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A series of multiple choice questions and answers related to various medical conditions, including hiatal hernia, inflammatory bowel disease (ibd), pancreatitis, celiac disease, esophageal atresia and tracheoesophageal fistula (ea/tef), satiety, obesity, colorectal cancer, liver failure, anorexia nervosa, acetaminophen overdose, cholestasis, and crohn's disease. The questions are designed to assess understanding of the pathophysiology, signs and symptoms, and treatment of these conditions.
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"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
commonly implicated in the development of hiatal hernias. *****If esophageal acid clearance is impaired, esophagitis can result. The root causes of hiatal hernias are normally treatable with medication. Paraesophageal hiatal hernias are common and are normally not treated if the patient is asymptomatic."
cramping do not worsen during periods of high stress. 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. *****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." A 32-year-old mother who complains of intermittent abdominal pain that persists even after defecation." "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 a temperature of 38.8°C (101.8°F), blood pressure of 89/48 mm Hg, and heart rate of 116 beats per minute. Blood work indicates that his serum levels of C-reactive protein, amylase, and lipase are all elevated. Which of
pancreatitis Liver cirrhosis Cholecystitis
Hepatitis C" "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
fat content of breast milk results in malnutrition and deficiency of fat-soluble vitamins. Neurogenic or muscular inhibition of peristalsis results in inappropriate motility of ingested food in the lower small intestine and the colon. *******An inappropriate T-cell mediated response results in increased levels of antibodies and an inflammatory response. Bacterial or chemical invasion of the peritoneum leads to decreased nutrient absorption and transport." "A female neonate has been in respiratory 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?
surgery will be pain management, as the contents of her stomach can burn her lungs." "The biggest risk that will face your daughter until this is fixed is the danger of malnutrition and dehydration." "This problem will require respiratory therapy and supplementary feeding, but it will likely resolve itself over time." *******"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." Question 8 (1 point)" "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
*****Cholecystokinin and glucagon-like peptide-1 suppress the hunger impulse.
A 68-year-old female patient with sudden onset of confusion, a history of alcohol abuse, and low levels of serum AST and ALT A 50-year-old woman with blood pressure of 189/103, jaundice, and multiple thromboses ******A 44-year-old man with low hemoglobin levels, low platelet levels, and spider angiomas" "As part of the intake protocol at an eating disorders clinic, an interview precedes a physical examination. Which of the following questions would a clinician be justified in excluding from an intake interview for a 16-year-old female referred by her pediatrician for the treatment of
have related to food in your daily routine?" *******"Have you had any episodes of shortness of breath in the recent past?" "Have you noticed any new hair growth on your body in the last several months?" "Do you remember when your last menstrual period was?" "A 29-year-old female has been admitted to the emergency department following a suicide attempt by overdose of acetaminophen. What changes in the patient's liver and diagnostic results
increased GGT, ALT, and bilirubin levels Cholestatic reaction with increased bilirubin count Allergic inflammation accompanied by an increase in serum IgE and basophils ********Centrilobular necrosis evidenced by increased ALT and AST levels" "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
*******"When your body has to regularly break down that much alcohol, your blood and the functional cells in your liver accumulate a lot of potentially damaging toxic byproducts." "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."
"That may be the case, but you are still creating a high risk of hepatitis A or B or liver cancer." "You are more than likely inflicting damage on your liver, but this damage would cease as soon as you quit drinking." "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
soluble vitamins Skin xanthomas (focal accumulations of cholesterol) with consequences of increased risk of bleeding due to deficient clotting factors Anorexia with consequences of impaired drug metabolism and blood filtration Complaints of lower flank pain with consequences of impaired fat metabolism" "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
*******The patient is borderline obese but is not yet at the point of significantly increased risks to health. He is classified as being obese, likely as the result of the interplay of genetic and lifestyle factors. The patient faces an increased risk of type 2 diabetes and hyperlipidemia. Further investigation of his nutritional status is needed to supplement the BMI value." "David has an acute exacerbation of Crohn's disease. Which of the following lab tests would you
******Vitamins A, B complex and C levels Liver enzyme levels Sedimenatation rate"
stimulation blocks the release of the excitatory neuromediators and inhibits GI motility." "Sympathetic innervation of much of the GI tract occurs by way of the vagus nerve." *******"The enteric nervous system is made up of the myenteric and submucosal plexuses; these are located in the wall of the GI tract." "The myenteric plexus is responsible for controlling the function of each segment of the intestinal tract.""
protein diet *******Gluten free diet Low residue diet Low fat diet" "Which of the following statements best captures an aspect of the process of fat digestion and
Long-chain fatty acids are absorbed more readily than medium-chain triglycerides. *******Simple forms of fats are absorbed in the upper jejunum. Ingested triglycerides are broken down into absorbable form by gastric lipase." "As a result of oral ingestion of the microorganisms, an individual has contracted H. pylori. Which
*******Gastric adenocarcinoma Gastric atrophy Peptic ulcer Esophagitis
Diverticular disease" "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
drugs Interferon-alfa-2b Peginterferon and ribavirin Lamivudine" “Which of the following measures would likely be rejected as part of a first-line weight loss plan
minutes or more of moderate-intensity activity at least 3 days per week Calorie reduction by 500 to 1,000 kcal/day *****Gastric bypass Prescription drug therapy" "A 55-year-old man has been diagnosed with a hiatal hernia, in which the function of the lower esophageal sphincter is compromised. Which of the following consequences of this condition is
******Protrusion of the stomach or regurgitation of stomach contents into the esophagus Impaired control of the gastric emptying rate Decreased absorption of ingested foods and fluids" "A 20-year-old male who is addicted to crystal methamphetamine has been admitted to the hospital with a diagnosis of protein-calorie malnutrition after many months of inadequate food
*****Incremental feeding combined with vitamin and mineral supplementation Total parenteral nutrition
in the hours prior to admission. Which of the following potential contributing factors would the
Staphylococcal enterotoxins ******Alcohol consumption Overuse of aspirin"