Chapter 18: Gastrointestinal and Accessory Organ Problems Nursing School Test Banks

Chapter 18: Gastrointestinal and Accessory Organ Problems
Test Bank

MULTIPLE CHOICE

1. The lower esophageal sphincter muscle controls entry of food into the
a. esophagus.
b. stomach.
c. small intestine.
d. rectum.
ANS: C
The lower esophageal sphincter muscle controls entry of food into the small intestine.

DIF: Cognitive Level: Knowledge REF: 355-356 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

2. The term used to describe difficulty in swallowing is
a. pyrosis.
b. polydipsia.
c. dysphagia.
d. dyspepsia.
ANS: C
Dysphagia means difficulty swallowing.

DIF: Cognitive Level: Knowledge REF: 354-355 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

3. Many people who have gastroesophageal reflux are
a. underweight.
b. obese.
c. male.
d. children.
ANS: B
Gastrointestinal reflux is more common in people who are obese or pregnant or who have pernicious vomiting or nasogastric tubes.

DIF: Cognitive Level: Knowledge REF: 355-356 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

4. A resident who has Parkinsons disease and resides in a long-term care facility has recurring pneumonia and coughs while eating. This may be evidence of
a. dysphasia.
b. dysphagia.
c. achalasia.
d. dyspnea.
ANS: B
Dysphagia can cause persons to aspirate food particles, sometimes without evidence of coughing or choking. Aspiration of food contents into the lung causes pneumonia and other serious problems.

DIF: Cognitive Level: Application REF: 354-355
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

5. Small outpouchings in the lower gastrointestinal tract are called
a. hernias.
b. lesions.
c. diverticula.
d. epiploic appendages.
ANS: C
The small outpouchings that can develop in the lower intestine are called diverticula.

DIF: Cognitive Level: Knowledge REF: 366 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

6. An eroded mucosal area in the central portion of the gastrointestinal tract describes a
a. hiatal hernia.
b. diverticulum.
c. peptic ulcer.
d. Crohns lesion.
ANS: C
A peptic ulcer is an eroded mucosal area in the central portion of the gastrointestinal tract.

DIF: Cognitive Level: Knowledge REF: 357-358 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

7. Most ulcers occur in the
a. esophagus.
b. stomach.
c. duodenal bulb.
d. ileum.
ANS: C
Most ulcers occur in the duodenal bulb.

DIF: Cognitive Level: Knowledge REF: 357 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

8. A food that should be omitted from the diet of a patient with peptic ulcer disease is
a. black pepper.
b. apple juice.
c. milk.
d. popcorn.
ANS: A
Current diet therapy is based on individual response to foods, but a few foods have been shown to affect acid secretion, such as black pepper, hot chili peppers, and chili powder. Other food items that stimulate acid secretion are coffee, chocolate, and alcohol.

DIF: Cognitive Level: Knowledge REF: 360-361
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

9. Which of the following describes general nutrition guidelines for a patient with a peptic ulcer?
a. General, well-balanced diet as tolerated
b. High-protein, low-fiber diet with no seasonings
c. High-protein diet and regularly scheduled meals
d. Low-fiber diet with no seasonings and no milk or cream
ANS: A
A patient with a peptic ulcer should receive a general, well-balanced diet as tolerated. Current diet therapy is based on a liberal diet approach guided by individual responses to food.

DIF: Cognitive Level: Application REF: 359-361
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

10. A food that appears to reduce symptoms of irritable bowel syndrome is
a. white bread with butter
b. peanut butter pretzels
c. sesame seed crackers
d. whole grain wheat toast
ANS: D
Whole grain wheat toast is a high-fiber food that may help reduce symptoms of irritable bowel syndrome. Dietary fiber can help regulate bowel function.

