Question 1

A 55-year-old man has been diagnosed with a gastroesophageal reflux disease (GERD), in which the function of his lower esophageal sphincter is compromised. Which of the following consequences of this condition is most likely to occur?

Accepted Answer

Given that the role of the lower esophageal sphincter is to control the exchange of foods and fluids, a deficit is likely to allow the stomach contents, or the stomach itself, to protrude into the esophagus. Absorption is unlikely to be directly affected, and the sphincter is not responsible for controlling gastric emptying or enzyme secretion.

Question 2

Place the following components of the gastrointestinal tract in the chronological order that a bolus of food would pass through them. Use all the options.

Accepted Answer

Ingested food and fluids enter the stomach through the hiatus, exit through the pylorus, and pass through the three subdivisions of the small intestine: the duodenum, jejunum, and ileum. The cecum is a component of the large bowel.

Question 3

While explaining to a group of nursing students what the function of the first mucosal layer of the lower two thirds of the esophagus, the pathophysiology instructor mentions which of the following functions? Select all that apply.

Accepted Answer

The first layer performs numerous functions. These include production of mucus that lubricates and protects the inner surface of the alimentary canal; secretion of digestive enzymes and substances that break down food; absorption of the breakdown products of digestion; and maintenance of a barrier to prevent the entry of noxious substances and pathogenic organism. The facilitation of movement of contents of the GI tract occurs in the third layer while holding the organs in place, and storage of fats occurs in the fourth layer.

Question 4

The instructor asks a group of nursing students to explain the function of the omentum. The students will respond based on which pathophysiologic principle?

Accepted Answer

The greater omentum has considerable mobility and moves around in the peritoneal cavity with the peristaltic movements of the intestines. It also cushions the abdominal organs against injury and provides insulation against the loss of body heat. The mesentery holds the organs in place and attaches the jejunum and ileum to the abdominal wall. The mucosal layer acts as a barrier to prevent the entry of noxious substances and pathogenic organisms.

Question 5

When the sympathetic nervous system is stimulated, the interstitial cells of Cajal, pacemaker cells of the GI tract, react by

Accepted Answer

The interstitial cells of Cajal that are found in groups between the layers of smooth muscle tissue are hypothesized to function as the pacemakers. These cells display rhythmic, spontaneous oscillations in the membrane potentials, called slow waves, ranging in frequency from approximately 3 per minute in the stomach to 12 per minute in the duodenum. The vagus nerve responds to parasympathetic innervation. GI motility is enhanced because of increased vagal activity that could cause diarrhea.

Question 6

A gastroenterologist is teaching a group of medical students about the enteric nervous system in preparation for a consult on client who has suffered a spinal cord injury. Which of the physician's teaching points is most accurate?

Accepted Answer

The enteric nervous system consists of the myenteric and submucosal plexuses, which are located within the wall of the gastrointestinal tract. The myenteric plexus is responsible for controlling overall function along the entire length of the gut, while the vagus nerve provides parasympathetic, not sympathetic, innervation. Sympathetic simulation lessens excitatory neuromediators and inhibits GI motility.

Question 7

A speech therapist is performing a swallowing assessment on a 72-year-old man who has suffered a stroke 3 weeks ago. The man has been NPO (nothing by mouth) since his stroke, and the health care team is considering the introduction of oral food. The speech therapist is cueing the client to swallow to preclude either aspiration of food or pocketing of food in the sides of his mouth. The client most likely to have conscious control over which of the following processes listed below involved in swallowing?

Accepted Answer

Moving a bolus to the posterior wall of the pharynx is a component of the oral, or voluntary, phase of swallowing. Initiation of primary peristalsis, moving the epiglottis back to cover the larynx, and moving the bolus backward in the esophagus are all involuntary components of the pharyngeal and esophageal phases of swallowing.

Question 8

A male infant is brought into the clinic because of colic-like symptoms. The mother states he acts like something is hurting. After eating, he vomits most of the feeding and then assumes a fetal position. He is also not gaining weight. The nurse practitioner is thinking that he is displaying clinical manifestations of obstruction and may have which of the following medical diagnoses?

