Chapter 33: Structure and Function of the Digestive System My Nursing Test Banks

Huether and McCance: Understanding Pathophysiology, 5th Edition

Chapter 33: Structure and Function of the Digestive System

Test Bank

MULTIPLE CHOICE

1. The nursing faculty is discussing digestion and indicates it begins in the mouth with salivary -amylase (ptyalin) that initiates the digestion of:

a.

Proteins

b.

Carbohydrates

c.

Fats

d.

Amino acids

ANS: B

Salivary amylase initiates the digestion of carbohydrates.

Protein digestion occurs in the stomach and is influenced by pepsin.

Fat digestion is aided by bile.

Amino acids are not involved in the digestive process.

REF: p. 873

2. A new drug is being tested that is known to inhibit parasympathetic nervous system activity. It is expected that the salivary glands will become:

a.

Hyperactive

b.

Hypoactive

c.

Atrophied

d.

Enlarged

ANS: B

Inhibition of the parasympathetic nervous system would result in decreased (hypoactive) functions of the salivary glands. The individual would experience dry mouth.

The glands would be hypoactive, not hyperactive.

The gland would become hypoactive, but would not atrophy.

The gland would become hypoactive; it would not enlarge.

REF: p. 873

3. The chemist analyzing a sample of normal saliva would expect it to reveal which immunoglobulin?

a.

IgG

b.

IgD

c.

IgE

d.

IgA

ANS: D

Normal saliva contains IgA.

Normal saliva contains IgA, not IgG.

Normal saliva contains IgA, not IgD.

Normal saliva contains IgA, not IgE.

REF: p. 873

4. The nursing student is teaching a class to second graders. The student would correctly identify that food moves down the esophagus via the process termed:

a.

Peristalsis

b.

Retropulsion

c.

Haustral segmentation

d.

Defecation

ANS: A

Swallowed food is moved from the esophagus to the stomach by peristalsis.

Swallowed food is moved by peristalsis, not retropulsion.

Swallowed food is moved by peristalsis; haustral segmentation occurs in the small intestine.

Swallowed food is moved by peristalsis; defecation is the process of eliminating stool from the rectum.

REF: p. 873

5. For the patient experiencing esophageal reflux, the nurse would expect which sphincter to be malfunctioning?

a.

Pyloric

b.

Lower esophageal

c.

Upper esophageal

d.

Gastric

ANS: B

The lower esophageal sphincter keeps food from refluxing into the esophagus.

The pylorus is located at the connection between the stomach and the duodenum.

The upper esophageal sphincter keeps air from entering the esophagus during respiration.

There is no gastric sphincter.

REF: p. 873

6. The patient asks how the GI system works. The nurse would identify that autonomic and hormonal control are involved in GI motility and:

a.

Defecation

b.

Swallowing

c.

Mastication

d.

Digestive enzyme secretion

ANS: D

Autonomic control is involved in digestive enzyme secretion.

Autonomic control is involved in digestive enzyme secretion, not defecation.

Autonomic control is involved in digestive enzyme secretion, not swallowing.

Autonomic control is involved in digestive enzyme secretion, not mastication.

REF: p. 873

7. Which cells of the gastric glands secrete hydrochloric acid?

a.

Chief

b.

Parietal

c.

Zymogenic

d.

Surface epithelial

ANS: B

The parietal cells secrete hydrochloric acid.

The chief cells secrete pepsinogen.

Zymogenic cells do not secrete acid.

Epithelial cells line the GI tract and do not secrete acid.

REF: p. 876

8. Mucus production to form the mucosal barrier in the stomach is stimulated by the release of:

a.

Somatostatin

b.

Gastrin

c.

Prostaglandins

d.

Histamine

ANS: C

Prostaglandins protect the mucosal barrier by stimulating the secretion of mucus and bicarbonate and by inhibiting secretion of acid.

Somatostatin is secreted by the pancreas and is not involved in secretion of mucus.

Gastrin is not involved in mucus secretion.

Histamine initiates secretion of acid, not mucus.

REF: p. 877

9. A young male student becomes very hungry during class. He begins thinking of a cheeseburger and fries, his favorite meal. These thoughts will trigger which phase of gastric secretion?

a.

Cephalic

b.

Caudal

c.

Enteral

d.

