Endocrine and Gastrointestinal Disorders, Exams of Nursing

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PATHO 370 QUIZ CH. 36, 37, 38, 40, 41

A tumor which results in excessive production and release of catecholamine is: a. Cushing disease b. Conn syndrome c. Goiter d. pheochromocytoma - Answers-Pheochromocytoma Barrett esophagus is a. gastrin-secreting lesion b. gastrin-secreting tumor c. benign condition d. preneoplastic lesion - Answers-Preneoplastic lesion It is true that growth hormone excess in adults a. results in the condition of acromegaly b. leads to abnormally tall stature c. is associated with hypoglycemia d. is usually asymptomatic - Answers-Results in the condition of acromegaly Elevated serum lipase and amylase levels are indicative of a. appendicits b. pancreatitis c. peritonitis d. gallbladder disease - Answers-pancreatitis The most common cause of mechanical bowel obstruction is a. fecal impaction b. intussusception c. adhesions d. volvulus - Answers-adhesions A patient being treated for hepatic encephalopathy could be expected to receive a(n) _________________ diet a. high-sodium b. high-protein c. unrestricted d. low-protein and high-fiber - Answers-low-protein and high-fiber Celiac sprue is a malabsorptive disorder associated with a. inflammatory reaction to gluten-containing foods b. megacolon at regions of autonomic denervation c. ulceration of the distal colon and rectum d. deficient production of pancreatic enzymes - Answers-inflammatory reaction to gluten-containing foods

What indicator is most helpful in evaluating long-term blood glucose management in patients with diabetes mellitus? a. clinical manifestations of hyperglycemia b. urine glucose levels c. glycosylated hemoglobin levels (HbA1c) d. blood glucose levels - Answers-Glycosylated hemoglobin levels (HbA1c) The breakdown of stored glycogen in the liver and muscles is called a. glycogenesis b. glycogenolysis c. glycolysis d. gluconeogenesis - Answers-Glycogenolysis It is true that the synthesis of thyroid hormone a. is inhibited by iodine deficiency b. is stimulated by ACTH c. occurs in perifollicular C cells d. is increased by thyrotropin-inhibiting factor - Answers-is inhibited by iodine deficiency Surgical removal of a gland may result in a. hyporesponsiveness b. hyposecretion c. hypersecretion d. tissue resistance - Answers-hyposecretion _______ is the most powerful predictor of developing type 2 diabetes mellitus a. cardiovascular disease b. aging c. obesity d. sedentary lifestyle - Answers-obesity Diabetes insipidus is a condition that a. is characterized by oliguria b. leads to glycosuria c. results from inadequate ADH secretion d. is associated with anterior pituitary dysfunction - Answers-results from inadequate ADH secretion Growth hormone-deficient infants would display a. low birth length and weight b. normal length and low weight c. normal birth length and weight d. high birth length and weight - Answers-normal birth length and weight An early indicator of colon cancer is a. rectal pain

b. jaundice c. a change in bowel habits d. bloody diarrhea - Answers-a change in bowel habits Clinical manifestations of Graves disease may include a. tremor b. cold intolerance c. lethargy d. weight gain - Answers-tremor A laboratory finding that would help confirm the diagnosis of hyperaldosteronism is a. hyperkalemia b. hyperglycemia c. hypernatremia d. hypokalemia - Answers-hypokalemia Proton pump inhibitors may be used in the management of peptic ulcer disease to a. neutralize gastic acid b. decrease hydrochloric acid (HCl) secretion c. inhibit secretion of pepsinogen d. increase gastric motility - Answers-decrease hydrochloric acid (HCl) secretion What form of viral hepatitis is likely to be transmitted sexually? A. Hepatitis A B. Hepatitis B C. Hepatitis C D. Hepatitis E - Answers-Hepatitis B The finding of hypotension, rigid abdomen, and absent bowel sounds in a patient with pancreatitis A. is an expected finding and requires no specific intervention. B. indicates peritonitis with substantial risk for sepsis and shock. C. requires immediate surgical intervention. D. is an unusual finding in pancreatitis and indicates misdiagnosis. - Answers-indicates peritonitis with substantial risk for sepsis and shock Chronic pancreatitis may lead to a. celiac sprue b. gallstones c. Crohn disease d. diabetes mellitus - Answers-diabetes mellitus A patient reporting vision changes, photophobia, and lid lag may be exhibiting signs of a. myedema b. Graves disease

