[Ex3] - C37 - AP

Question 1

37-1. Digestion begins in the mouth with salivary -amylase (ptyalin) that initiates the digestion of:
a. proteins.
b. carbohydrates.
c. fats.
d. amino acids.

Answer 1

ANS: B
Salivary amylase initiates the digestion of carbohydrates. Protein digestion occurs in the
stomach and is influenced by pepsin. Fat digestion is aided by bile. Amino acids are not
involved in the digestive process.

Question 2

37-2. When parasympathetic nervous system activity is inhibited what is the expected effect on
salivary glands?
a. Hyperactive function
b. Hypoactive function
c. Atrophy
d. Enlargement

Answer 2

ANS: B
Inhibition of the parasympathetic nervous system would result in decreased (hypoactive)
functions of the salivary glands. The individual would experience dry mouth. Inhibition of the
parasympathetic nervous system would not result in hyperactivity, atrophy, or enlargement of
the salivary glands.

Question 3

37-3. Which immunoglobulin is found in normal saliva?
a. IgG
b. IgD
c. IgE
d. IgA

Answer 3

ANS: D
Normal saliva contains IgA. Normal saliva does not contain IgG, IgD, or IgE.

Question 4

37-4. Food is moved down the esophagus via what process?
a. Peristalsis
b. Retropulsion
c. Haustral segmentation
d. Defecation

Answer 4

ANS: A
Swallowed food is moved from the esophagus to the stomach by peristalsis, not retropulsion.
Haustral segmentation occurs in the small intestine. Defecation is the process of eliminating
stool from the rectum.

Question 5

37-5. Which cells of the gastric glands secrete hydrochloric acid?

a. Chief
b. Parietal
c. Zymogenic
d. Surface epithelial

Answer 5

ANS: B
The parietal cells secrete hydrochloric acid. The chief cells secrete pepsinogen. Zymogenic
cells do not secrete acid. Epithelial cells line the GI tract and do not secrete acid.

Question 6

37-6. A young male student becomes very hungry during class. He begins thinking of a
cheeseburger and fries, his favorite meal. These thoughts will trigger which phase of gastric
secretion?
a. Cephalic
b. Gastric
c. Enteral
d. Intestinal

Answer 6

ANS: A
The cephalic phase is stimulated by the thought, smell, and taste of food. The gastric phase is
stimulated by distention of the stomach. The enteral phase is not a phase of gastric secretion.
The intestinal phase is stimulated by histamine and digested protein.

Question 7

37-7. Mucus production to form the mucosal barrier in the stomach is stimulated by the release of:
a. somatostatin.
b. gastrin.
c. prostaglandins.
d. histamine.

Answer 7

ANS: C
Prostaglandins protect the mucosal barrier by stimulating the secretion of mucus and
bicarbonate and by inhibiting secretion of acid. Somatostatin is secreted by the pancreas and is
not involved in secretion of mucus. Gastrin is not involved in mucus secretion. Histamine
initiates secretion of acid, not mucus.

Question 8

37-8. Which sphincter prevents reflux of digested material from the colon into the small intestine?
a. Haustral
b. Lower esophageal
c. Pyloric
d. Ileocecal valve

Answer 8

ANS: D
The ileocecal valve prevents reflux of digested material from the colon into the small
intestine. The haustral segments facilitate propulsion; they do not prevent reflux. Lower
esophageal prevents reflux from the stomach to the esophagus. The pylorus is the opening
between the stomach and the duodenum.

Question 9

37-9. Absorption of nutrients from the intestine occurs initially through the:
a. mesentery.
b. villi.
c. lamina propria.
d. splenic veins.

Answer 9

ANS: B
Villi are small finger-like projections that extend from the small intestinal mucosa and
increase its absorptive surface area. The ileum and jejunum are suspended in loose folds from
the posterior abdominal wall by a peritoneal membrane called the mesentery. The lamina
propria (a connective tissue layer of the mucous membrane) lies beneath the epithelial cells of
the villi and contains lymphocytes and plasma cells, which produce immunoglobulins. The
splenic vein drains the stomach and is not involved in absorption.

Question 10

37-10. Which reflex inhibits gastric motility when the ileum becomes overdistended?
a. Ileogastric
b. Gastroduodenal
c. Gastroileal
d. Gastrocolic

Answer 10

ANS: A
The ileogastric reflex, not the gastroduodenal, inhibits gastric motility when the ileum
becomes distended. The gastroileal reflex, which is activated by an increase in gastric motility
and secretion, stimulates an increase in ileal motility and relaxation of the ileocecal valve
(sphincter). The gastrocolic reflex initiates propulsion in the entire colon, usually during or
immediately after eating, when chyme enters from the ileum.

Question 11

37-11. The vermiform appendix is attached to the:
a. duodenum.
b. ileum.
c. cecum.
d. sigmoid colon.

Answer 11

ANS: C
The vermiform appendix is attached to the cecum. The vermiform appendix is not attached to
the duodenum, the ileum, or the sigmoid.

Question 12

37-12. The ________ sphincter controls the movement of waste from the sigmoid colon into the
rectum?
a. oddi
b. ileocecal
c. O’Beirne
d. internal anal

Answer 12

ANS: C
The O’Beirne sphincter controls the movement of wastes from the sigmoid colon into the
rectum. None of the other options performs this function.