Accepted Answer

An example of obstruction is hypertrophic pyloric stenosis, which can occur in infants with an abnormally thick muscularis layer in the terminal pylorus. A defect in the lining of the first part of the small intestine (duodenal ulcer) is usually caused by an infection with a bacterium (germ) called H. pylori. When food is ingested and digested but not excreted, it forms a blockage in the colon. Regular bowel movements are needed in order for this not to occur. When bowel movements are irregular, constipation may result. This infant appears to be vomiting his stomach content; therefore, no BM is occurring since no food is being digested in the small intestine. Gastrin provides the major stimulus for gastric acid production. Its action on the lower esophageal sphincter protects the esophageal mucosa when gastric acid levels are elevated. If stomach acids reflux into the esophagus, acid irritation and inflammation cause extensive injuries to the esophagus.

Question 9

A 79-year-old male resident of a long-term care facility has contracted Clostridium difficile and is experiencing consequent diarrhea. Auscultation of the man's abdomen indicates hyperactive bowel sounds. What process in the man's small intestine is most likely accompanying his current status?

Accepted Answer

Inflammation of the small intestine is accompanied by an increase in motility, an effect that is the result of increased peristaltic waves. Segmentation waves are responsible primarily for mixing rather than moving food. Neither dilation nor inadequate slowing of passage contents is responsible for the increase in motility.

Question 10

Which of the following statements best communicates the nature of movements in the colon?

Accepted Answer

The colon, unlike the small intestine, moves contents by the simultaneous contraction of large segments. The anal sphincters control defecation rather than movements within the colon, and haustrations perform mixing, not motility. Segmentation waves are present in the small intestine.

Question 11

A 42-year-old female client with a long-standing history of chronic nausea and vomiting but a near-insatiable appetite has had her symptoms attributed to an enzyme deficiency. Further diagnostic testing indicates that she has inadequate pancreatic enzyme levels and that her large appetite is due to a lack of enzyme control of food intake inhibition. In which of the following enzymes is the woman most likely deficient?

Accepted Answer

Cholecystokinin is responsible for inhibiting food intake as well as stimulating pancreatic enzyme secretion. Ghrelin stimulates food intake, while gastrin stimulates gastric acid production, and secretin inhibits it.

Question 12

A science teacher is talking to a group of fifth graders about the role of "spit." During the course of the discussion, the teacher asks the students which of the following are functions of saliva?

Accepted Answer

Saliva has three functions. The first is to protect and lubricate. The second is to provide antimicrobial protection. The third is to initiate digestion of starches by secreting enzymes. If anxious, SNS activity causes dry mouth. Saliva begins breaking down starches (carbohydrates), not fatty foods. The chief cells secrete pepsinogen, which is converted into pepsin, the enzyme that breaks down protein. This occurs in the stomach.

Question 13

Which of the following medications used in the treatment of peptic ulcers and^{gastroesophageal reflux binds to H}2 ^{receptors and blocks the action of histamine on} parietal cells?

Accepted Answer

^{Cimetidine is a H}2 ^{receptor blocker used to treat peptic ulcers and GERD. It binds to H}2 receptors and blocks the action of histamine on parietal cells. Levbid and Lotronex are anticholinergics, while Nexium is a proton pump inhibitor that inhibits gastric acid secretion.

Question 14

A 77-year-old woman has been admitted to hospital following several weeks of increasing fatigue. On observation, she is pale, and blood work indicates she has low hemoglobin and red cell counts. Stool tests for occult blood are positive, and following endoscopy, she has been diagnosed with an upper GI bleed that has been shown to originate in her stomach. She admits to regularly exceeding the recommended doses of nonsteroidal anti-inflammatory drugs (NSAIDs) in an effort to control her rheumatoid arthritis. Which of the following phenomena is most likely responsible for her present health problems?

Accepted Answer

NSAIDs damage the mucosal barrier, allowing hydrogen ions to damage cells of the stomach lining. They do not directly increase gastrin production or H⁺levels, and decreased, not increased, prostaglandin synthesis would potentially compromise the gastric surfaces.

