WGU D115 OA Study Guide Unit 6 exam questions and answers

What type of fibers stimulate the salivary glands? Cholinergic fibers What part of the esophagus is innervated by nerve fibers? The lower third What artery provides blood to the stomach? Celiac artery What hormone is responsible for the inhibition of stomach contraction? Secretin Gastrin increases stomach contraction (aids in motility) and produces acid in the antrum, duodenum, and pancreas by G-cells Which cells of the stomach secrete hydrochloric acid and intrinsic factor? Parietal cells Pernicious anemia* (Vitamin B12 deficiency) Which enzyme is responsible for cleaving fatty acids from phospholipids? Phospholipase Which enzyme is responsible for breaking the end amino acids away from the ingested protein? Carboxypeptidase What is true of unconjugated bilirubin? Unconjugated bilirubin is bilirubin bound to albumin. Also called "free bilirubin" Define pepsin Produced in the stomach and breaks down proteins Think P and P Define Lipase Produced by the pancreas and breaks down triglycerides Define amylase Produced in the mouth and breaks down starch "Amy eats a starchy meal" What are 3 characteristics of celiac disease? Anemia Diminished growth Deficiences in fat-soluble vitamins Is pyloric stenosis more common in male or female infants ? Males A 74-year-old male complains of rectal bleeding for the past year. He has not change in bowel habits and denies abdominal pain, weight loss, and rectal pain. He has seen blood in the toilet water and when wiping approximately once every few weeks, but lately the bleeding has increased. He had colonoscopy 5 year ago. The FNP should: Schedule a colonoscopy to look for colon polyps and/or cancer An overweigh, middle-aged woman has right upper quadrant pain that radiates to her right subscapular area and is severe and persistent. She is also experiencing anorexia, nausea, and a fever. Her most recent meal was a double quarter-pound cheeseburger, French fries, and a milkshake. The FNP examines the abdomen and percusses for CVA tenderness. the abdomen is tender in the RUQ. Which of the following signs corresponds with the correct diagnosis? Murphy's sign: the patient has cholecystitis McBurney's sign is related to appendicitis CVA tenderness is related to UTIs A sudden onset of diarrhea that consists of five to six loose stools a day and awakens the pt at night with cramping, but without blood in the stools, would most likely be caused by what? Infection Clues for infection are awakening at night, cramping without blood, sudden onset Those S/S are either infection or inflammation The FNP is discussion Clostridium difficile infection with the family of a 68-year-old female who lives with them and who was recently diagnosed with the infection. Which of the following statements would be the most important for the family to understand? Pt needs to use a different bathroom than the rest of the family Contact isolation An older woman is noted to have iron-deficiency anemia. She has no pain or rectal bleeding. What hx would raise suspicion of a gastric ulcer? An ankle sprain requiring 800mg of ibuprofen 3 times a day for the last 6 weeks NSAIDs have a high risk of causing ulcers and erosion - there may be no s/s until anemia develops Which problem would MOST likely worsen the s/s of gerd? Gastroparesis which is delayed gastric emptying A 54 year-old female complains fo intermittent crampy abdominal pain over the last 18 hours, loss of appetite, vomiting, abdominal bloating, and inability to have a bowel movement. She has a history of hysterectomy 20 years ago, cholecystectomy 5 years ago, and tow laparoscopies for abdominal pain over the last 4 years. The FNP send her to the ER because she suspects: SBO hx of having multiple abd surgeries increases adhesions which can cause a small bowel obstruction Non-pharmacologic management of GERD includes which of the following? Weight reduction Sleep with HOB elevated Avoid heavy meals What is an organism associated with the etiology of PUD? H. Pylori Responsible for most duodenal and gastric ulcers A 65-year-old male presents to the FNP for evaluation of years of "heartburn" and recent weight loss of 30lbs over the last month. He has been taking antacids and an oral histamine 2 receptor antagonist for years "off and on". He has a 60 pack per year smoking history and drinks alcohol daily. What differential diagnoses should the FNP consider? Esophageal cancer Long-term GERD without tx increases risk for barret esophagus and cancer Rapid weight loss is concerning Which is true of PUD in pts over the age of 65? Weight loss and anorexia are often the only symptoms A pt compains of melena-black, tarry stools. the FNP knows that this... May likely be bleeding from the esophagus or stomach Tarry stools is usually a bleed from the upper GI track Bright red bleeds usually from lower GI track A 21-year-old white college female complains of fatigue, RLQ pain, and diarrhea for the last 2 months. She has lost 10lbs and notes chills periodically. She denies rectal bleeding. She notes she is stressed about final exam. The FNP would be most concerned about: Chron disease Most commonly in the small intestine Peak age of onset is 15-25 years old with females and whites most affected Differences between IBS, ulcerative colitis, and crohns disease IBS: Irritable bowel syndrome -No specific structural or biochemical alterations UC: Ulcerative colitis: -Ulceration of mucosa -Sigmoid colon and rectum -Lesions are continuous with NO SKIPPING, limited to the mucosa, NOT transmural, normally age 20-40 -S/S: watery diarrhea, bloody stools, cramps, pain, urge to defecate, remission and exacerbations Antineutrophil cytoplasmic antibody Crohns: Inflammatory, affects ANY part of the digestive tract; mouth to anus -SKIPPED LESIONS -NonCaseating granulomas which causes "cobblestone appearance" -Entire intestinal wall (transmural inflammation) _S/S: rectal bleeding and diarrhea are most common Antisaccaromyces cerevisiae antibody A pt is more likely to have had a recent strep infection with what type of kidney syndrome? Nephritic syndrome HTN +ASO Decreased GFR What is the definition of a struvite stone? Grow large and branch into a staghorn configuration Associated with UTIs More common in woman than men What does stomach acid do? Converts pepsinogen into pepsin Acts as a bactericide Dissolves food fibers What is true of colorectal cancer? Most arise from adenomatous polyps In the distal tubule, which cells reabsorb sodium and water, as well as secrete potassium? Principal cells Which muscle lies between the two openings of the ureter and urethra? Trigone A pt has a posterior pituitary tumor that is producing excess ADH. The blood volume and BP are elevated. What other increased hormonal release would be expected? Atrial natriuretic peptide