c. Cushing syndrome d. Addison disease - Answers-Graves disease A patient who should be routinely evaluated for peptic ulcer disease is one who is a. routinely drinking alcoholic beverages b. being treated with high-dose oral glucocorticoids c. experiencing chronic diarrhea d. taking six to eight tablets of acetaminophen per day - Answers-being treated with high-dose oral glucocorticoids An infusion of mannitol would be prescribed to treat A. varices. B. encephalopathy C. peritonitis. D. cerebral edema - Answers-cerebral edema What finding should prompt further diagnostic testing in a child presenting with diarrhea? a. blood and mucus in the stools b. periumbilical discomfort c. frequent, large-volume diarrhea d. greenish, watery diarrhea - Answers-blood and mucus in the stools Normal bile is composed of a. water, electrolytes, and organic solutes b. bile acids c. proteins d. phospholipids - Answers-water, electrolytes, and organic solutes Premature infants are at greater risk for developing a. diverticular disease b. necrotizing enterocolitis c. appendicitis d. pseudomembranous colitis - Answers-necrotizing enterocolitis Untreated acute cholecystitis may lead to _______ of the gallbladder wall a. gangrene b. inflammation c. infection d. distention - Answers-gangrene Dumping syndrome is commonly seen after ___________ procedures a. appendectomy b. colonscopy c. gastric bypass d. intestinal biopsy - Answers-gastric bypass

Myxedema coma is a severe condition associated with a. acute cortisol insufficiency b. pheochromocytoma c. hyperthermia d. hypothyroidism - Answers-hypothyroidism The underlying pathogenic mechanism for type 1 diabetes is - Answers-pancreatic β-cell destruction More than half of the initial cases of pancreatitis are associated with a. trauma b. high cholesterol c. alcoholism d. stones - Answers-alcoholism Esophageal varices represent a complication of __________ hypertension a. secondary b. pregnancy-induced c. portal d. primary - Answers-portal Pathophysiologically, esophageal varices can be attributed to a. elevated bilirubin b. fluid accumulation c. portal hypertension d. diminished protein metabolism - Answers-portal hypertension A patient receiving chemotherapy may be at greater risk for development of a. gastroesophageal reflux b. stomatitis c. esophageal varices d. Mallory-Weiss syndrome - Answers-stomatitis A viral hepatitis screen with positive hepatitis B surface antigen (HBsAg) should be interpreted as ____________ hepatitis B a. recovered from b. immunity to c. chronic active d. acute - Answers-acute Ulcerative colitis is commonly associated with a. malabsorption of nutrients b. fistula formation between loops of bowel c. inflammation and scarring of the submucosal layer of the bowel d. bloody diarrhea - Answers-bloody diarrhea

Hepatitis B is usually transmitted by exposure to a. feces b. hepatitis vaccine c. blood or semen d. contaminated food - Answers-blood or semen A type of insuling that would be most appropriate for acute management of hyperglycemia is a. ultralente b. semilente c. regular d. NPH - Answers-regular A patient with pancreatitis may experience muscle cramps secondary to a. hypocalcemia b. hyperglycemia c. hypermagnesemia d. alkalosis - Answers-hypocalcemia In the United States, nearly ___________ people have diabetes mellitus a. 29.1 million b. 7 million c. 366 million d. 176 billion - Answers-29.1 million A thyroid gland that grows larger than normal is known as a. myxedema b. cretinism c. goiter d. colloidosis - Answers-goiter Brain injury secondary to high serum bilirubin is called A. hepatic encephalopathy. B. hepatic meningitis. C. kernicterus. D. encephalitis. - Answers-kernicterus The formation of active vitamin D a. occurs in the skin b. is impaired in renal failure c. is necessary for normal potassium metabolism d. is dependent on oral intake of vitamin D - Answers-is impaired in renal failure Fecal leukocyte screening would be indicated in a patient with suspected a. giardiasis

