Chapter 23. Liver and Pancreas
1. 1. What is being assessed when auscultating the gastrointestinal
system?
1. 1. Changes in the abdominal appearance
2. 2. Presence or absence of bowel sounds
3. 3. Distension as well as spleen and liver size
4. 4. Presence of a hernia
ANS: 2
Feedback
1.A visual inspection is done or this.
2.Auscultation allows the examiner to assess the bowel sounds and
assess for any changes that may occur in the bowel sounds due to a GI
problem.
3.Palpation assesses the distension and size.
4.Presence of a hernia is detected with palpation and a visual inspection.
2. Which of the following symptoms may be found in Celiac
Disease?
1. 1. Abdominal pain with bloating
2. 2. Weight gain with very skinny extremities
3. 3. Small, hard stools
4. 4. Normal growth
ANS: 1
Feedback
1.The most common complaint of celiac patients is abdominal bloating
that is usually painful.
2.Patients with this disorder usually appear skinny with thin extremities.
3.Patients with this disorder tend to have diarrhea and foul
smelling stools.
4.This can affect growth because of villi damage due to
gluten intolerance.
, 1. 3. When teaching the family about a gluten-free diet, what are the recommendations
for the family about diet?
1. 1. Many gluten-free products are available, so it is important to read labels.
2. 2. Participation in a support group may help with identifying stores that
carry gluten-free food.
3. 3. Communion wafers contain gluten and may need to be avoided.
4. 4. All of the above.
ANS: 4
Feedback
1.Reading labels will help identify food that can cause difficulty, as well
as make the family aware of foods that the child will not tolerate.
2.Support groups are excellent resources for information about gluten-free
foods and stores in the area that carry these products.
3.Speaking with the clergy may be important due to the gluten in
communion wafers.
4.All are important factors for teaching about a gluten-free diet.
4. Appendicitis may have abdominal pain as a symptom. Where does the abdominal pain
occur?
1. 1. Left upper quadrant
2. 2. Right lower quadrant
3. 3. Periumbilical
4. 4. 2 and 3 only
ANS: 4
Feedback
1.Pain usually is not in the upper left quadrant.
2.Advances to the right lower quadrant
3.Begins in the periumbilical area
4.Pain usually is not in the upper left quadrant. It begins in the
periumbilical area.
5. The most commonly used measure to diagnose obesity is:
1. 1. Body mass index.
2. 2. Ultrasound.
, 3. 3. Weight measurement.
4. 4. Cholesterol measurement.
ANS: 4
Feedback
1.Body mass index is the most commonly used measurement for
diagnosing obesity. The CDC web site allows for the computation
of body mass index for children and adults.
2.Ultrasounds do not assess obesity.
3.Weight measurements may be part of the diagnosis, but are not as
definitive as the body mass index.
4.Cholesterol measurements may be part of the diagnosis, but are not as
definitive as the body mass index.
1. 6. Gallstones are occurring more often in children. Which of the following is not
a treatment for children with gallstones?
1. 1. Surgery is always the treatment for gallstones.
2. 2. Infants do not need treatment.
3. 3. Crohns patients may have an ERCP, only without surgery.
4. 4. Laser lithotripsy may be an effective option.
ANS: 1
Feedback
1.Surgery is not the only treatment for gallstones.
2.Infants usually resolve gallstones on their own.
3.Children with Crohns disease need a functioning gallbladder, and an
ERCP may help them retain the gallbladder while removing the stones.
4.Laser lithotripsy has been found to be an effective treatment and
is being used in children as an alternative treatment.
1. 7. The first symptom in an infant of the gastrointestinal manifestation of cystic fibrosis
is:
1. 1. Constipation.
2. 2. Meconium ileus.
3. 3. Rapid weight gain.
4. 4. Inability to breastfeed.
, ANS: 2
Feedback
1.Newborns with cystic fibrosis fail to pass meconium in the first
48 hours.
2.Newborns with cystic fibrosis fail to pass meconium in the first 48
hours and develop meconium ileus. That may be followed by diarrhea
and
poor weight gain.
3.Rapid weight loss may occur due to diarrhea and poor weight gain.
4.Mothers of children with cystic fibrosis are encouraged to
breastfeed because children with cystic fibrosis can breastfeed.
1. 8. Treatment for a child with cystic fibrosis with gastrointestinal symptoms may
include:
1. 1. Pancreatic enzymes.
2. 2. Fat-soluble vitamins.
3. 3. No immunizations.
4. 4. 1 and 2.
ANS: 4
Feedback
1.A child with cystic fibrosis will require replacement
pancreatic enzymes.
2.A child with cystic fibrosis will require fat-soluble vitamins for
proper growth and nutrition.
3.Regular immunizations are recommended.
4.More than one answer applies.
1. 9. Symptoms of Biliary Atresia would include which of the following?
1. 1. Prolonged jaundice (appearing for longer than two weeks)
2. 2. Elevated direct bilirubin (greater than 20 percent of the total
bilirubin measurement)
3. 3. Very dark stools
4. 4. 1 and 2
ANS: 4
Feedback
1.Biliary Atresia causes prolonged jaundice, lasting well past two weeks.
