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NURS 611 EXAM 4 PATHO ACTUAL EXAM AND REAL EXAM
TEST BANK 2023-2024 COMPLETE 300 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES|ALREADY GRADED A+ (MARYVILLE
UNIVERSITY)
1. Exposure to which substance protectsthe mucosal barrier of the stomach?
a. Prostaglandins
b. Helicobacter pylori
c. Aspirin
d. Regurgitated bile
Prostaglandins. Prostaglandins and enterogastrones,such as gastric inhibitory
peptide, somatostatin, and secretin, inhibit acid secretion.
2. Glucose transport enhancesthe absorption of which electrolyte?
a. Sodium
b. Potassium
c. Phosphate
d. Chloride
Sodium. Sodium passes through the tight junctions and is actively transported
across cell membranes. Sodium and glucose share a common active transport
carrier (sodium-glucose ligand transporter 1 [SGLT1]).
3. What isthe cause of gastroesophageal reflux disease?
a. Excessive production of hydrochloric acid
b. Zone of low pressure of the lower esophageal sphincter
c. Presence of Helicobacter pylori in the esophagus
d. Reverse muscular peristalsis of the esophagus
Zone of low pressure of the lower esophageal sphincter. Normally, the resting
tone of the lower esophageal sphincter maintains a zone of high pressure that
prevents gastroesophageal reflux. In individuals who develop reflux esophagitis,
this pressure tendsto be lower than normal from either transient relaxation or a
weakness of the sphincter.
4. By what mechanism doesintussusception cause an intestinal obstruction?
a. Telescoping of part of the intestine into anothersection of intestine,
usually causing strangulation of the blood supply
b. Twisting the intestine on its mesenteric pedicle, causing occlusion of the
blood supply
c. Loss of peristaltic motor activity in the intestine, causing an adynamic ileus
d. Forming fibrin and scartissue that attach to the intestinal omentum,
causing obstruction
A. Intussusception is the telescoping of part of the intestine into another section
of intestine, usually causing strangulation of the blood supply.
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5. What isthe most immediate result of a small intestinal obstruction?
a. Vomiting
b. Electrolyte imbalances
c. Dehydration
d. Distention
Distention begins almost immediately, as gases and fluids accumulate proximal
to the obstruction. Within 24 hours, up to 8 L of fluid and electrolytes
enters the lumen in the form of saliva, gastric juice, bile, pancreatic juice, and
intestinal secretions. Copious vomiting or sequestration of fluids in the
intestinal lumen preventstheir reabsorption and producessevere fluid and
electrolyte disturbances.
6. An intestinal obstruction at the pylorus or high in the small intestine causes metabolic
alkalosis by causing which outcome?
a. Gain of bicarbonate from pancreatic secretionsthat cannot be absorbed
b. Excessive loss of hydrogen ions normally absorbed from gastric juices
c. Excessive loss of potassium, promoting atony of the intestinal wall
d. Loss of bile acid secretions that cannot be absorbed
Excessive loss of hydrogen ions. If the obstruction is at the pylorus or high in the
small intestine, then metabolic alkalosisinitially develops as a result of
excessive loss of hydrogen ionsthat normally would be reabsorbed from the
gastric juices.
7. What are the cardinalsymptoms ofsmall intestinal obstruction?
a. Constant, dull pain in the lower abdomen relieved by defecation
b. Acute, intermittent pain 30 minutesto 2 hours after eating
c. Colicky pain caused by distention, followed by vomiting
d. Excruciating pain in the hypogastric area caused by ischemia
Colicky pain caused by distention followed by vomiting.
8. What isthe primary cause of peptic ulcers?
a. Hypersecretion of gastric acid
b. Helicobacter pylori
c. Hyposecretion of pepsin
d. Escherichia coli
Helicobacter pylori.