Question 15

Chronic anxiety and stress contribute to ulcers. Which of the following effects of the sympathetic nervous system is most responsible for this effect?

Accepted Answer

Brunner glands, which produce large amounts of alkaline mucus that protects the duodenum from acid and digestive enzymes, are strongly affected by sympathetic stimulation, which causes a marked decrease in mucus production. Where the stomach contents and secretions from the liver and pancreas enter the duodenum, deficiency of mucus can cause irritation and, potentially, ulcers. Overstimulation of the oxyntic glands is not produced by the SNS. The hormone cholecystokinin, which is thought in part to control gastric emptying, is released in response to the pH, osmolality, and fatty acid composition of the chyme. The two largest salivary glands are called parotid glands.One is located in each cheek over the jaw in front of the ears. Inflammation of one or more of these glands is called parotitis.

Question 16

Following a 14-day course of broad-spectrum antibiotics for the treatment of sepsis, a 60-year-old woman has developed watery diarrhea. Her care team attributes this to likely elimination of normal intestinal flora by the antibiotics. What other phenomena is most likely accompanying her low levels of normal flora?

Accepted Answer

Central among the functions of normal intestinal flora are the fermentation of dietary components that are not digestible and the facilitation of vitamin absorption. Mineral and nutrient absorption as well as carbohydrate metabolism are less likely to be affected, while vitamin K production would likely decrease somewhat. pH is unlikely to be affected.

Question 17

A patient has just been diagnosed with pernicious anemia. The patient asks the nurse^{why his body is not able to absorb vitamin B}12^{. The nurse}^responds,

Accepted Answer

^{Vitamin B}12 ^{is not absorbed in the absence of intrinsic factor, which is secreted by the}parietal cells of the stomach. Ulcers in the stomach do not cause pernicious anemia. This is not a congenital problem, nor does the intake of fats interfere with the secretion of intrinsic factor.

Question 18

A male client complaining of chronic cramping, bloating, and diarrhea has been determined to have a deficiency in brush border enzymes within his small intestine. Which of the following meals or snacks high in carbohydrates and protein will likely exacerbate the client's signs and symptoms?

Accepted Answer

Brush border enzymes are primarily responsible for the metabolism of carbohydrates and proteins, substances best exemplified by a baked potato and roast beef, respectively. Of the distracters, choice C has both high protein and high carbohydrate content.Distracters A, B, and D are not high in both carbohydrates and proteins.

Question 19

A mom asks her neighbor, a nurse, why every time she takes her daughter (10 years old) out for ice cream she comes home with a stomachache and then experiences a bout of diarrhea. The nurse is thinking that this girl is experiencing

Accepted Answer

People with a deficiency of lactase, the enzyme that breaks down lactose, experience diarrhea when they drink milk or eat dairy products. Doubtful the child is anxious about the calories in ice cream. Gallbladder disease s/s usually occur in relation to high saturated fat intake. Peptic ulcer s/s include bloating, vomiting blood, foul coffee ground stools, etc.

Question 20

Which of the following statements best captures an aspect of the process of fat digestion and absorption?

Accepted Answer

After breakdown, by pancreatic lipase, triglycerides are absorbed primarily in the upper jejunum. Long-chain fatty acids are absorbed less easily than medium-chain triglycerides, while stool often contains a certain amount of fat.

Quiz 42: Structure and Function of the Male Reproductive System

A 55-year-old man has been diagnosed with a gastroesophageal reflux disease (GERD) , in which the function of his lower esophageal sphincter is compromised. Which of the following consequences of this condition is most likely to occur?

Place the following components of the gastrointestinal tract in the chronological order that a bolus of food would pass through them. Use all the options.

While explaining to a group of nursing students what the function of the first mucosal layer of the lower two thirds of the esophagus, the pathophysiology instructor mentions which of the following functions? Select all that apply.

The instructor asks a group of nursing students to explain the function of the omentum. The students will respond based on which pathophysiologic principle?

When the sympathetic nervous system is stimulated, the interstitial cells of Cajal, pacemaker cells of the GI tract, react by

A gastroenterologist is teaching a group of medical students about the enteric nervous system in preparation for a consult on client who has suffered a spinal cord injury. Which of the physician's teaching points is most accurate?

