TEST BANK FOR PORTH’S PATHOPHYSIOLOGY 10TH EDITION BY NORRIS CHAPTER 37: Disorders of Gastrointestinal Function

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1. A teenager who has a history of achalasia will likely complain of which of the following clinical manifestations? A) Excessive heartburn following a high-fat meal of French fries B) Feeling like ... there is food stuck in the back of the throat C) Projectile vomiting across the room unrelated to meals D) Vomiting large amounts of bright red emesis Ans: B Feedback: Achalasia produces functional obstruction of the esophagus so that food has difficulty passing into the stomach, and the esophagus above the lower esophageal sphincter becomes distended. Symptoms following high-fat intake is usually associated with gallbladder disease. Projectile vomiting is usually related to increased intracranial pressure. Vomiting blood can be associated with esophagitis, erosion of the esophagus, bleeding esophageal varices, or esophageal cancer. 2. A client has had severe heart burn associated with persistent gastroesophageal reflux for many years. Which of the following statements made by the client leads the nurse to suspect the client is having a complication related to his reflux? The client is having: A) Difficulty in swallowing with feelings that food is “stuck” in the throat B) Burning sensation a half-hour after a meal C) Substernal chest pain that radiates to the shoulder and arm D) “Hoarseness” unrelieved by coughing or taking a drink of water Ans: A Feedback: Complications can result from persistent reflux, which produces a cycle of mucosal damage that causes hyperemia, edema, and erosion of the luminal surface. Strictures are caused by a combination of scar tissue, spasm, and edema, which narrow the esophagus. The most frequent symptom of gastroesophageal reflux is heartburn. Other symptoms include belching, wheezing, chronic cough, hoarseness, and epigastric or retrosternal area chest pain, radiating to the throat, shoulder, or back. Because of its location, the pain may be confused with angina. 3. Which of the following signs and symptoms most clearly suggests the need for endoscopy to rule out esophageal cancer? A) Heartburn after an individual consumes high-fat meals B) Dysphagia in an individual with no history of neurologic disease C) A new onset of gastroesophageal reflux in a previously healthy individual D) Recurrent episodes of gastritis that do not respond to changes in diet Ans: B Feedback: Dysphagia is by far the most frequent complaint of persons with esophageal cancer. It is apparent first with ingestion of bulky food, later with soft food, and finally with liquids. Heartburn, reflux, and gastritis are not health problems that are closely associated with the development of esophageal cancer. 4. Acute gastritis refers to a transient inflammation of the gastric mucosa that is most commonly associated with: A) Diarrhea B) Food allergies C) Gastric reflux D) Alcohol intake Ans: D Feedback: Acute gastritis refers to a transient inflammation of the gastric mucosa that is most commonly associated with local irritants such as bacterial endotoxins, alcohol, or aspirin. Gastritis associated with excessive alcohol consumption often causes transient gastric distress, which may lead to vomiting, bleeding, and hematemesis. Allergic response to ingested substances may cause acute itching, rash, vomiting, or diarrhea. Gastric reflux causes esophageal inflammation rather than gastritis. [Show More]

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