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Pathop Exam 2

Terms in this set (47)

A client has general symptoms of gallstones but is also jaundiced. Cholangiography would most likely reveal that the gallstones are obstructing what?
A. Cystic duct
B. Gallbladder
C. Common bile duct
D. Intrahepatic bile canaliculi
Common bile duct
Hepatitis A is characterized by which of the following?
A. An acute onset with fever
B. A positive carrier state
C. A sexual mode of transmission
D. An incubation period of 180 days
An acute onset with fever
Which of the following is the most common site for intestinal obstruction?
A. Large intestine
B. Transverse colon
C. Small intestine
D. Gallbladder
Small intestine
A client with a history of IV drug abuse was diagnosed with Hepatitis C five years ago. He is now experiencing impaired blood clotting. A decrease in which of the following could be the cause?
A. Folic acid
B. Vitamin K
C. Thiamine
D. Vitamin B12
Vitamin K
A client with a history of IV drug used and advanced liver disease presents with oliguria, jaundice, ascites, and gastrointestinal bleeding. He is diagnosed with hepatorenal syndrome. Which of the following would support this diagnosis?
A. Hepatitis and glomerulonephritis
B. Ascites and nephrotic syndrome
C. Portal hypertension and renal failure caused by circulatory problems
D. Cirrhosis and renal artery stenosis
Portal hypertension and renal failure caused by circulatory problems
Clients with alcoholism and liver cirrhosis often develop edema due to which of the following mechanisms?
A. Decreased production of angiotensin II causing an increase in hydrostatic pressure
B. Decreased albumin and the inability to break down aldosterone
C. Inability to absorb Vitamin K and decreased production of aldosterone
D. Increased production of albumin
Decreased albumin and the inability to break down aldosterone
Hepatic encephalopathy from chronic liver disease is the result of which of the following?
A. Impaired ammonia metabolism
B. Fluid and electrolyte imbalances
C. Hyperbilirubinemia and jaundice
D. Decreased cerebral blood flow
Impaired ammonia metabolism
The cardinal sign of pyloric stenosis caused by ulceration or tumors is which of the following?
A. Constipation
B. Diarrhea
C. Heartburn
D. Projectile vomiting
Projectile vomiting
The nurse cares for a client in the long term care facility with large volume, secretory diarrhea. Which of the following is most likely to be the cause of this client's diarrhea?
A. Pancreatic enzyme deficiency
B. Chronic laxative misuse
C. Irritable bowel syndrome
D. Clostridium difficile infection
Clostridium difficile infection
A client was diagnosed with a bacterial gastrointestinal infection. Which of the following diarrhea types would most likely occur with this condition?
A. Motility
B. Secretory
C. Osmotic
D. Hypotonic
Secretory
Mucus production to form the mucosal barrier in the stomach is stimulated by the release of which substance?
A. Prostaglandins
B. Somatostatin
C. Gastrin
D. Histamine
Prostaglandins
The icteric phase of jaundice is characterized by which of the following clinical manifestations?
A. Resolution of jaundice, liver function returns to normal
B. Fulminant liver failure, hepatorenal syndrome
C. Jaundice, dark urine, enlarged liver
D. Fatigue, malaise, vomiting
Jaundice, dark urine, enlarged liver
A client is diagnosed with peptic ulcer disease. This condition is most likely caused by which of the following?
A. Hereditary hormonal imbalances
B. Decreased vagal activity and vascular engorgement
C. Breaks in the mucosa and presence of corrosive secretions
D. Gastric erosions related to a high ammonia level and bile reflux
Breaks in the mucosa and presence of corrosive secretions
A patient has a GI bleed. In response to this, the nurse would expect the BUN to:
A. increase due to the breakdown of blood in the GI tract
B. increase only if blood supply to the kidneys is decreased --
C. decrease due to the breakdown of blood in the GI tract
D. decrease due to lack of blood flow to the kidneys
increase due to the breakdown of blood in the GI tract
Which of the following describes the secretions of acinar cells of the pancreas?