Intestinal

ANS: A

The cephalic phase is stimulated by the thought, smell, and taste of food.

The gastric phase is stimulated by distention of the stomach.

The enteral phase is not a phase of gastric secretion.

The intestinal phase is stimulated by histamine and digested protein.

REF: p. 876

10. Which sphincter prevents reflux of digested material from the colon into the small intestine?

a.

Haustral

b.

Lower esophageal

c.

Pyloric

d.

Ileocecal valve

ANS: D

The ileocecal valve prevents reflux of digested material from the colon into the small intestine.

The haustral segments facilitate propulsion; they do not prevent reflux.

Lower esophageal prevents reflux from the stomach to the esophagus.

The pylorus is the opening between the stomach and the duodenum.

REF: p. 878

11. The ileum and jejunum are suspended by folds of the peritoneum known as the _____ that contains an extensive vascular and nervous network.

a.

Myenteric plexus

b.

Mesentery

c.

Auerbach fold

d.

Meissner plexus

ANS: B

The ileum and jejunum are suspended in loose folds from the posterior abdominal wall by a peritoneal membrane called the mesentery.

Intrinsic motor innervation is mediated by the myenteric plexus (Auerbach plexus) and the submucosal plexus (Meissner plexus).

Intrinsic motor innervation is mediated by the myenteric plexus (Auerbach plexus) and the submucosal plexus (Meissner plexus).

Intrinsic motor innervation is mediated by the myenteric plexus (Auerbach plexus) and the submucosal plexus (Meissner plexus).

REF: p. 878

12. Absorption of nutrients from the intestine occurs initially through the:

a.

Mesentery

b.

Villi

c.

Lamina propria

d.

Splenic veins

ANS: B

Villi are small finger-like projections that extend from the small intestinal mucosa and increase its absorptive surface area.

The ileum and jejunum are suspended in loose folds from the posterior abdominal wall by a peritoneal membrane called the mesentery.

The lamina propria (a connective tissue layer of the mucous membrane) lies beneath the epithelial cells of the villi and contains lymphocytes and plasma cells, which produce immunoglobulins.

The splenic vein drains the stomach and is not involved in absorption.

REF: p. 878

13. Digested fats are primarily absorbed into the:

a.

Lacteals

b.

Central arterioles

c.

Lamina propria

d.

Villus capillaries

ANS: A

Digested fats move into the lacteals and eventually reach the liver through the systemic circulation.

Digested fats move into the lacteals and eventually reach the liver through the systemic circulation. They are not absorbed by central arterioles.

Digested fats move into the lacteals and eventually reach the liver through the systemic circulation. They are not absorbed by the lamina propria.

Digested fats move into the lacteals and eventually reach the liver through the systemic circulation. They are not absorbed by the villus capillaries.

REF: p. 878

14. Which reflex inhibits gastric motility when the ileum becomes overdistended?

a.

Ileogastric

b.

Gastroduodenal

c.

Gastroileal

d.

Colonointestinal

ANS: A

The ileogastric reflex inhibits gastric motility when the ileum becomes distended.

The ileogastric reflex, not the gastroduodenal, inhibits gastric motility when the ileum becomes distended.

The ileogastric reflex, not he gastroileal, inhibits gastric motility when the ileum becomes distended.

The ileogastric reflex, not the colonointestinal, inhibits gastric motility when the ileum becomes distended.

REF: p. 881

15. The vermiform appendix is attached to the:

a.

Duodenum

b.

Ileum

c.

Cecum

d.

Sigmoid colon

ANS: C

The vermiform appendix is attached to the cecum.

The vermiform appendix is attached to the cecum, not the duodenum.

The vermiform appendix is attached to the cecum, not the ileum.

The vermiform appendix is attached to the cecum, not the sigmoid.

REF: p. 881

16. The ________ sphincter controls the movement of chyme from the sigmoid colon into the rectum?

a.

Oddi

b.

Ileocecal

c.

OBeirne

d.

Internal anal

ANS: C

The OBeirne sphincter controls the movement of wastes from the sigmoid colon into the rectum.

The OBeirne sphincter, not the Oddi sphincter, controls the movement of wastes from the sigmoid colon into the rectum.

The OBeirne sphincter, not the ileocecal sphincter, controls the movement of wastes from the sigmoid colon into the rectum.

