Patho Quiz 5 Part 2
Terms in this set (33)
While assessing a client who is experiencing diarrhea caused by Clostridium difficile,
the nurse should anticipate hearing:
A) Normal bowel sounds
B) Hypoactive bowel sounds
C) Absence of bowel sounds
D) Hyperactive bowel sounds
When discussing digestion with a group of nursing students, the instructor asks,
"Where does the digestion of our food begin?" The most accurate student response
A) The stomach with its hydrochloric acid production
B) The duodenum with common bile duct secretions
C) The mouth with ptyalin and amylase breaking down starches
D) The jejunum, where peristaltic waves begin
Which of the following clients likely faces the greatest risk of a gastrointestinal
A) A man whose hypertension requires him to take a diuretic, an ACE inhibitor, and a β-
B) A client who is taking a broad-spectrum antibiotic to treat a urinary tract infection
C) A client with a history of anxiety who takes benzodiazepines several times daily
D) A client who takes aspirin with each meal to control symptoms of osteoarthritis
When explaining absorption to a client, the nurse mentions that a number of
substances require a specific carrier or transport system. An example the nurse could
use relates to the transport of amino acids and glucose, which requires the presence
of which of the following for absorption to occur?
A child who is experiencing the signs and symptoms of influenza has vomited
frequently over the last 24 hours. While discussing vomiting with a group of nursing
students, the instructor asks, "What site in the neurologic system is responsible for
vomiting?" Which student response is most accurate?
A) Myenteric plexus
B) Intramural plexus
C) Vagus nerve
D) Chemoreceptor trigger zone
A teenager who has a history of achalasia will likely complain of which of the
following clinical manifestations?
A) Excessive heartburn following a high-fat meal of French fries
B) Feeling like there is food stuck in the back of the throat
C) Projectile vomiting across the room unrelated to meals
D) Vomiting large amounts of bright red emesis
A client has had severe heart burn associated with persistent gastroesophageal reflux
for many years. Which of the following statements made by the client leads the
nurse to suspect the client is having a complication related to his reflux? The client
A) Difficulty in swallowing with feelings that food is "stuck" in the throat
B) Burning sensation a half-hour after a meal
C) Substernal chest pain that radiates to the shoulder and arm
D) "Hoarseness" unrelieved by coughing or taking a drink of water
Acute gastritis refers to a transient inflammation of the gastric mucosa that is most
commonly associated with:
B) Food allergies
C) Gastric reflux
D) Alcohol intake
A 60-year-old male client has presented to his primary care provider to follow up
with his ongoing treatment for peptic ulcer disease. What is the most likely goal of
this client's pharmacologic treatment?
A) Inhibiting gastric acid production
B) Promoting hypertrophy of the gastric mucosa
C) Increasing the rate of gastric emptying
D) Increasing muscle tone of the cardiac sphincter
While assessing a client diagnosed with inflammatory bowel diseases, the nurse
should assess for systemic manifestations that may include: Select all that apply.
A) Autoimmune anemia
B) Rheumatoid arthritis
D) Lactose intolerance
E) Mouth ulcerations
The ulcerative colitis client should be assessed by the health care provider for which
of the following clinical manifestations? Select all that apply.
A) Persistent diarrhea
C) Stool containing blood (hematochezia)
D) External hemorrhoids
E) Prolapsed colon
41. The nurse caring for a client with diverticulitis should assess for which of the
following clinical manifestations?
A) Frequent rectal bleeding
B) Increased abdominal distention
C) Large-volume diarrhea
D) Lower left quadrant pain
42. A 66-year-old woman has been diagnosed with diverticular disease based on her
recent complaints and the results of a computed tomography (CT) scan. Which of
the client's following statements demonstrates an accurate understanding of this
A) "From now on, I'm going to stick to an organic diet and start taking more
B) "I think this might have happened because I've used enemas and laxatives too much."
C) "I've always struggled with heartburn and indigestion, and I guess I shouldn't have
ignored those warning signs."
D) "I suppose I should try to eat a bit more fiber in my diet."
43. Which of the following signs/symptoms would lead the nurse to suspect the post-op
client has developed a mechanical bowel obstruction? Select all that apply.
A) Sluggish to absent bowel sounds
B) Increase in abdominal distention
C) Nausea and vomiting
D) Rectal bleeding
E) Continuous abdominal pain
A, B, C, E
44. Which of the following clients should the nurse observe most closely for the signs
and symptoms of paralytic ileus?
A) A client who is first day postoperative following gallbladder surgery
B) A client whose acute diarrhea has necessitated the use of antidiarrheal medications
C) An obese client who refuses to ambulate because he complains of shortness of breath
D) A client with a long-standing diagnosis of irritable bowel syndrome
45. A teenager has been diagnosed with failure to thrive. The health care providers
suspect a malabsorption syndrome. In addition to having diarrhea and bloating, the
client more than likely has what hallmark manifestation of malabsorption?