A. electrolytes
B. mucus
C. bicarbonate
D. enzymes
enzymes
Which of the following causes initial tissue damage in the case of pancreatitis?
A. premature activation of pancreatic enzymes
B. systemic inflammatory response syndrome
C. hydrochloric acid reflux into the pancreatic duct
D. immune system destruction of the pancreas
premature activation of pancreatic enzymes
Cholecystitis is inflammation of the gallbladder usually caused by what?
A. Viral or bacterial infection of the gallbladder
B. Obstruction of the cystic duct by a gallstone
C. Accumulation of fat in the wall of the gallbladder
D. Accumulation of bile in the hepatic duct
Obstruction of the cystic duct by a gallstone
The basic function of bile is to perform which of the following functions?
A. Maintain pH of optimum fat absorption
B. Dissolve fatty acids
C. Convert fats to fatty acids
D. Emulsify fats
Emulsify fats
Which of the following is associated with pancreatitis?
A. Hypokalemia
B. Hypocalcemia
C. Decreased serum amylase
D. Hypercalcemia
Hypocalcemia
The capillaries of the liver are more commonly known as hepatic __.
A. papillae
B. sinusoids
C. ducts
D. canaliculi
sinusoids
Autodigestion of cells and tissues is associated with which of the following conditions?
A. Acute pancreatitis
B. Hepatitis C
C. Gastroesophageal Reflux Disease (GERD)
D. Cholecystitis
Acute pancreatitis
What is the term for excessive fat content in feces?
A. Hyperlipidemia
B. Hematochezia
C. Steatorrhea
D. Cheilosis
Steatorrhea
Protein digestion and absorption occurs in which of the following?
A. Stomach and small intestine
B. Mouth and stomach
C. Stomach and large intestine
D. Small intestine and large intestine
Stomach and small intestine
Which of the following is true about aging and the gastrointestinal system?
A. Intestinal villi become longer
B. Salivary secretion increases
C. Dysphagia is more common
D. Acid content of gastric juice increases
Dysphagia is more common
Absorption of nutrients from the small intestine is primarily achieved by which structure?
A. Lamina propria
B. Villi
C. Mesentery
D. Splenic veins
Villi
Shock can develop with acute pancreatitis for which of the following reasons?
A. Insulin deficiency and hyperglycemia lead to a high output state
B. Vasoactive inflammatory mediators are released into the bloodstream
C. The pancreas is always infected in pancreatitis
D. Pancreatitis usually results in severe bleeding
Vasoactive inflammatory mediators are released into the bloodstream
In the liver, ammonia is what?
A. Detoxified and stored in the liver
B. Converted into urea and excreted by the kidneys
C. Made into amino acids and used in protein synthesis
D. Released into the intestines and converted into urea by bacteria
Converted into urea and excreted by the kidneys
The first symptom of acute appendicitis in an otherwise healthy individual is what?
A. right lower quadrant pain
B. periumbilical pain or discomfort
C. muscle spasm and rebound tenderness
D. nausea and vomiting
periumbilical pain or discomfort
Which information indicates the nurse understands digestion? During the cephalic and gastric phases of digestion, gallbladder contraction is mediated by branches of which nerve/system?
A. Glossopharyngeal nerve
B. Vagus nerve
C. Sympathetic nervous system
D. Somatic nervous system
Vagus nerve
Which of the following is a function of prostaglandins in the gastrointestinal system?
A. Stimulate secretion of mucus
B. Decrease secretion of bicarbonate
C. Increase secretion of acid
D. Diminishes gastric mucosa
Stimulate secretion of mucus
The anatomic feature of the appendix that increases the likelihood of obstructions and inflammation is that it has which of the following properties?