The OBeirne sphincter, not the internal anal sphincter, controls the movement of wastes from the sigmoid colon into the rectum.

REF: p. 881

17. The _____ reflex initiates propulsion in the entire colon, usually during or immediately after eating.

a.

Gastrocolic

b.

Ileocolic

c.

Duodenocolic

d.

Cephalocolic

ANS: A

The gastrocolic reflex initiates propulsion in the entire colon.

The gastrocolic reflex, not the ileocolic, initiates propulsion in the entire colon.

The gastrocolic reflex, not the duodenocolic, initiates propulsion in the entire colon.

The gastrocolic reflex, not the cephalocolic, initiates propulsion in the entire colon.

REF: p. 882

18. The colon receives splanchnic blood flow from which artery(ies)?

a.

Celiac

b.

Superior and inferior mesenteric

c.

Hepatic and portal

d.

Omental

ANS: B

The blood supply of the large intestine and rectum is derived primarily from branches of the superior and inferior mesenteric arteries.

The blood supply of the large intestine and rectum is derived primarily from branches of the superior and inferior mesenteric arteries, not the celiac.

The blood supply of the large intestine and rectum is derived primarily from branches of the superior and inferior mesenteric arteries, not the hepatic or portal.

The blood supply of the large intestine and rectum is derived primarily from branches of the superior and inferior mesenteric arteries, not the omental.

REF: p. 882

19. The capillaries of the liver are more commonly known as hepatic:

a.

Canaliculi

b.

Ducts

c.

Sinusoids

d.

Papillae

ANS: C

Small capillaries, or sinusoids, are located between the plates of hepatocytes of the liver.

Small capillaries, or sinusoids, not canaliculi, are located between the plates of hepatocytes of

the liver.

Small capillaries, or sinusoids, not ducts, are located between the plates of hepatocytes of the liver.

Small capillaries, or sinusoids, not papillae are located between the plates of hepatocytes of

the liver.

REF: p. 884

20. Which of the following liver cells are phagocytic?

a.

Glisson

b.

Kupffer

c.

Meissner

d.

Lieberkhn

W

ANS: B

The sinusoids are also lined with phagocytic Kupffer cells and are part of the mononuclear phagocyte system.

The Glisson is the capsule that covers the liver.

The Meissner is a part of the nerve plexus that innervated the liver.

The Lieberkhn is a part of the livers secretory cells.

REF: p. 884

21. The primary bile acids are synthesized from _______ by hepatocytes lining the bile canaliculi.

a.

Lecithin

b.

Fatty acids

c.

Cholesterol

d.

Testosterone

ANS: C

Bile acids are synthesized from cholesterol.

Bile acids are synthesized from cholesterol, not lecithin.

Bile acids are synthesized from cholesterol, not fatty acids.

Bile acids are synthesized from cholesterol, not testosterone.

REF: p. 884

22. In the liver, free bilirubin moves from the plasma in the sinusoids into the hepatocytes, where it is converted into:

a.

Unconjugated bilirubin

b.

Biliverdin

c.

Conjugated bilirubin

d.

Urobilinogen

ANS: C

Within hepatocytes, unconjugated bilirubin joins with glucuronic acid to form conjugated bilirubin, which is water soluble and is secreted in the bile.

Within hepatocytes, unconjugated bilirubin joins with glucuronic acid to form conjugated bilirubin, not unconjugated, which is water soluble and is secreted in the bile.

Biliverdin is a precursor of bilirubin.

When conjugated bilirubin reaches the distal ileum and colon, it is deconjugated by bacteria and converted to urobilinogen.

REF: pp. 884-885

23. Which information indicates the nurse understands digestion? During the cephalic and gastric phases of digestion, gallbladder contraction is mediated by branches of the:

a.

Sympathetic nervous system

b.

Somatic nervous system

c.

Vagus nerve

d.

Glossopharyngeal nerve

ANS: C

Gallbladder contraction is mediated by cholinergic branches of the vagus nerve.

Gallbladder contraction is mediated by cholinergic branches of the vagus nerve, not the sympathetic nervous system.

Gallbladder contraction is mediated by cholinergic branches of the vagus nerve, not the somatic nerves.

Gallbladder contraction is mediated by cholinergic branches of the vagus nerve, not the glossopharyngeal nerve.