1. 1. What is being assessed when auscultating the gastrointestinal
system?
1. 1. Changes in the abdominal appearance
2. 2. Presence or absence of bowel sounds
3. 3. Distension as well as spleen and liver size
4. 4. Presence of a hernia
ANS: 2
Feedback
1.A visual inspection is done or this.
2.Auscultation allows the examiner to assess the bowel sounds and
assess for any changes that may occur in the bowel sounds due to a GI
problem.
3.Palpation assesses the distension and size.
4.Presence of a hernia is detected with palpation and a visual inspection.
2. Which of the following symptoms may be found in Celiac
Disease?
1. 1. Abdominal pain with bloating
2. 2. Weight gain with very skinny extremities
3. 3. Small, hard stools
4. 4. Normal growth
ANS: 1
Feedback
1.The most common complaint of celiac patients is abdominal bloating
that is usually painful.
2.Patients with this disorder usually appear skinny with thin extremities.
3.Patients with this disorder tend to have diarrhea and foul
smelling stools.
4.This can affect growth because of villi damage due to
gluten intolerance.
, 1. 3. When teaching the family about a gluten-free diet, what are the recommendations
for the family about diet?
1. 1. Many gluten-free products are available, so it is important to read labels.
2. 2. Participation in a support group may help with identifying stores that
carry gluten-free food.
3. 3. Communion wafers contain gluten and may need to be avoided.
4. 4. All of the above.
ANS: 4
Feedback
1.Reading labels will help identify food that can cause difficulty, as well
as make the family aware of foods that the child will not tolerate.
2.Support groups are excellent resources for information about gluten-free
foods and stores in the area that carry these products.
3.Speaking with the clergy may be important due to the gluten in
communion wafers.
4.All are important factors for teaching about a gluten-free diet.
4. Appendicitis may have abdominal pain as a symptom. Where does the abdominal pain
occur?
1. 1. Left upper quadrant
2. 2. Right lower quadrant
3. 3. Periumbilical
4. 4. 2 and 3 only
ANS: 4
Feedback
1.Pain usually is not in the upper left quadrant.
2.Advances to the right lower quadrant
3.Begins in the periumbilical area
4.Pain usually is not in the upper left quadrant. It begins in the
periumbilical area.
5. The most commonly used measure to diagnose obesity is:
1. 1. Body mass index.
2. 2. Ultrasound.
, 3. 3. Weight measurement.
4. 4. Cholesterol measurement.
ANS: 4
Feedback
1.Body mass index is the most commonly used measurement for
diagnosing obesity. The CDC web site allows for the computation
of body mass index for children and adults.
2.Ultrasounds do not assess obesity.
3.Weight measurements may be part of the diagnosis, but are not as
definitive as the body mass index.
4.Cholesterol measurements may be part of the diagnosis, but are not as
definitive as the body mass index.
1. 6. Gallstones are occurring more often in children. Which of the following is not
a treatment for children with gallstones?
1. 1. Surgery is always the treatment for gallstones.
2. 2. Infants do not need treatment.
3. 3. Crohns patients may have an ERCP, only without surgery.
4. 4. Laser lithotripsy may be an effective option.
ANS: 1
Feedback
1.Surgery is not the only treatment for gallstones.
2.Infants usually resolve gallstones on their own.
3.Children with Crohns disease need a functioning gallbladder, and an
ERCP may help them retain the gallbladder while removing the stones.
4.Laser lithotripsy has been found to be an effective treatment and
is being used in children as an alternative treatment.
1. 7. The first symptom in an infant of the gastrointestinal manifestation of cystic fibrosis
is:
1. 1. Constipation.
2. 2. Meconium ileus.
3. 3. Rapid weight gain.
4. 4. Inability to breastfeed.
, ANS: 2
Feedback
1.Newborns with cystic fibrosis fail to pass meconium in the first
48 hours.
2.Newborns with cystic fibrosis fail to pass meconium in the first 48
hours and develop meconium ileus. That may be followed by diarrhea
and
poor weight gain.
3.Rapid weight loss may occur due to diarrhea and poor weight gain.
4.Mothers of children with cystic fibrosis are encouraged to
breastfeed because children with cystic fibrosis can breastfeed.
1. 8. Treatment for a child with cystic fibrosis with gastrointestinal symptoms may
include:
1. 1. Pancreatic enzymes.
2. 2. Fat-soluble vitamins.
3. 3. No immunizations.
4. 4. 1 and 2.
ANS: 4
Feedback
1.A child with cystic fibrosis will require replacement
pancreatic enzymes.
2.A child with cystic fibrosis will require fat-soluble vitamins for
proper growth and nutrition.
3.Regular immunizations are recommended.
4.More than one answer applies.
1. 9. Symptoms of Biliary Atresia would include which of the following?
1. 1. Prolonged jaundice (appearing for longer than two weeks)
2. 2. Elevated direct bilirubin (greater than 20 percent of the total
bilirubin measurement)
3. 3. Very dark stools
4. 4. 1 and 2
ANS: 4
Feedback
1.Biliary Atresia causes prolonged jaundice, lasting well past two weeks.
