Final Test Session

2nd Professional BSN,4 year Programme

Subject: Adult Health Nursing I

Topic: Unit I (Gastrointestinal System)

Name:_______________ Roll No._____________ Date:_____________ Total Marks:65

(Objective Section)

Encircle the correct answer:

1. How does food move through your digestive tract?

a. By gravity
b. By wavelike muscle contractions
c. By cilia
d. By chemical absorption
2. Where does most of the digestive process take place?
a. Small intestine
b. Large intestine
c. Stomach
d. All of the above
3. What does the liver do to help digestion?
a. Makes important enzymes
b. Neutralizes stomach acid
c. Produce bile
d. Regulate insulin
4. Which of these can harm the intestinal lining?
a. Aspirin
b. Antibiotics
c. Caffeine
d. A &B
5. Which of these best maintains intestinal health?
a. Starches
b. Vitamin
c. Fiber
d. Fat
6. Which of these can cause heartburn?
a. Lying over weight
 b. Laying down soon after having a large meal
c. Having high fat food
d. All of the above

7. Which of these causes ulcers?

a. Bacterial infection in the stomach
b. Aspirin and other anti-inflammatory medicines
c. Chronic stress
d. All of the above
8. Food poisoning is caused by eating contaminated food. How can it be prevented?
a. Cooking meat and poultry thoroughly
b. Wash fruits and vegetables before eating and cooking them
c. Storing food properly
d. All of the above
9. How does age affect digestion?
a. Slow swallowing
b. Overgrowth of bacteria reduces the amount of nutrients intestine absorbs
c. Reduces stomach secretions
d. All of the above
10. Which of the following nursing diagnoses would be inappropriate for the infant
with gastroesophageal reflux(GER)?
a. Fluid volume deficit
b. Risk for aspiration
c. Altered nutrition,less than body requirement
d. Altered oral mucus membrane