b. laxative abuse c. enterocolitis d. lactose intolerance - Answers-enterocolitis A clinical finding consistent with a hypoglycemic reaction is a. termors b. acetone breath c. hyperventilation d. warm dry skin - Answers-tremors Hepatic enephalopathy is associated with a. hyperbilirubinemia b. toxic effects of alcohol on brain cells c. increased blood ammonia levels d. hyperuricemia - Answers-increased blood ammonia levels Most gallstones are composed of a. uric acid salts b. cholesterol c. bile d. calcium - Answers-cholesterol Epigastric pain that is relieved by food is suggestive of a. pancreatitis b. cardiac angina c. dysphagia d. gastic ulcer - Answers-gastric ulcer Jaundice is a common manifestation of A. malabsorption syndromes. B. anemia. C. liver disease. D. cholecystitis. - Answers-liver disease What effect would adrenocortical insufficiency have on an individual's response to surgical stress? a. more susceptible to hypertensive crisis b. more prone to hypotension c. more prone to hyperglycemia d. decreased sensitivity to anesthesia - Answers-more prone to hypotension The American Diabetes Association recommends a postprandial blood glucose level of ____________ mg/dL for adults with diabetes. - Answers-less than 180 Diabetic neuropathy is thought to result from a. deficient neuronal insulin receptors

b. neuronal demyelination c. elevated HbA1c- d. decreased myoinositol transport - Answers-decreased myoinositol transport Clinical manifestation of hypoparathyroidism a. result from decreased neuromuscular excitability b. are similar to those occurring with hypokalemia c. are similar to those occurring with hypermagnesemia d. result from decreased serum ionized calcium - Answers-result from decreased serum ionized calcium Hepatitis with the presence of autoantibodies and positive antinuclear antibodies (ANA) is a. hepatitis A b. hepatitis D c. autoimmune hepatitis d. hepatitis B - Answers-autoimmune hepatitis A clinical finding that is consistent with a diagnosis of adrenocortical insufficiency is a. hypertension b. hypoglycemia c. moon face d. hypokalemia - Answers-hypoglycemia It is true that biliary cancer a. tend to be asymptomatic and progress insidiously b. is most often cured by surgery c. are identifiable and treatable when diagnosed early d. respond well to chemotherapy - Answers-tend to be asymptomatic and progress insidiously A clinical finding consistent with a diagnosis of syndrome of inappropriate ADH secretion (SIADH) is a. hypovolemia b. dehydration c. decreased osmolality d. hyponatremia - Answers-hyponatremia Radioactive iodine treatment is the therapy of choice in patients with Graves disease. The patient should be exptected to a. need lifelong thyroid replacement therapy b. receive lifelong iodine therapy c. need short-term thyroid replacement therapy d. achieve full recovery after treatment - Answers-need lifelong thyroid replacement therapy

Steatohepatitis is caused by an accumulation of ________ in the liver cells a. bile b. fat c. ferritin d. acetaminophen - Answers-fat Patients with acute pancreatitis are generally made NPO and may require continuous gastric suctioning in order to a. prevent hyperglycemia associated with loss of insulin secretion b. remove the usual stimuli for pancreatic secretion c. prevent abdominal distension d. prevent mechanical obstruction of the intensine - Answers-remove the usual stimuli for pancreatic secretion A patient with a history of alcoholism presents with hematemesis and profound anemia. The expected diagnosis is a. ascites b. gastroesophageal varices c. hepatic encephalopathy d. cerebral edema - Answers-gastroesophageal varices A type of insulin that would be most appropriate for acute management of hyperglycemia is a. semilente b. regular c. ultralente d. NPH - Answers-regular In type 1 diabetes, respiratory compensation may occur through a process of a. Respiratory acidosis b. Metabolic alkalosis c. Respiratory alkalosis d. Metabolic acidosis - Answers-Respiratory alkalosis What clinical finding would suggest an esophageal cause of a client's report of dysphagia? A. Nasal regurgitation B. Airway obstruction with swallowing C. Chest pain during meals D. Coughing when swallowing - Answers-chest pain during meals A patient presenting with muscle cramps, fatigue, anxiety, depression, and prolonged Q- T intervals on EKG may be showing symptoms of a. hyperparathyroidism. b. SIADH. c. hypoparathyroidism.