DIF: Cognitive Level: Application REF: 366-367 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Reduction of Risk Potential

11. To reduce the incidence of constipation, an appropriate dietary intervention would be to
a. encourage daily use of over-the-counter laxatives.
b. include 2 servings of ice cream twice a week between meals.
c. include servings of natural laxatives such as dried apricots and prunes.
d. decrease fluid intake since this may interfere with bowel regularity.
ANS: C
Natural laxative type of fruits such as dried apricots and prunes can help reduce the incidence of constipation by helping increasing the fiber content of the diet.

DIF: Cognitive Level: Application REF: 367
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Reduction of Risk Potential

12. A cause of diarrhea is
a. drinking too much liquid with a meal.
b. lactose intolerance.
c. excessive intake of protein.
d. swallowing air while eating.
ANS: B
Lactose intolerance occurs in people who lack the digestive enzyme lactase and is a cause of diarrhea. Lactase deficiency causes malabsorption, which results in diarrhea.

DIF: Cognitive Level: Knowledge REF: 365
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

13. A patient with a history of diverticulosis who complains of severe left lower quadrant pain with diarrhea, nausea, and vomiting should be evaluated for
a. diverticulitis.
b. obstruction.
c. diarrhea.
d. celiac disease.
ANS: A
Diverticulitis develops when the small pouches or pockets in the muscular mucosal lining of the small intestine (diverticula) become infected. The infected area is painful and can present with diarrhea, nausea, and vomiting.

DIF: Cognitive Level: Application REF: 366
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

14. Treatment for diverticulosis includes a diet that is
a. bland.
b. low in fiber.
c. high in fiber.
d. full liquid.
ANS: C
The diet for diverticulosis should be high in fiber, void of foods that may cause gas or intolerance (such as lactose), and low in fat.

DIF: Cognitive Level: Knowledge REF: 366
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

15. The characteristic symptoms of celiac disease are
a. vomiting and diarrhea.
b. diarrhea and steatorrhea.
c. abdominal pain and constipation.
d. chronic, bloody diarrhea.
ANS: B
Celiac disease is characterized by diarrhea and steatorrhea. Hypersensitivity to the protein gluten in certain grains causes mucosal surface damage to the intestine. The villi are malformed, which reduces the absorbing surface by as much as 95%.

DIF: Cognitive Level: Knowledge REF: 368-369 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

16. Hepatitis is usually the result of
a. a viral infection or alcohol or drug abuse.
b. a bacterial or viral infection.
c. excessive fat and protein intake.
d. chronic malnutrition.
ANS: A
Hepatitis is an inflammatory condition caused by viruses, alcohol, drugs, or toxins.

DIF: Cognitive Level: Knowledge REF: 371 TOP: Nursing Process: Diagnosis
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

17. Viral hepatitis can be contracted through
a. ingestion of contaminated food or water.
b. airborne viruses from coughing and sneezing.
c. physical contact with an infected person.
d. alcohol abuse.
ANS: A
Viral hepatitis can be contracted through contaminated food or water.

DIF: Cognitive Level: Knowledge REF: 371 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

18. The treatment of hepatitis includes
a. rest and optimal nutrition.
b. antibiotics and optimal nutrition.
c. fluid restriction and rest.
d. diuretics and optimal nutrition.
ANS: A
Hepatitis is treated by rest and optimal nutrition with a high-carbohydrate, moderate-fat, high-energy, and high-protein diet.

DIF: Cognitive Level: Knowledge REF: 371-372 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

19. Nutrition therapy for hepatitis includes a diet that is _____ in protein, _____ in carbohydrate, and _____ in fat.
a. high, high, high
b. low, high, low
c. low, low, high
d. high, high, moderate
ANS: D
Optimal nutrition should consist of a diet that is high in protein, high in carbohydrate, and moderate in fat. The amount of carbohydrate depends on individual needs and condition. A maximum of 30% of total calories should come from fat; as the disease progresses, more energy is supplied from this nutrient. Protein is essential for building new cells and tissues of the liver.

