NBCE Part 3 Exam & Study Guide –
300 Questions with Detailed Verified
Answers and Rationales (100%
Correct, A+ Graded)
Which disorder is characterized by damage to the mucosa of
the duodenum and jejunum and impaired secretion of
secretin, cholecystokinin, and pancreatic enzymes?
a. Wilson disease
b. Cystic fibrosis
c. Gluten/sensitive enteropathy
d. Galactosemia - ....ANSWER...c. Gluten/sensitive
enteropathy
EXPLANATION: Gluten/sensitive enteropathy is
characterized by damage to the mucosa of the duodenum
and jejunum and has secondary effects that exacerbate
malabsorption. The secretion of intestinal hormones, such as
secretin and cholecystokinin, may be diminished. Because
these chemical messengers are scarce, secretion of
pancreatic enzymes and expulsion of bile from the
gallbladder decrease. These statements are not true of the
other options. page 1495
What factor associated with gluten/sensitive enteropathy
(celiac sprue) causes an infant to bruise and bleed easily?
,a. Vitamin K deficiency from fat malabsorption
b. Bone marrow function depression
c. Iron, folate, and B12 deficiency anemias
d. Prescribed daily warfarin ;Coumadin - ....ANSWER...a.
Vitamin K deficiency from fat malabsorption
Explanation: Deficiencies of fat/soluble vitamins (such as
vitamin K) are common in children with gluten/sensitive
enteropathy. Vitamin K malabsorption leads to
hypoprothrombinemia, causing the child to bruise and bleed
easily. This selection is the only option that accurately
describes the mechanism that causes bruising and bleeding
in children diagnosed with celiac sprue. page 1497
In an infant who is 6 weeks old, an increase in bilirubin
production and persistent jaundice support which diagnosis?
a. Pathologic hyperbilirubinemia
b. Physiologic Jaundice
c. Hepatitis A
d. Infantile cirrhosis - ....ANSWER...a. Pathologic
hyperbilirubinemia
Explanation: Physiologic jaundice develops during the
second or third day after birth and usually subsides in 1 to 2
weeks in full/term infants and in 2 to 4 weeks in premature
infants. After this development, increased bilirubin values
and persistent jaundice indicate pathologic
hyperbilirubinemia. This selection is the only option that
accurately identifies the diagnosis associated with these
,symptoms and timeline. page 1500 - 1501
Physiologic jaundice in a newborn is caused by:
a. Reabsorption of bilirubin in the small intestine
b. Impaired hepatic uptake and excretion of bilirubin
c. Increased bilirubin production
d. Mild conjugated (indirect-reacting) hyperbilirubinemia -
....ANSWER...d. Mild conjugated (indirect-reacting)
hyperbilirubinemia
In children, the risk factors for hepatitis B virus (HBV) are
primarily associated with:
a. Living in urban communities
b. Mothers who are hepatitis C carriers
c. Transfusion therapy for hemophilia
d. Those of hispanic ethnic background - ....ANSWER...c.
Transfusion therapy for hemophilia
Explanation: Risk factors for HBV infection include infants
of mothers who are carriers of chronic hepatitis B surface
antigen (HBsAg), hemophiliacs who receive frequent blood
transfusions, children who abuse parenteral drugs, and
children who live in residences for those who are mentally
delayed. HBV is endemic in China and other parts of Asia
where most infections occur in infants and children as a
result of maternal/neonatal
transmission. page 1502
, Cystic fibrosis is directly responsible for complications to
which structures? (Select all that apply.)
a. Muscles
b. Kidneys
c. Lymph nodes
d. Cervix
e. Liver - ....ANSWER...d. Cervix
e. Liver
Explanation: Of the options available, only cervical
inflammation and portal hypertension (liver) are
complications directly related to cystic fibrosis. page 1495
Table 42-1
What type of fracture occurs at a site of a preexisting bone
abnormality and is a result of a force that would not
normally cause a fracture?