11. A nurse prepares a patient for insertion of a nasoenteric tube. The nurse positions
the patient
a. In high fowler position
b. Flat in bed
c. On his/her right side
d. With semi fowlers position with head turned left side
12. Which of the following is the most common cause of ulcerative colitis-related
mortality?
a. Colonic adenocarcinoma
b. Toxic megacolon
c. Perforated colon
d. Colonic infarction
13. Ulcerative colitis
a. Carries a risk of colonic cancer
b. Can be treated with a LOFFLEX
 c. Can be caused by small intestinal bacterial overgrowth
d. an be caused by milk intolerance
14. Fibre supplement
a. May be helpful in diverticular disease
b. Are always easily fermented by colonic bacteria
c. Are usually derived from soluble fibre source
d. Should be avoided in constipation
15. Inflammatory bowel syndrome(IBS)
a. Is primarily a psychological problem
b. Is a contra-indication to colonoscopy
c. May be associated with constipation
d. Always resolves with a gluten free diet.
16. Commonest cause of intestinal obstruction:
a. Tumors
b. Inflammatory
c. Adhesions
d. Intraluminal
17. Gastritis is defined as...
a. Increased acid production in stomach.
b. Increased sensitivity of the stomach lining.
c. Inflammation of the stomach lining.
d. Wounds and lesions in the stomach lining
18. A chronic cause of gastritis is infection with a microorganism known as...
a. E. coli
b. Heliobacter pylori
c. Salmonella
d. Staphylococcus
19. Some common symptoms of gastritis include...
a. Nausea and vomiting
b. Pain in the upper abdomen
c. Loss of appetite
d. All the answers are correct
20. A patient arrives to the clinic for evaluation of epigastric pain. The patient
describes the pain to be relieved by food intake. In addition, the patient reports
awaking in the middle of the night with a gnawing pain in the stomach. Based on
the patient's description this appears to be what type of peptic ulcer?
a. Duodenal
b. Gastric
c. Esophageal
d. Refractory
21. A patient comes in complaining that their stomach hurts. They tell you that they've
noticed that their stool has been really dark for the last three weeks. You run a
 complete blood count and determine that your patient is also anemic. What
should you do next?
a. An endoscopy to look for an ulcer somewhere along the gastrointestinal tract
b. A urinalysis to help diagnose kidney disease
c. An ocular exam to make sure their retina doesn't show signs of high blood
pressure
d. An echocardiogram to ensure that the heart isn't bleeding out
22. Which of the following has been associated with peptic ulcers?
a. Helicobacter pylori, a gram negative bacterium
b. H. pylori, a gram positive bacterium
c. Helicobacter pylori, a gram positive fungus
d. H. pylori, a gram negative fungus
23. Which of the following is accurate about the etiology of PUD and related
conditions?
a. Tobacco, ethanol, and caffeine are all considered major causes of PUD
b. Helicobacter pylori and nonsteroidal anti-inflammatory drug (NSAID) use have a
synergistic causal relationship
c. Although once thought to be a factor, seasonal changes and climate extremes do
not have a relationship to PUD or related conditions
d. Most individuals with PUD have a family history of duodenal ulcers, and genetic
factors are a major risk factor for development
24. Which of the following is accurate about endoscopic findings in PUD and related
conditions?
a. Most gastric ulcers tend to occur at the junction of the fundus and antrum, along
the lesser curvature
b. Most duodenal ulcers are found in the second and third parts of the duodenum
c. Malignant ulcers tend to have a smooth, regular, rounded edge with a flat,
smooth base and surrounding mucosa that shows radiating folds
d. The most common finding in individuals undergoing endoscopy for dyspepsia is
peptic ulcer
25. A 28-year-old woman with a history of an appendectomy presents with a
nontender palpable mass in the right lower quadrant abdominal incision. The
following statement(s) is/are true concerning the diagnosis and management of
this patient.
a. The best diagnostic test involves imaging of the abdominal wall by either CT or
MRI
b. Resection of the mass with a 2 cm margin is usually adequate
c. Low dose radiation is a suitable alternative to surgery for primary treatment
d. Re-resection for recurrence will likely have a higher rate of recurrence than for
primary
26. A 48-year-old woman maintained on Warfarin for a history of cardiac valvular
replacement and a history of recent upper respiratory infection presents with
severe abdominal pain exacerbated by movement. Her physical examination
shows tenderness in the right paramedian area with voluntary guarding but no
peritoneal signs. The following statement(s) is/are true concerning the diagnosis
and management of this patient.
a. Urgent laparotomy should be performed because of concern for arterial
mesenteric embolus
b. The correct diagnosis could likely be made by CT scan and operation avoided
c. The status of her anticoagulation should be checked and if her prothrombin time
is excessively prolonged, correction is necessary
d. Both B & C
27. Crohn's disease:
a. Is caused by Mycobacterium paratuberculosis.
b. Is more common in Asians than in Jews.
c. Tends to occur in families.
d. Is less frequent in temperate climates than in tropical ones.
28. An 80-year-old man who has been bedridden for many years following a stroke
presents with acute onset of abdominal distention, obstipation, and colicky
abdominal pain. Abdominal x-rays reveal dilated loops of small bowel and a
dilated sigmoid colon resembling a bent inner tube. Examination reveals distention
with mild direct tenderness but no rigidity or rebound tenderness. Initial
management should consist of:
a. Barium enema examination.
b. Laparotomy with resection of descending colon and descending colostomy.
c. Multiple cleansing enemas to remove impacted feces.
d. Rigid sigmoidoscopy and decompression of the sigmoid colon.
29. Which of the following are used as screening methods for gastric cancer
a. Upper endoscopy
b. Contrast radiography
c. Serum trefoil factor 3, micrornas, and multi-analysis blood tests
d. All of the above
30. Which of the following is the greatest risk factor for pancreatic cancer :
a. Family history
b. Smoking
c. Alcohol consumption
d. Obesity
31. GBC(Gall bladder cancer) occurs most commonly at :
a. Fundus
b. Body
c. Neck
 d. Equally in all parts
32. Inflammation and breakdown of the oral mucosa is
a. Appendicitis
b. Hepatitis
c. Stomatitis
d. Uveitis
33. Most common causative organism of parotitis is
a. Staphylococcus aureus
b. Streptococcus aureus
c. Pneumococcus
d. H.Pylori
34. Sialolithiasis is:
a. Inflammation of salivary gland
b. Calculus in salivary gland
c. Calculus in salivary gland duct
d. Both B& C
35. To reduce gastroesophageal reflux ,we should elevate the head of the bed
a. 6-8 inches
b. 2-4 inches
c. 10-12 inches
d. 12-15 inches
36. Gastro-esophageal junction and fundus of stomach slide through the esophageal
hiatus
a. Paraesophageal hiatal hernia
b. Sliding hiatal hernia
c. Abdominbal hernia
d. None of the above
37. The gastro-esophageal junction is in normal place but part of stomach herniates
through esophageal hiatus
a. Paraesophageal hiatal hernia
b. Sliding hiatal hernia
c. Abdominal hernia
d. None of the above
38. All are the sign and symptoms of ca esophageous except
a. Dysphagia
b. Substernal pain
c. A sensation of mass in the chest
d. Regurgitation of food
39.Anal fissure is
a. Always caused by constipation
b. A linear ulcer of the squamous epithallium below the dentate line
 c. A linear ulcer of the columnar epithallium below the dentate line
d. Typically found in the 12 o clock position
40.Typically anal fissure causes
a.Abdominal pain and bright rectal bleeding
b.Anal pain and bright rectal bleeding
c.Abdominal pain and dark rectal bleeding
d.Anal pain and dark rectal bleeding
41. Which of the following condition can lead to peritonitis except
a.abdominal wound or injury
b.A ruptured appendix
c.A stomach ulcer
d.Cholecystitis
42. All are the Sign and symptoms of peritonitis except
a.Cloudy bag
b.Constipation
c.Nausea vomiting
d.Tummy pain
43. Management of peritonitis include all of the following except:
a.Stool softeners
b.Administration of colloid solutions
c.Intestinal intubation
d.Oxygen therapy
44. Internal hemmorhoids:
a.Are usually not painful
b.Always bleed
c.Cause dark brown bleeding
d.All of the above
45. Management of hemorrhoids include all of the following except:
a.Sitz bath
b.Low residue diet
c.Warm compress
d.Local analgesics
46. Which of the following is accurate about the workup of hemorrhoids
a.Barium enema is routinely indicated for patients with suspected hemorrhoids
b.Histologic examination of hemorrhoidal tissue is routinely indicated
c.Proctoscopy may be used in place of anoscopy in the assessment of internal
hemorrhoids
d.The presence of anemia on laboratory testing should raise suspicion of an
alternate diagnosis to hemorrhoids
47. Pancolitis involves
a.Only the rectum
 b.The entire colon
c.Left side of the colon
d.Right side of the colon
48. Backwash ileitis involves:
a.The distal ileum
b.The proximal ileum
c.The entire ileum
d.The entire rectum
49. The abscess between the internal surface of the perineal skin and the plate of the
levator ani muscle is called
a.Perianal abscess
b.Ischiorectal abscess
c.Intersphincteric abscess
d.Supralevator abscess
50. Cause/causes of anorectal abscess are/is
a.STD
b.Blocked gland in the anal area
c.Trauma
d.All of the above

(Subjective Section)

1. Write down the types of intestinal obstruction (05 Marks)

2. Write down the pre and post operative nursing care for appendicectomy (05 Marks)
3. Write down the risk factors of gallbladder cancer (05 Marks)