9. A peptic ulcer may occur in all of the following areas except the:
a. Stomach
b. Jejunum
c. Duodenum
d. Esophagus
Jejunum
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10. After a partial gastrectomy or pyloroplasty, clinical manifestationsthat include increased
pulse, hypotension, weakness, pallor, sweating, and dizziness are the results of which
mechanism?
a. Anaphylactic reaction in which chemical mediators, such as histamine,
prostaglandins, and leukotrienes, relax vascularsmooth muscles, causing
shock.
b. Postoperative hemorrhage during which a large volume of blood is lost,
causing hypotension with compensatory tachycardia.
c. Concentrated bolusthat movesfrom the stomach into the small intestine,
causing hyperglycemia and resulting in polyuria and eventually
hypovolemic shock.
d. Rapid gastric emptying and the creation of a high osmotic gradient in the
small intestine, causing a sudden shift of fluid from the blood vessels to
the intestinal lumen.
D. Dumping syndrome occurs with varying severity in 5% to 10% of individuals
who have undergone partial gastrectomy or pyloroplasty. Rapid gastric
emptying and the creation of a high osmotic gradient in the small intestine cause a
sudden shift of fluid from the vascular compartment to the intestinal
lumen. Plasma volume decreases, causing vasomotor responses, such as
increased pulse rate, hypotension, weakness, pallor, sweating, and dizziness.
Rapid distention of the intestine produces a feeling of epigastric fullness,
cramping, nausea, vomiting, and diarrhea
11. Which statement is consistent with dumping syndrome?
a. Dumping syndrome usually responds well to dietary management.
b. It occurs 1 to 2 hours after eating.
c. Constipation is often a result of the dumping syndrome.
d. It can result in alkaline reflux gastritis.
Usually responds well to dietary management.
12. Which statement isfalse regarding the sources of increased ammonia that contribute to
hepatic encephalopathy?
a. End products of intestinal protein digestion are sources of increased
ammonia.
b. Digested blood leaking from ruptured varicesis a source of increased
ammonia.
c. Accumulation ofshort-chain fatty acidsthat is attached to ammonia is a
source of increased ammonia.
d. Ammonia-forming bacteria in the colon are sources of increased
ammonia.
The accumulation of short-chain fatty acids, serotonin, tryptophan, and false
neurotransmitters probably contributesto neural derangement and is not
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associated with ammonia levels. The other options provide accurate
information regarding how the sources of ammonia contribute to hepatic
encephalopathy.
13. Which statement isfalse regarding the pathophysiologic process of acute pancreatitis?
a. Bile duct or pancreatic duct obstruction blocksthe outflow of pancreatic
digestive enzymes.
b. Acute pancreatitis can also result from direct cellular injury from drugs or
viral infection.
c. Acute pancreatitisis an autoimmune disease in which immunoglobulin G
(IgG) coats the pancreatic acinar cells; consequently, the pancreatic
enzymes destroy the cells.
d. Acute pancreatitisis usually mild and spontaneously resolves.
The false answer is C. The backup of pancreatic secretions and the activation and
release of enzymes (activated trypsin activates chymotrypsin, lipase, and
elastase) within the pancreatic acinar cells cause acute pancreatitis, an
obstructive disease. The activated enzymes cause autodigestion
(e.g., proteolysis, lipolysis) of the pancreatic cells and tissues, resulting
in inflammation. Acute pancreatitis is usually a mild disease and
spontaneously resolves; however, approximately 20% of those with the
disease develop a severe acute pancreatitis that requires hospitalization.
Pancreatitis develops because of a blockage to the outflow of pancreatic
digestive enzymes caused by bile duct or pancreatic duct obstruction (e.g.,
gallstones). Acute pancreatitis can also result from direct cellular injury from
drugs or viral infection.
14. Obesity is defined as a body mass index (BMI) greater than what measurement?
a. 22
b. 28
c. 25
d. 30
Obesity is an energy imbalance, with caloric intake exceeding energy
expenditure, and is defined as a BMI greater than 30.
15. Which are the early (prodromal) clinical manifestations of hepatitis? (Select all that
apply.)
a. Fatigue
b. Vomiting
c. Itching
d. Splenomegaly
e. Hyperalgia
A, B, E. The prodromal (preicteric) phase of hepatitis begins approximately 2
weeks after exposure and ends with the appearance of jaundice. Fatigue,
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