/L) (high)

Question 76

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?

Answer 76

Kupffer cells

Question 77

The nurse is performing a physical assessment of the gastrointestinal tract. In which area does the nurse place the hands for palpation of the liver?

Answer 77

Right upper quadrant

Question 78

Antibody testing has confirmed that a client is positive for hepatitis A virus (HAV). Which statement does the nurse apply as evidence that the client understands the new diagnosis?

Answer 78

“I don’t know why I didn’t bother to get vaccinated against this.”

Question 79

The nurse is caring for a client with advanced cirrhosis who had a transjugular intrahepatic portosystemic shunt (TIPS) procedure performed 3 months ago. Which assessment(s) related to the client having a TIPS procedure should the nurse perform? Select all that apply.

Answer 79

Neurologic assessment., Platelet level., & Hemoglobin level.

Question 80

Given the fact that acute pancreatitis can result in severe, life-threatening complications, the nurse should be assessing the client for which complication?

Answer 80

Acute tubular necrosis

Question 81

The nurse is caring for the client with hepatocellular carcinoma. What does the nurse recognize is a cause of this disease?

Answer 81

Illness with hepatitis B or C

Question 82

A client with chronic pancreatitis is experiencing an episode of recurring epigastric pain. The nurse teaches the client to limit which type of meal to avoid further episodes?

Answer 82

fried chicken and french fries

Question 83

A client has been diagnosed with alcohol-induced liver disease. He admits to the nurse, “I know what the lungs do, and I know what the heart does, but honestly, I have no idea what the liver does in the body.” The nurse should tell the client that the liver:

Answer 83

metabolizes most components of food and also cleans the blood of bacteria and drugs.

Question 84

Primary biliary cirrhosis is an autoimmune disease that destroys the small intrahepatic bile ducts causing cholestasis. It is insidious in onset and is a progressive disease. What are the earliest symptoms of the disease?

Question 85

A client newly diagnosed with pancreatic cancer is admitted to begin treatment. Which pain descriptors can be associated with adenocarcinomas of the pancreas?

Answer 85

Dull epigastric pain accompanied by back pain, worse when lying flat and relieved by sitting forward.

Question 86

A 24-year-old woman undergoing a screening test is found to have elevated levels of AST, ALT, and IgG, but no antibody-specific markers for viral hepatitis. A liver biopsy reveals inflammation and cellular damage. Which treatment is most likely to be effective for her?

Answer 86

Corticosteroids and immunosuppressant drugs

Question 87

Cholestasis is a condition in which there is a decrease in bile flow through the intrahepatic canaliculi and a reduction in secretion of water, bilirubin, and bile acids by the hepatocytes. Cholestasis can have more than one cause, but in all types of cholestasis, there is:

Answer 87

accumulation of bile pigment in the liver.

Question 88

The nurse is caring for a client with hepatitis and jaundice. The nurse recognizes that without sufficient circulating bile salts the client will have intolerance to which ingested substance?

Answer 88

Fats

Question 89

One of the jobs the liver performs is to export triglyceride. When the liver’s capacity to export triglyceride is exceeded, excess fatty acids accumulate in the liver. To what disease do these excess fatty acids contribute?

Answer 89

Nonalcoholic fatty liver disease

Question 90

A client is prescribed erythromycin for an infection. What manifestations will the nurse recognize that indicate the onset of drug-induced cholestasis?

Answer 90

Jaundice and pruritus

Question 91

The nurse is caring for a client with asterixis. Which assessment should the nurse make to help a diagnosis of hepatic encephalopathy?

Answer 91

Mental status

Question 92

A client presents to the emergency department with suspected pancreatitis. Which manifestations would the nurse assess in this client? Select all that apply.

Answer 92

• Fever
• Tenderness
• Tachycardia
• Epigastric pain

Question 93

A client with no significant past medical history has just been diagnosed with early cirrhotic changes due to an undiagnosed chronic hepatitis C infection. The client asks the nurse about treatment options. Which information should the nurse provide?

Answer 93

“You may be eligible for pangenotypic direct-acting antiviral agents, which are often curative.”

Question 94

The nurse is caring for a client with liver disease who has edema throughout the body. When reviewing the medical record, the nurse recognizes that which altered diagnostic test is consistent with development of edema?

Answer 94

Decreased albumin

Question 95

The nurse is teaching a group of nursing students about alcohol-induced liver disease and the cytochrome P450 system (CYP P450). Which of these is correct for the nurse to include in the lesson?

Answer 95

Alcohol consumption enhances susceptibility to effects of drugs and toxins.

Question 96

When caring for a client with primary biliary cirrhosis, which of these statements by the nurse will best teach the client about the cause of this problem?

Answer 96

There is autoimmune destruction of the bile ducts.

Question 97

The nurse is caring for a client with a diagnosis of post-hepatic obstruction. Which of these questions will assist the nurse in determining the underlying cause of the obstruction?

Answer 97

“Have you been told you have had gallstones?”

Question 98

A decrease in the serum level of which substance is suggestive of liver injury?

Answer 98

Albumin

Question 99

The oncology nurse is teaching a group of nursing students about risk factors for pancreatic cancer. Which factors does the nurse include in the teaching session? Select all that apply.

Answer 99

Chronic pancreatitis, Age over 50 years, cig smoking

Question 100

Which manifestations will the nurse expect to find in a client with advanced liver failure?

Answer 100

Hematuria, Hyperkalemia, Asterixis

Question 100

The nurse is teaching a client about surgical treatments available for chronic viral hepatitis. Which of these is appropriate for the nurse to relate?

Answer 100

Liver transplant

Question 101

The nurse is caring for a college student with infectious mononucleosis. For which reason does the nurse teach the client to abstain from alcohol during the acute phase of the disease?

Answer 101

Alcohol may worsen a mild hepatitis which occurs in the acute phase.