A. it is routinely exposed to fecal matter as it moves through the GI tract
B. part of the ileocecal valve
C. a structure with only one opening
D. a very thin walled structure
a structure with only one opening
A client presents complaining of severe abdominal pain accompanied by vomiting, sweating, nausea, and dizziness. Testing reveals a condition where one part of the intestine telescopes into another. Which of the following intestinal abnormalities is this client suffering from?
A. Ileus
B. Intussusception
C. Torsion
D. Hernia
Intussusception
Which of the following is the primary function of the gallbladder?
A. Release nutrients into the blood
B. Stores bile between meals
C. Produces bile
D. Metabolizes bile salts
Stores bile between meals
Which of the following symptoms would help a nurse distinguish between ulcerative colitis and Crohn's disease?
A. Malabsorption and steatorrhea
B. Pattern of exacerbation and remission
C. Diarrhea
D. Abdominal pain
Malabsorption and steatorrhea
In the liver, indirect bilirubin moves from the plasma in the sinusoids into the hepatocytes where it is converted into which of the following substances?
A. Red blood cells --
B. Conjugated bilirubin?
C. Unconjugated bilirubin--
D. Urobilinogen
...
An outpouching of the mucosa through the muscle layers of the colon wall is termed which of the following?
A. Varicies
B. Diverticula
C. Stricture
D. Gallstone
Diverticula
Complete the following statement. Intrahepatic obstructive jaundice is characterized by elevated levels of serum _______.
A. Conjugated bilirubin
B. Unconjugated and conjugated bilirubin
C. Unconjugated bilirubin only
D. Urobilinogen
Unconjugated and conjugated bilirubin
Gallstones are aggregates of substances found in which of the following?
A. Mucus
B. Chyme
C. Unconjugated bilirubin
D. Bile
Bile
Why does a client with cholelithiasis have pain after eating fatty foods?
A. Fatty foods are hard to digest
B. The liver is manufacturing inadequate amounts of bile
C. Bile flow into the intestine is obstructed
D. There is inadequate closure of the common bile duct
Bile flow into the intestine is obstructed
Complete the following statement. The primary bile acids are synthesized from _______ by hepatocytes lining the bile canaliculi
A. fatty acids
B. testosterone
C. lecithin
D. cholesterol
cholesterol
A client is complaining of pain in the right upper quadrant. Assuming the source of the pain is caused by a stimulus acting on an organ, the pain would be classified as which of the following?
A. Parietal
B. Visceral
C. Retroperitoneal
D. Somatic
Visceral
The nurse cares for a client with a hiatal hernia. In review of the client's chart, the nurse correctly identifies that which of the following comorbidities is associated with the client's condition?
A. Diverticulosis
B. Pancreatitis
C. Gastroesophageal Reflux Disease
D. Lower gastrointestinal bleeding
Gastroesophageal Reflux Disease
In cirrhosis, increased blood ammonia levels result from impaired liver function related to which of the following?
A. Ammonium production
B. Prothrombin production
C. Protein breakdown
D. Bile production
Protein breakdown
Which sphincter prevents reflux of digested material from the colon into the small intestine?
A. Haustral segmentation
B. Pyloric sphincter
C. Ileocecal valve
D. Lower esophageal sphincter
Ileocecal valve
A sedated, intubated trauma patient develops an ulcer after being hypotensive for two weeks in the ICU. This type of ulcer is called what?
A. Stress ulcer
B. H. pylori ulcer
C. Duodenal ulcer
D. Gastric ulcer
Stress ulcer
One of the first lines of defense against autodigestion of the stomach is which of the following?
A. Secretion of gastrin
B. Production of gastric mucus
C. Presence of serosal membrane
D. Secretion of pepsinogen
Production of gastric mucus
A client has adult onset gastric mucosal atrophy in which parietal cells are destroyed. Which of the following is a realistic condition that this client will likely experience?
A. Acid reflux gastritis
B. Hiatal hernia--
C. Pernicious anemia
D. Constipation
...
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