Question 13

37-13. The _____ reflex initiates propulsion in the entire colon, usually during or immediately after
eating.
a. gastrocolic
b. ileocolic
c. duodenocolic
d. cephalocolic

Answer 13

ANS: A

The gastrocolic reflex initiates propulsion in the entire colon. None of the other options
performs this function.

Question 14

37-14. The blood supply of the large intestine is derived from which vessel(s)?
a. Celiac
b. Superior and inferior mesenteric
c. Hepatic and portal
d. Omental

Answer 14

ANS: B
The blood supply of the large intestine and rectum is derived primarily from branches of the
superior and inferior mesenteric arteries. None of the other options performs this function.

Question 15

37-15. The capillaries of the liver are more commonly known as hepatic:
a. canaliculi.
b. ducts.
c. sinusoids.
d. papillae.

Answer 15

ANS: C
Small capillaries, or sinusoids, are located between the plates of hepatocytes of the liver. None
of the other options presents an appropriate term.

Question 16

37-16. Which of the following liver cells are phagocytic?
a. Glisson
b. Kupffer
c. Meissner
d. Lieberkühn

Answer 16

ANS: B
The sinusoids are also lined with phagocytic Kupffer cells and are part of the mononuclear
phagocyte system. The Glisson is the capsule that covers the liver. The Meissner is a part of
the nerve plexus that innervates the liver. The Lieberkühn is a part of the liver’s secretory
cells.

Question 17

37-17. The primary bile salts are synthesized from _______ by hepatocytes lining the bile canaliculi.
a. lecithin
b. fatty acids
c. cholesterol
d. testosterone

Answer 17

ANS: C
Bile acids (salts) are synthesized from cholesterol. The process is not reliant on lecithin, fatty
acids, or testosterone.

Question 18

37-18. In the liver, free bilirubin moves from the plasma in the sinusoids into the hepatocytes, where
it is converted into:
a. unconjugated bilirubin.
b. biliverdin.
c. conjugated bilirubin.
d. urobilinogen.

Answer 18

ANS: C
Within hepatocytes, unconjugated bilirubin joins with glucuronic acid to form conjugated
bilirubin, not unconjugated, which is water soluble and is secreted in the bile. Biliverdin is a
precursor of bilirubin. When conjugated bilirubin reaches the distal ileum and colon, it is
deconjugated by bacteria and converted to urobilinogen.

Question 19

37-19. Which information indicates the nurse understands digestion? During the cephalic and gastric
phases of digestion, gallbladder contraction is mediated by branches of the:
a. sympathetic nervous system.
b. somatic nervous system.
c. vagus nerve.
d. glossopharyngeal nerve.

Answer 19

ANS: C
Gallbladder contraction is mediated by cholinergic branches of the vagus nerve, not the
sympathetic nervous system. Gallbladder contraction is not mediated by the somatic or
glossopharyngeal nerves.

Question 20

37-20. Which sphincter, when it relaxes, allows bile to flow into the duodenum?
a. Pyloric sphincter
b. Sphincter of Oddi
c. Ampulla of Vater
d. Ileocecal valve

Answer 20

ANS: B
When the sphincter of Oddi relaxes, bile flows into the duodenum. The pyloric sphincter
controls flow of fluid from the stomach to the duodenum. Secretions from the pancreas empty
into the common bile duct at the ampulla of Vater. The ileocecal valve prevents reflux of
digested material from the colon into the small intestine.

Question 21

37-21. The exocrine portion of the pancreas contains:
a. alpha cells.
b. beta cells.
c. acinar cells.
d. islets of Langerhans.

Answer 21

ANS: C
The exocrine portion of the pancreas contains acinar cells. It is the endocrine portion that
contains the alpha and beta cells as well as the islets of Langerhans.

Question 22

37-22. The function of the acinar cells of the pancreas is to secrete:
a. bicarbonate.
b. enzymes.
c. mucus.
d. electrolytes.

Answer 22

ANS: B
The exocrine pancreas is composed of acinar cells that secrete enzymes. These cells are not
associated with bicarbonate, mucus, or electrolytes.

Question 23

37-23. Parasympathetic stimulation to the pancreas will cause which of the following reactions?
a. Hormonal inhibition
b. Enzyme secretion
c. Vasoconstriction
d. Decreased bicarbonate production

Answer 23

ANS: B
Pancreatic innervation arises from preganglionic parasympathetic fibers of the vagus nerve.
These fibers activate postganglionic fibers, which stimulate enzymatic and hormonal
secretion. Pancreatic innervations stimulate hormone secretion, not inhibit it. Sympathetic
postganglionic fibers from the celiac and superior mesenteric plexuses innervate the blood
vessels, cause vasoconstriction, and inhibit pancreatic secretion. Parasympathetic stimulation
is not involved in bicarbonate production.

Question 24

37-24. The pancreas produces which substance to prevent the premature activation of proteolytic
enzymes in the pancreas?
a. Bicarbonate
b. Carboxypeptidase
c. Secretin
d. Trypsin inhibitor

Answer 24

ANS: D
The pancreas produces trypsin inhibitor, which prevents the activation of proteolytic enzymes
while they are in the pancreas. Bicarbonate is responsible for neutralizing fluid.
Carboxypeptidase is a protein-digesting enzyme. Secretin is not produced by the pancreas.