REF: p. 887

24. Which sphincter, when it relaxes, allows bile to flow into the duodenum?

a.

Pyloric sphincter

b.

Sphincter of Oddi

c.

Ampulla of Vater

d.

Ileocecal valve

ANS: B

When the Sphincter of Oddi relaxes, bile flows into the duodenum.

The pyloric sphincter controls flow of fluid from the stomach to the duodenum.

Secretions from the pancreas empty into the common bile duct at the ampulla of Vater.

The ileocecal valve prevents reflux of digested material from the colon into the small intestine.

REF: p. 887

25. The exocrine portion of the pancreas contains:

a.

Alpha cells

b.

Beta cells

c.

Ducts

d.

Islets of Langerhans

ANS: C

The exocrine portion of the pancreas contains ducts.

The endocrine portion contains the alpha cells.

The endocrine portion contains the beta cells.

The endocrine portion contains the islets of Langerhans.

REF: p. 888

26. The function of the acinar cells of the pancreas is to secrete:

a.

Bicarbonate

b.

Enzymes

c.

Mucus

d.

Electrolytes

ANS: B

The exocrine pancreas is composed of acinar cells that secrete enzymes.

The exocrine pancreas is composed of acinar cells that secrete enzymes, not bicarbonate.

The exocrine pancreas is composed of acinar cells that secrete enzymes, not mucus.

The exocrine pancreas is composed of acinar cells that secrete enzymes, not electrolytes.

REF: p. 888

27. Parasympathetic stimulation to the pancreas will cause which of the following reactions?

a.

Hormonal inhibition

b.

Enzyme secretion

c.

Vasoconstriction

d.

Decreased bicarbonate production

ANS: B

Pancreatic innervation arises from preganglionic parasympathetic fibers of the vagus nerve. These fibers activate postganglionic fibers, which stimulate enzymatic and hormonal secretion.

Pancreatic innervations stimulate hormone secretion, not inhibit it.

Sympathetic postganglionic fibers from the celiac and superior mesenteric plexuses innervate the blood vessels, cause vasoconstriction, and inhibit pancreatic secretion.

Parasympathetic stimulation is not involved in bicarbonate production.

REF: p. 888

28. The pancreas produces which substance to prevent the premature activation of proteolytic enzymes in the pancreas?

a.

Bicarbonate

b.

Carboxypeptidase

c.

Secretin

d.

Trypsin inhibitor

ANS: D

The pancreas produces trypsin inhibitor, which prevents the activation of proteolytic enzymes while they are in the pancreas.

Bicarbonate is responsible for neutralizing fluid.

Carboxypeptidase is a protein-digesting enzyme.

Secretin is not produced by the pancreas.

REF: p. 889

MULTIPLE RESPONSE

1. The patient asks the student to explain what the gastrointestinal (GI) tract actually does. The student would be correct in telling the patient the GI tract performs which of the following processes? (Select all that apply.)

a.

Absorption of digested food

b.

Chemical breakdown of food particles

c.

Erythropoiesis

d.

Mechanical breakdown of food particles

e.

Secretion of mucus

ANS: A, B, D, E

The GI tract carries out the following process: (1) ingestion of food; (2) propulsion of food and wastes from the mouth to the anus; (3) secretion of mucus, water, and enzymes; (4) mechanical digestion of food particles; (5) chemical digestion of food particles; (6) absorption of digested food; and (7) elimination of waste products by defecation.

REF: p. 871

2. A 70-year-old male reports frequent GI problems. His primary care provider explains that during aging many GI processes decrease, including (select all that apply):

a.

Gastric juice secretion

b.

Gallbladder function

c.

Hepatic regeneration

d.

Efficiency of drug metabolism

e.

Mucosal barrier protection

ANS: A, C, D, E

GI processes that decrease include gastric motility, blood flow, and volume, and acid content of gastric juice may be reduced, particularly with gastric atrophy. Protective mucosal barrier decreases. Decreased hepatic regeneration occurs; size and weight decrease. Blood flow decreases, influencing efficiency of drug metabolism. No changes occur in the gallbladder and bile ducts.

REF: p. 890

Mosby items and derived items 2012 Mosby, Inc., an imprint of Elsevier Inc.

Leave a Reply