DIF: Cognitive Level: Application REF: 371 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

20. A major difficulty in treating hepatitis is that
a. the person must stay in isolation for a long time.
b. the person can have only a clear liquid diet.
c. the person usually has a poor appetite.
d. typically only one kind of antibiotic will cure it.
ANS: C
Symptoms of hepatitis include anorexia, jaundice, and underlying malnutrition. The person usually has a poor appetite associated with these symptoms.

DIF: Cognitive Level: Application REF: 371 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

21. Pathologic changes in the liver caused by cirrhosis include
a. fatty infiltration.
b. spongy tissue formation.
c. gallstone formation.
d. edema and swelling.
ANS: A
Pathologic changes in the liver caused by cirrhosis include fatty infiltration caused by a state of liver disease where the liver is damaged beyond repair.

DIF: Cognitive Level: Knowledge REF: 372 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

22. The major nutrition problem related to development of ascites is
a. protein deficiency.
b. excessive fat intake.
c. deficiency of digestive enzymes.
d. excessive sodium intake.
ANS: A
Low plasma protein levels contribute to ascites, or abdominal fluid accumulation.

DIF: Cognitive Level: Knowledge REF: 372 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

23. Nutrition therapy for the patient with cirrhosis includes a diet that is
a. low in sodium, high in protein, and low in carbohydrates.
b. soft textured and high in energy.
c. high in protein, high in carbohydrates, and high in fat.
d. adequate in calories, low in sodium, and soft textured.
ANS: D
Nutrition therapy for the patient with cirrhosis is one that provides a balanced diet with energy intake equal to basal plus 20% low-sodium, soft-textured diet. Sodium is often restricted to 500 to 1000 mg/day with cirrhosis to help reduce fluid retention (ascites). Soft texture is necessary in the presence of esophageal varices to help prevent the danger of vessel rupture and hemorrhage.

DIF: Cognitive Level: Comprehension REF: 372-373 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

24. Of the following, a food item that may be restricted in the patient with cirrhosis is
a. apple slices.
b. orange sherbet.
c. hotdog.
d. peas.
ANS: C
Hotdogs are high in sodium. Sodium often is restricted to 500 to 1000 mg/day in a patient with cirrhosis to help reduce fluid retention (ascites).

DIF: Cognitive Level: Application REF: 372-373
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

25. The primary objective of treatment of hepatic encephalopathy is to
a. encourage the patient to eat.
b. feed the patient parenterally to give the liver a rest.
c. remove sources of excess ammonia.
d. encourage the patient to exercise and maintain mental functions.
ANS: C
The primary objective of treatment for hepatic encephalopathy is to remove the excess ammonia. One of the main functions of the liver is to remove ammonia and therefore nitrogen from the blood by converting it to urea for urinary excretion. When cirrhosis continues and fibrous scar tissue replaces more and more functional liver tissue, the blood can no longer circulate normally through the liver. Therefore other vessels develop around the scar tissue, bypass the liver, and proceed to the brain, producing ammonia intoxication.

DIF: Cognitive Level: Knowledge REF: 372 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

26. Bile is produced by the
a. gallbladder.
b. pancreas.
c. liver.
d. intestine.
ANS: C
Bile is produced by the liver. The basic function of the gallbladder is to concentrate and store bile, then release the concentrated bile into the small intestine when fat is present.

DIF: Cognitive Level: Knowledge REF: 370 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

27. The most important function of the gallbladder is to
a. produce bile.
b. synthesize cholesterol.
c. release lipase enzymes.
d. concentrate and store bile.
ANS: D
The most important function of the gallbladder is to concentrate and store bile, then release the concentrated bile into the small intestine when fat is present.

DIF: Cognitive Level: Knowledge REF: 373 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

28. The presence of gallstones in the gallbladder is called
a. cholecystitis.
b. cholelithiasis.
c. cholecystectomy.
d. cholecystokinin.
ANS: B
Cholelithiasis refers to the presence of gallstones in the gallbladder. When continued infection alters the solubility of the bile ingredients, cholesterol separates out and forms gallstones.

