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A series of multiple-choice practice questions covering various aspects of gastrointestinal disorders. It includes questions on constipation, the enteric nervous system, diarrhea, gastroesophageal reflux disease (gerd), celiac disease, diverticulitis, irritable bowel syndrome, and pancreatitis. Each question features a clinical scenario and multiple answer choices, with the correct answer highlighted. This resource can be valuable for students studying gastrointestinal health and related conditions.
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"A patient is seen in the office and is complaining of constipation. The patient lists all of the following medications. Which drug could be responsible for the constipation? A. Multivitamin B. Magnesium hydroxide C. PeptoBismol
"A gastroenterologist is teaching a group of nurse practitioner students about the enteric nervous system in preparation for a consultation on a patient who has suffered a spinal cord injury. Which of the physician's teaching points is most accurate? A. "Parasympathetic stimulation blocks the release of the excitatory neuromediators and inhibits GI motility." B. "Sympathetic innervation of much of the GI tract occurs by way of the vagus nerve."* C. "The enteric nervous system is made up of the myenteric and submucosal plexuses; these are located in the wall of the GI tract." D. "The myenteric plexus is responsible for controlling the function of each segment of the
myenteric and submucosal plexuses; these are located in the wall of the GI tract."" "A patient with complaints of diarrhea is seen. Which of the following should be included on the differential diagnosis list for a patient with diarrhea? A. Gastroenteritis B. Inflammatory bowel disease C. Lactase deficiency
"Mr. J. K., 38 years old, is 5 feet 8 inches tall and weighs 189 pounds. He reports that he has had intermittent heartburn for several months for which he takes Tums with temporary relief. He has been waking during the night with a burning sensation in his chest. Which additional information would lead you to believe that gastroesophageal reflux disease (GERD) is the cause of his pain? A. The pain seems better when he smokes to relieve his nerves. B. Coffee and fried foods do not bother him. C. He awakens at night coughing with a bad taste in his mouth.
mouth." "Which of the following is associated with celiac disease (AKA celiac sprue or gluten- sensitivity enteropathy)? A. Malabsorption B. Constipation C. Rectal bleeding
"A 45yearold patient presents with a chief complaint of generalized abdominal pain. Her physical exam is remarkable for left lower quadrant (LLQ) tenderness. Which of the following should be considered in the differential diagnosis at this time? A. Endometriosis B. Colon cancer C. Diverticulitis
"Which of the following dietary information should be given to a patient with gastroesophageal reflux disease (GERD)? A. Eliminate coffee. B. Drink peppermint tea to relieve stomach distress. C. Recline and rest after meals.
"The patient with gastroesophageal reflux disease (GERD) should be instructed to eliminate which of these activities? A. Swimming B. Weight lifting C. Golfing
"A patient is diagnosed with Giardia (protozoan infection) after a backpacking trip in the mountains. Which of the following would be the appropriate treatment? A. Vancomycin B. Penicillin C. Metronidazole
"A 22yearold is seen complaining of vague belly pain. This type of pain is seen at what point in appendicitis? A. Very early B. 3 to 4 hours after perforation
C. Late in inflammation
"The clinician suspects the patient has a peptic ulcer. Which of the following items on the history would lead the clinician to this conclusion? A. Use of NSAIDs (and infection with H. pylori are two most important) B. Cigarette smoker C. Alcohol (ETOH) consumption
"Which of the following patients on a hospital medical unit is most clearly demonstrating the signs and symptoms of liver failure? A. A 55-year-old man with ascites, fever, and recent onset of atrial fibrillation B. A 68-year-old female patient with sudden onset of confusion, a history of alcohol abuse, and low levels of serum AST and ALT C> A 50-year-old woman with blood pressure of 189/103, jaundice, and multiple thromboses
spider angiomas" "A 21yearold student presents with a chief complaint of fatigue, headache, anorexia, and a runny nose, all of which began about 2 weeks ago. She started taking vitamins and overthe- counter (OTC) cold preparations, but feels worse. The smell of food makes her nauseated. Her boyfriend had mononucleosis about a month ago, and she wonders if she might have it also. An examination reveals cervical adenopathy and enlarged liver and spleen. Which of the following laboratory tests would be most helpful in the differential diagnosis at this point? A. Stool culture
B. Tylenol with codeine C. Daily laxatives
"Chronic anxiety and stress contribute to ulcers. Which of the following effects of the sympathetic nervous system is most responsible for this effect? A. Inhibition of the actions of Brunner glands B. Overstimulation of the oxyntic glands C. Suppression of cholecystokinin
Brunner glands" "Which of the following patients is most clearly displaying the signs and symptoms of IBD? A. A 32-year-old mother who complains of intermittent abdominal pain that persists even after defecation. B. A 51-year-old male who states that his stomach pain is in his lower abdomen, "comes and goes," and "feels more like a cramp than a dull ache." C. A 44-year-old man who is under great financial stress and who states that his lower abdominal pain is much worse at night than during the day. D. A 24-year-old man who has a stressful job but whose diarrhea and cramping do not worsen
stomach pain is in his lower abdomen, "comes and goes," and "feels more like a cramp than a dull ache."" "A male patient 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 is most likely to exacerbate the patient's signs and symptoms? A. Tortilla chips and guacamole
B. Roast beef and a baked potato C. Tossed salad with an oil and vinegar dressing
"A 24-year-old woman undergoing a premarital 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 of the following treatments is most likely to be effective for her? A. Lamivudine B. Peginterferon and ribavirin C. Interferon-alfa-2b
immunosuppressant drugs" "Which of the following statements best captures an aspect of the process of fat digestion and absorption? A. Ingested triglycerides are broken down into absorbable form by gastric lipase. B. Simple forms of fats are absorbed in the upper jejunum. C. Long-chain fatty acids are absorbed more readily than medium-chain triglycerides. D. Stool is not excreted until all fat is absorbed.