a. Idiopathic
b. Incomplete
c. Pathologic
d. Greenstick - ....ANSWER...c. Pathologic
300 Questions with Detailed Verified
Answers and Rationales (100%
Correct, A+ Graded)
Which disorder is characterized by damage to the mucosa of
the duodenum and jejunum and impaired secretion of
secretin, cholecystokinin, and pancreatic enzymes?
a. Wilson disease
b. Cystic fibrosis
c. Gluten/sensitive enteropathy
d. Galactosemia - ....ANSWER...c. Gluten/sensitive
enteropathy
EXPLANATION: Gluten/sensitive enteropathy is
characterized by damage to the mucosa of the duodenum
and jejunum and has secondary effects that exacerbate
malabsorption. The secretion of intestinal hormones, such as
secretin and cholecystokinin, may be diminished. Because
these chemical messengers are scarce, secretion of
pancreatic enzymes and expulsion of bile from the
gallbladder decrease. These statements are not true of the
other options. page 1495
What factor associated with gluten/sensitive enteropathy
(celiac sprue) causes an infant to bruise and bleed easily?
,a. Vitamin K deficiency from fat malabsorption
b. Bone marrow function depression
c. Iron, folate, and B12 deficiency anemias
d. Prescribed daily warfarin ;Coumadin - ....ANSWER...a.
Vitamin K deficiency from fat malabsorption
Explanation: Deficiencies of fat/soluble vitamins (such as
vitamin K) are common in children with gluten/sensitive
enteropathy. Vitamin K malabsorption leads to
hypoprothrombinemia, causing the child to bruise and bleed
easily. This selection is the only option that accurately
describes the mechanism that causes bruising and bleeding
in children diagnosed with celiac sprue. page 1497
In an infant who is 6 weeks old, an increase in bilirubin
production and persistent jaundice support which diagnosis?
a. Pathologic hyperbilirubinemia
b. Physiologic Jaundice
c. Hepatitis A
d. Infantile cirrhosis - ....ANSWER...a. Pathologic
hyperbilirubinemia
Explanation: Physiologic jaundice develops during the
second or third day after birth and usually subsides in 1 to 2
weeks in full/term infants and in 2 to 4 weeks in premature
infants. After this development, increased bilirubin values
and persistent jaundice indicate pathologic
hyperbilirubinemia. This selection is the only option that
accurately identifies the diagnosis associated with these
,symptoms and timeline. page 1500 - 1501
Physiologic jaundice in a newborn is caused by:
a. Reabsorption of bilirubin in the small intestine
b. Impaired hepatic uptake and excretion of bilirubin
c. Increased bilirubin production
d. Mild conjugated (indirect-reacting) hyperbilirubinemia -
....ANSWER...d. Mild conjugated (indirect-reacting)
hyperbilirubinemia
In children, the risk factors for hepatitis B virus (HBV) are
primarily associated with:
a. Living in urban communities
b. Mothers who are hepatitis C carriers
c. Transfusion therapy for hemophilia
d. Those of hispanic ethnic background - ....ANSWER...c.
Transfusion therapy for hemophilia
Explanation: Risk factors for HBV infection include infants
of mothers who are carriers of chronic hepatitis B surface
antigen (HBsAg), hemophiliacs who receive frequent blood
transfusions, children who abuse parenteral drugs, and
children who live in residences for those who are mentally
delayed. HBV is endemic in China and other parts of Asia
where most infections occur in infants and children as a
result of maternal/neonatal
transmission. page 1502
, Cystic fibrosis is directly responsible for complications to
which structures? (Select all that apply.)
a. Muscles
b. Kidneys
c. Lymph nodes
d. Cervix
e. Liver - ....ANSWER...d. Cervix
e. Liver
Explanation: Of the options available, only cervical
inflammation and portal hypertension (liver) are
complications directly related to cystic fibrosis. page 1495
Table 42-1
What type of fracture occurs at a site of a preexisting bone
abnormality and is a result of a force that would not
normally cause a fracture?
a. Idiopathic
b. Incomplete
c. Pathologic
d. Greenstick - ....ANSWER...c. Pathologic