d. diabetes insipidus. - Answers-hypoparathyroidism Which response to an injection of ACTH indicates a primary adrenal insufficiency? a. No change in serum glucocorticoid level b. An increase in serum glucocorticoid level c. A decrease in serum glucose level d. An increase in serum ACTH level - Answers-no change in serum glucocorticoid level Rupture of esophageal varices is a complication of cirrhosis with portal hypertension and carries a high ________ rate. a. mortality b. cure c. insurance d. morbidity - Answers-mortality It is true that gallstones are a. more common in women. b. more common in men. c. at highest risk among Asians. d. a minimal risk for Native Americans. - Answers-more common in women An increase in ADH secretion occurs in response to a. dehydration. b. hyponatremia. c. decreased serum osmolality. d. hypervolemia. - Answers-dehydration Congenital adrenal hyperplasia (adrenogenital syndrome) results from a. cortisol excess. b. testosterone-secreting tumor. c. exogenous androgens. d. blocked cortisol production. - Answers-blocked cortisol production The underlying pathogenic mechanism for type 2 diabetes is a. pancreatic β-cell destruction. b. lack of exercise and chronic overeating. c. impaired glucose transport into cells. d. insulin resistance and β-cell dysfunction. - Answers-insulin resistance and β-cell dysfunction Antidiuretic hormone (ADH) increases a. sodium reabsorption in the distal tubule of the kidney. b. urinary output. c. water reabsorption in the collecting tubule of the kidney. d. potassium secretion in the distal tubule of the kidney. - Answers-water reabsorption in the collecting tubule of the kidney

A patient admitted with bleeding related to esophageal varices could be expected to receive a continuous intravenous infusion of A. glucose. B. octreotide acetate. C. anticoagulants. D. proton pump inhibitors. - Answers-octreotide acetate A silent abdomen 3 hours after bowel surgery most likely indicates A. peritonitis. B. mechanical bowel obstruction. C. perforated bowel. D. functional bowel obstruction. - Answers-functional bowel obstruction The most challenging aspect of treatment for chronic pancreatitis is A. pancreatectomy. B. strict dietary avoidance of fats. C. abstinence from alcohol. D. pain control. - Answers-pain control An infusion of mannitol would be prescribed to treat a. encephalopathy. b. peritonitis. c. cerebral edema. d. varices. - Answers-cerebral edema Insulin binding to its receptor on target cells results in - Answers-increased facilitated cellular diffusion of glucose. Which symptom suggests the presence of a hiatal hernia? A. Nausea B. Heartburn C. Diarrhea D. Abdominal cramps - Answers-heartburn What finding would rule out a diagnosis of irritable bowel syndrome in a patient with chronic diarrhea? A. Negative stool leukocytes B. Intermittent constipation C. Abdominal pain and distention D. Bloody stools - Answers-bloody stools Narcotic administration should be administered carefully in patients with acute pancreatitis related to potential for A. respiratory depression. B. narcotic dependency.

C. sphincter of Oddi dysfunction. D. allergic reaction. - Answers-sphincter of Oddi dysfunction. What laboratory data would support a diagnosis of hemochromatosis? A. Deficient protease inhibitor B. Elevated ferritin C. Elevated urine copper D. Positive antinuclear antibody - Answers-elevated ferritin Propylthiouracil may be used to treat hyperthyroidism, because it a. inhibits the release of TSH. b. destroys thyroid gland cells. c. suppresses production of autoantibodies. d. inhibits thyroid hormone synthesis. - Answers-inhibits thyroid hormone synthesis Celiac sprue is a malabsorptive disorder associated with A. inflammatory reaction to gluten-containing foods. B. megacolon at regions of autonomic denervation. C. ulceration of the distal colon and rectum. D. deficient production of pancreatic enzymes. - Answers-inflammatory reaction to gluten-containing foods.