fats are absorbed in the upper jejunum." "A 40-year-old female has been categorized as being obese, with a BMI of 33.2. Which of the following health problems is the patient at a significantly increased risk for compared with individuals with a BMI below 25? A. Cardiac arrhythmias
"A 48-year-old woman has been diagnosed with extrahepatic cholestasis following a thorough history, ultrasound, and blood work. Which of the following symptoms most likely caused her to seek medical treatment, and what consequences of her health problem would the medical team anticipate? A. Pruritus with consequences of deficient levels of fat-soluble vitamins B. Skin xanthomas (focal accumulations of cholesterol) with consequences of increased risk of bleeding due to deficient clotting factors C. Anorexia with consequences of impaired drug metabolism and blood filtration
"A 51-year-old male professional is in the habit of consuming six to eight rum and cokes each evening after work. He assures the nurse practitioner, who is performing his regular physical exam, that his drinking is under control and does not have negative implications for his work or family life. How could the nurse best respond to the patient's statement? A. "You are more than likely inflicting damage on your liver, but this damage would cease as soon as you quit drinking. B. "That may be the case, but you are still creating a high risk of hepatitis A or B or liver cancer." C. "In spite of that, the amount of alcohol you are drinking is likely to result first in cirrhosis and, if you continue, in hepatitis or fatty liver changes." D. "When your body has to regularly break down that much alcohol, your blood and the
blood and the functional cells in your liver accumulate a lot of potentially damaging toxic byproducts."" "A nurse practitioner is providing care for a male patient with a long-standing hiatal hernia. Which of the following statements most accurately captures an aspect of the pathophysiology of hiatal hernias? A. Paraesophageal hiatal hernias are common and are normally not treated if the patient is asymptomatic. (this is true for small sliding hiatal hernias)
B. The root causes of hiatal hernias are normally treatable with medication. C. If esophageal acid clearance is impaired, esophagitis can result. D. An incompetent pyloric sphincter and high fat diet are commonly implicated in the
impaired, esophagitis can result." "As a result of oral ingestion of the microorganisms, an individual has contracted H. pylori. Which of the following health problems is the individual now at increased risk for? A. Inflammatory bowel disease (IBD) B. Gastric adenocarcinoma C. Gastric atrophy D. Esophagitis E. Diverticular disease
"A 43-year-old male who is 5 feet 10 inches tall and weighs 216 pounds has been informed by his nurse practitioner that his body mass index (BMI) is 31. Which of the following clinical conclusions based on these data would his nurse be most justified in rejecting? A. Further investigation of his nutritional status is needed to supplement the BMI value. B. The patient faces an increased risk of type 2 diabetes and hyperlipidemia. C. He is classified as being obese, likely as the result of the interplay of genetic and lifestyle factors. D. The patient is borderline obese but is not yet at the point of significantly increased risks to
significantly increased risks to health."
"A female neonate has been in respire distress since delivery and is unresponsive to oxygen therapy. Endoscopy has confirmed a diagnosis of esophageal atresia and tracheoesophageal fistula (EA/TEF). Which of the following explanations should the care team provide to the infant's parents? A. "We will have to perform surgery to correct the hole in her throat to make sure that she is able to swallow and breathe normally." B. "This problem will require respiratory therapy and supplementary feeding, but it will likely resolve itself over time." C. "The biggest risk that your daughter will face until this is fixed is the danger of malnutrition and dehydration." D. "The priority in our immediate treatment prior to her surgery will be pain management, as the
surgery to correct the hole in her throat to make sure that she is able to swallow and breathe normally."" "The mother of a 19-week-old infant has brought her baby to a nurse practitioner for assessment because of the baby's persistent weight loss and diarrhea. An intestinal biopsy has confirmed a diagnosis of celiac disease, and the child's mother is anxious to know what caused the disease. Which of the following aspects of the etiology of celiac disease would underlie the explanation that the nurse practitioner provides? A. Inability to process or absorb the fat content of breast milk results in malnutrition and deficiency of fat-soluble vitamins. B. Neurogenic or muscular inhibition of peristalsis results in inappropriate motility of ingested food in the lower small intestine and the colon. C. An inappropriate T-cell mediated response results in increased levels of antibodies and an inflammatory response. D. Bacterial or chemical invasion of the peritoneum leads to decreased nutrient absorption and
increased levels of antibodies and an inflammatory response."