DIF: Cognitive Level: Knowledge REF: 373 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

29. A clinical symptom of gallbladder inflammation or gallstones is
a. pain and distention after eating.
b. jaundice.
c. anorexia.
d. weakness and apathy.
ANS: A
A clinical symptom of gallbladder inflammation is pain and distention after eating. When infection, stones, or both are present, the normal contraction of the gallbladder, triggered by fat entering the intestine, causes pain.

DIF: Cognitive Level: Knowledge REF: 373 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

30. Nutrition therapy for gallbladder disorders includes
a. reducing cholesterol intake.
b. eliminating gas-forming foods.
c. lowering fat intake.
d. increasing caloric intake.
ANS: C
A low-fat intake may help avoid pain and discomfort because the presence of fat entering the small intestine stimulates the contraction of the gallbladder.

DIF: Cognitive Level: Application REF: 373-374 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

31. Of the following, a food choice that would help provide adequate protein for recovery from hepatitis is
a. grilled chicken.
b. apple turnover.
c. fruit salad.
d. English muffin.
ANS: A
Grilled chicken provides a good source of dietary protein which is essential for tissue repair, which is an important part of recovery from hepatitis.

DIF: Cognitive Level: Application REF: 371
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

32. Ascites, a localized edema of the peritoneal cavity, is caused by
a. low plasma protein levels.
b. inadequate intake of carbohydrate.
c. too much fat in the diet.
d. excessive fluid intake.
ANS: A
In patients with liver failure, low plasma protein levels may lead to ascites, or abdominal fluid accumulation.

DIF: Cognitive Level: Knowledge REF: 372 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

33. Crohns disease is a(n)
a. disorder of protein metabolism.
b. chronic enzyme deficiency.
c. excess in the production of insulin.
d. inflammatory bowel disease.
ANS: D
Crohns disease and ulcerative colitis are inflammatory bowel diseases.

DIF: Cognitive Level: Knowledge REF: 364-365 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

34. An elemental diet provides
a. all necessary vitamins and minerals.
b. all nutrients needed in a bland, low-residue form.
c. all nutrients needed in their simplest absorbable form.
d. a diet high in mineral elements.
ANS: C
An elemental diet formula provides nutrients needed in their simplest absorbable form.

DIF: Cognitive Level: Knowledge REF: 365 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

35. Patients with cystic fibrosis need to take
a. enzymes and supplements.
b. large doses of vitamins and minerals.
c. antidiarrheal agents.
d. hormones and enzymes.
ANS: A
Enzymes and supplements are necessary for treatment of cystic fibrosis. Pancreatic enzymes are ingested orally along with vitamin supplements, especially fat-soluble vitamins.

DIF: Cognitive Level: Knowledge REF: 362-363 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

36. A food that is considered a common food allergen is
a. peanut butter.
b. rice crackers.
c. lemonade.
d. chocolate.
ANS: A
Milk, eggs, peanuts, tree nuts, fish, shellfish, wheat, soy, and sesame are the most common food allergens.

DIF: Cognitive Level: Application REF: 368 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

37. A food that individuals with celiac disease might need to avoid is
a. malted milk.
b. buttermilk.
c. rice.
d. prune juice.
ANS: A
Malted milk and all other products that contain dietary sources of gluten including wheat, barley and rye products, and any other products that may be processed in facilities that process wheat products can result in cross-contamination.

DIF: Cognitive Level: Application REF: 370
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Reduction of Risk Potential

38. A food that individuals with celiac disease would need to eliminate is
a. cream of wheat.
b. homemade applesauce.
c. vanilla yogurt.
d. buttermilk.
ANS: A
Individuals with celiac disease eliminate any food prepared with wheat, rye, oat, or barley products.

DIF: Cognitive Level: Application REF: 368-370
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Reduction of Risk Potential

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