A) Feeling there is incomplete emptying of the bowel
B) Abdominal distention
C) Esophageal reflux with heartburn
D) Fatty, yellow-gray, foul-smelling stools
46. The role Kupffer cells play in removing harmful substances or cells from the portal
blood as it moves through the venous sinusoids is known as:
D) Cytotoxic cells
47. A newborn is admitted to the hospital with a high bilirubin level of 13 mg/dL. The
assessment data related to this lab value includes: Select all that apply.
A) Yellowish discoloration of the skin
B) Colicky, intermittent pain associated with formula feeding
D) Yellowing of the sclera of the eye
E) Dark-colored urine
48. 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?
49. A client has been diagnosed with cholestasis and is experiencing pruritus. The nurse
caring for this client should be educating the client about reduced bile flow that will
interfere with intestinal absorption of which of the following vitamins? Select all
A) Vitamin A
B) Vitamin B
C) Vitamin C
D) Vitamin D
E) Vitamin K
50. A client with hepatitis B asks the nurse, "How did I get this hepatitis?" The nurse
responds that the mode of transmission is predominantly by: Select all that apply.
A) Intravenous drug use
B) Fecal-oral route
C) Unprotected sexual intercourse
D) Sharing oral secretions by kissing
E) Inhalation of airborne droplets
51. Clients with chronic autoimmune hepatitis may display which of the following
clinical manifestations upon physical exam? Select all that apply.
A) Enlarged liver
C) Bacterial meningitis
D) Nuchal rigidity
E) Edematous joints
52. A client is suspected of having the onset of alcoholic liver disease. The nurse should
be assessing for which of the following manifestations related to the necrosis of
A) Tremors of the hands
B) Rapid onset of jaundice
C) Long muscle group atrophy
D) Development of multiple skin nodules
53. A client is admitted with late manifestations of cirrhosis. Which of the following
clinical manifestations confirm this diagnosis? Select all that apply.
A) Hepatomegaly felt on deep palpation
B) Diffuse liver fibrosis with large, palpable lumps
C) GI bleeding related to esophageal varices
D) Acute renal failure with electrolyte imbalances
E) Splenomegaly with bleeding tendencies
54. Both prehepatic and posthepatic causes of portal hypertension include the formation
A) Fibrous nodules
B) Venous thrombosis
C) Collateral circulation
D) Portosystemic shunts
55. A client presents to the emergency department vomiting large amounts of bright red
blood. The client has a history of alcohol abuse, and the physician suspects
esophageal varices. The drug that is used to reduce splanchnic and hepatic blood
flow and portal pressures is:
A) Propranolol, a β-adrenergic blocking agent
B) Lisinopril, an ACE inhibitor
C) Ocetrotide, a long-acting synthetic analog of somatostatin
D) Famotidine, a histamine-2 blocker to decrease stomach acid
56. A major factor in the development of hepatic encephalopathy is:
B) High sodium level
C) Neurotoxin accumulation
D) Steroid hormone deficiency
57. Hepatocellular cancer usually has a poor prognosis due in part to which of the
A) Surgical options do not exist because removal of all or part of the liver is a threat to
B) Liver cancer typically metastasizes at a much earlier stage than other cancers.
C) Liver tumors are poorly differentiated due to the low density of hepatic tissue.
D) The nonspecific symptomatology of liver cancer leads to a diagnosis at a late stage.
58. An ultrasound (US) of a client with intermittent pain reveals gallbladder sludge.
Which of the following client history items are likely factors in the US result? Select
all that apply.
A) Had lap band surgery 2 years ago and lost 100 pounds
B) Recent pregnancy with a 6-month-old child at home
C) Current prescription for a medicine to lower cholesterol
D) A runner training for a marathon
E) Works in surgery with long periods of standing in one place
59. Which of the following factors is most strongly associated with the pathogenesis of
A) Excess serum ammonia and urea levels
B) Portal hypertension
C) Abnormalities or stasis of bile
D) High-cholesterol diet
60. Which of the following signs and symptoms is most suggestive of acute
A) Upper right quadrant or epigastric pain
B) Fever and sudden abdominal distention
C) Appearance of undigested fat in feces
D) Nausea resulting in greenish vomitus
61. 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 of
the flowing lab values?
A) Albumin 2.0 g/dL (low)
B) Amylase 150 unites/L (high)
C) Bilirubin 15 mg/dL (high)
D) Serum calcium level 7 mg/dL (low)
62. When explaining acute pancreatitis to a newly diagnosed client, the nurse will
emphasize the pathogenesis begins with an inflammatory process whereby:
A) Activated pancreatic enzymes escape into surrounding tissues, causing autodigestion
of pancreatic tissue.
B) The pancreas is irreversibly damaged and will not recover to normal functioning
C) The pancreas will hypertrophy (enlarge) to the point of causing bowel obstruction.
D) Stones will develop in the common bile duct, resulting in acute jaundice.