A 79-year-old male resident of a long-term care facility has contracted Clostridium difficile and is experiencing consequent diarrhea. Auscultation of the man's abdomen indicates hyperactive bowel sounds. What process in the man's small intestine is most likely accompanying his current status?

Which of the following statements best communicates the nature of movements in the colon?

A science teacher is talking to a group of fifth graders about the role of "spit." During the course of the discussion, the teacher asks the students which of the following are functions of saliva?

Which of the following medications used in the treatment of peptic ulcers and^{gastroesophageal reflux binds to H}2 ^{receptors and blocks the action of histamine on} parietal cells?

Chronic anxiety and stress contribute to ulcers. Which of the following effects of the sympathetic nervous system is most responsible for this effect?

A patient has just been diagnosed with pernicious anemia. The patient asks the nurse^{why his body is not able to absorb vitamin B}12^{. The nurse}^responds,

A male client complaining of chronic cramping, bloating, and diarrhea has been determined to have a deficiency in brush border enzymes within his small intestine. Which of the following meals or snacks high in carbohydrates and protein will likely exacerbate the client's signs and symptoms?

A mom asks her neighbor, a nurse, why every time she takes her daughter (10 years old) out for ice cream she comes home with a stomachache and then experiences a bout of diarrhea. The nurse is thinking that this girl is experiencing

Which of the following statements best captures an aspect of the process of fat digestion and absorption?

Quiz 42: Structure and Function of the Male Reproductive System

A 55-year-old man has been diagnosed with a gastroesophageal reflux disease (GERD) , in which the function of his lower esophageal sphincter is compromised. Which of the following consequences of this condition is most likely to occur?

Place the following components of the gastrointestinal tract in the chronological order that a bolus of food would pass through them. Use all the options.

While explaining to a group of nursing students what the function of the first mucosal layer of the lower two thirds of the esophagus, the pathophysiology instructor mentions which of the following functions? Select all that apply.

The instructor asks a group of nursing students to explain the function of the omentum. The students will respond based on which pathophysiologic principle?

When the sympathetic nervous system is stimulated, the interstitial cells of Cajal, pacemaker cells of the GI tract, react by

A gastroenterologist is teaching a group of medical students about the enteric nervous system in preparation for a consult on client who has suffered a spinal cord injury. Which of the physician's teaching points is most accurate?

A 79-year-old male resident of a long-term care facility has contracted Clostridium difficile and is experiencing consequent diarrhea. Auscultation of the man's abdomen indicates hyperactive bowel sounds. What process in the man's small intestine is most likely accompanying his current status?

Which of the following statements best communicates the nature of movements in the colon?

A science teacher is talking to a group of fifth graders about the role of "spit." During the course of the discussion, the teacher asks the students which of the following are functions of saliva?

Which of the following medications used in the treatment of peptic ulcers and gastroesophageal reflux binds to H2 receptors and blocks the action of histamine on parietal cells?

Chronic anxiety and stress contribute to ulcers. Which of the following effects of the sympathetic nervous system is most responsible for this effect?

A patient has just been diagnosed with pernicious anemia. The patient asks the nurse why his body is not able to absorb vitamin B12. The nurse responds,

A male client complaining of chronic cramping, bloating, and diarrhea has been determined to have a deficiency in brush border enzymes within his small intestine. Which of the following meals or snacks high in carbohydrates and protein will likely exacerbate the client's signs and symptoms?

A mom asks her neighbor, a nurse, why every time she takes her daughter (10 years old) out for ice cream she comes home with a stomachache and then experiences a bout of diarrhea. The nurse is thinking that this girl is experiencing

Which of the following statements best captures an aspect of the process of fat digestion and absorption?

Which of the following medications used in the treatment of peptic ulcers and^{gastroesophageal reflux binds to H}2 ^{receptors and blocks the action of histamine on} parietal cells?

A patient has just been diagnosed with pernicious anemia. The patient asks the nurse^{why his body is not able to absorb vitamin B}12^{. The nurse}^responds,