"While on tour, a 32-year-old male musician has presented to the emergency department of a hospital after a concert complaining of severe and sudden abdominal pain He admits to a history of copious alcohol use in recent years, and his vital signs include temperature 46.8 °C (101.8 °F), blood pressure 89/48 mm Hg, and heart rate 116 beats/minute. Blood work indicates that his serum levels of C-reactive protein, amylase, and lipase are all elevated. Which of the following diagnoses would the care team suspect first? A. Hepatitis C B. Cholecystitis C. Liver cirrhosis
"The patient who has been consuming a very low-calorie diet (VLCD) of 450 kcal/day should be assessed for which of the following high-risk complications? Select all that apply. A. Irregular heart rhythms B. Bone/joint inflammation C. Abdominal pain related to gallstones D. Flank pain and spasm associated with kidney sludge
"During a humanitarian trip to an underdeveloped country, a medical student is assessing a 6- year-old male who has a protuberant abdomen, dry hair, and wrinkled skin. The child's heart rate is 59 beats/minute, blood pressure 89/50, and temperature 95.2°F (35.1°C). What is the most likely etiology of the child's health problems? A. A diet lacking in fat-soluble vitamins B. Fluid and electrolyte imbalances secondary to low -carbohydrate intake C. A diet that is low or high in carbohydrates but low in fat
protein and calories"
C. Impaired control of the gastric emptying rate
stomach or regurgitation of stomach contents into the esophagus" "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 processes in the man's small intestine are most likely accompanying his current status? A. Inflammation is accompanied by an increase in peristaltic movements of his small intestine. B. Intestinal stasis brought on by infection is preventing his small intestine from sufficiently slowing the rate of motility. C. Segmentation waves have become more frequent as a result of his infection.
of his small intestine." “A 35 year-old female patient is seen in the clinic complaining of abdominal pain. Which of the following should be included in the history and physical exam? A. Digital rectal exam B. Pelvic exam C. Sexual history
"Cheryl has celiac disease. Which diet should you place her on? A. High protein diet B. Gluten free diet C. Low residue diet
"A 29yearold Englishman is seen in the office with complaints of pain in his chest and belly for 2 weeks. He gets temporary relief from Alka Seltzer. The burning pain wakes him at night and radiates up into his chest. Which factor favors a diagnosis of gastric ulcer? A. His gender B. His age
"Which of the following is most effective in diagnosing appendicitis? A. History and physical B. Sedimentation rate Kidneys, ureter, bladder (KUB) radiograph C. Complete blood cell (CBC) count with differential (note: there is not always and elevated WBC
"A 46 year-old female is seen in the clinic with abdominal pain. Which of the following tests is essential for this patient? A. Complete blood cell (CBC) count with differential B. Urine hCG C. Barium enema
"A 28yearold patient is seen with complaints of diarrhea. Which of the following questions would help the clinician establish the diagnosis of irritable bowel syndrome? A. Feels relief after a bowel movement B. Sometimes is constipated C. Does not defecate in the middle of the night
"A patient is seen in the office with complaints of six to seven liquid bowel movements per day. Which of the following assessment findings would lead the clinician to a diagnosis of inflammatory bowel disease? A. Intermittent constipation with periods of diarrhea B. Awakens at night with diarrhea C. History of international travel
"A 43-year-old male patient has presented to the emergency department with vomiting that he claims is of sudden onset. The patient also states that the emesis has often contained frank blood in the hours prior to admission. Which of the following potential contributing factors would the care team first suspect? A. Effects of Helicobacter pylori B. Staphylococcal enterotoxins C. Alcohol consumption
"A 20-year-old male college student has recently finished a Thanksgiving dinner of heroic proportions while home for the holiday weekend. Which of the following phenomena would most likely have produced his sensation of satiety? A. Cholecystokinin and glucagon-like peptide-1 suppress the hunger impulse. B. The breakdown of products of lipids such as ketoacids produces a decrease in appetite. C. Increased levels of leptin stimulate a decrease in appetite by way of the vagus nerve. D. Stretch receptors in the stomach and small intestine signal the feeding center in the medulla.
impulse."
"A teenage female has been admitted for complications resulting from bulimia nervosa. She has abused laxatives for many years and has been self-inducing vomiting since the age of 9. The nurse's admission assessment should pay close attention to which of the following complications that can arise from this disorder? Select all that apply. Assess for A. Dry, cracked lips and poor skin turgor. B. Missing tooth enamel and increased number of dental cavities. C. Painful swallowing and stomach cramping related to reflux and esophagitis. D. Fruity breath and labored, deep, gasping respirations.
"A 29-year-old female has been admitted to the emergency department following a suicide attempt by overdose of acetaminophen. What changes in the client's liver and diagnostic results would the care team most likely anticipate? A. Hepatocellular necrosis evidenced by increased ALT and AST levels B. Allergic inflammation accompanied by an increase in serum IgE and basophils C. Cholestatic reaction with increased bilirubin count
Hepatocellular necrosis evidenced by increased ALT and AST levels"