UNIVERSITY OF ALABAMA NUR 529
EXAM 3 FULL EXAM BLUEPRINT WITH
VERIFIED ANSWERS
The University of Alabama
NUR 529 Exam 3 Blueprint
Unit 11. Disorders of GI Function. Chapters 36-39. There are 10 questions from this unit.
1. Chapter 36. Intestinal flora, roles. Essential vitamins in clotting, what are they and how
are they made? Pg. 1067.
• Functions of the intestinal flora is:
o Metabolic activities that salvage energy & absorbable nutrients
o Trophic effects on intestinal epithelial cells
o Protection of the colonized host against invasion by pathogenic organisms
• Major metabolic function of colonic microflora is the fermentation of undigestible
dietary residue & endogenous mucus produced by the epithelial cells.
• Fermentation of carbohydrates, including resistant starches, cellulose, pectins,
unabsorbed sugars, is a major energy source in the colon
• Colonic microorganisms help with vitamin synthesis and absorption of calcium,
magnesium, and iron
o Colonic flora synthesizes vitamin K (essential for clotting & wound healing),
after first week of life
• Resident gut flora provides resistance to colonization by exogenous
microbes/pathogens
o Antibiotics can disrupt the microbial balance and allow overgrowth of species
with pathogenicity (i.e. C.diff)
• Probiotics (lactobacilli, bifidobacterial, escheria coli) can modify the composition of
enteral microflora & can help maintain remission in ulcerative colitis
,2. Chapter 37. Disorders of Gastrointestinal Function. Alterations in intestinal absorption.
Celiac disease. What are the dietary recommendations for celiac disease? Pg. 1107.
(note: I am not expecting you to learn Table 37.2 but I do recommend printing this table and
putting it in your notebook/clipboard for clinicals).
• Celiac disease (gluten-sensitive enteropathy) – immune-mediated disorder (T-cell)
triggered by ingestion of gluten containing grains (most common genetic diseases
today 1-6%)
o Inflammation reaction that results in the loss of absorptive villi from the
intestine impaired absorption of macronutrients (proteins, carbs, fats) and
micronutrients (vitamins, minerals)
o Exposure to gluten is most prominent in the proximal part of small intestine
o Dx is based on clinical manifestations (S&S), serologic tests, intestinal small
bowel biopsy, IgA antihuman tissue transgluaminase (TTG) and IgA
endomysial antibody immunofluorescence (EMA), common to get iron
deficiency anemia (IDA) if positive
o Dietary recommendations are complete elimination of gluten. Meats,
vegetables, fruits, and dairy are safe options provided they are not
contaminated during processing
3. Chapter 37. Disorders of the Stomach. Gastric mucosal layers. Which medications affect the
mucosal layer? Which ones increase the risk for GI bleeding? Pg. 1083.
• NSAIDS, ASA, and infections with H. Pylori cause gastric irritation
4. Chapter 38. Disorders of Hepatobiliary and Exocrine Pancreas Function. Bilirubin
elimination and jaundice. How do we get rid of bilirubin? Pg. 1122.
, •
Bilirubin jtis jtthe jtfinal jtproduct jtof jtthe jtbreakdown jtof jtheme jtcontained jtin jtaged jtRBCs
jtand jtit jtgives jtbile jtits jtcolor.
• free jtbilirubin jtis jttransported jtthrough jtblood jtattached jtto jtplasma jtalbumin jtuntil jtit
jtreaches jtthe jtliver jtwhere jt it jtis jtmade jtinto jtconjugated jtbilirubin jtand jtbecomes jtsoluble
jtin jtbile jtand jtthus jtsecreted jtas jta jtconstituent jtof jtbile jtwhich jtenables jtit jtto jtbass jtthrough
jtthe jtbile jtducts
into jtthe jtsmall jtintestine. jtIn jtthe jtinteresting jt~50% jtof jtbilirubin jtbecome jturobilinogen
jtby jtthe jtintestinal jtflora jtand jtis jtexcreted jtin jtthe jtfeces
• normal jt<1.5 jtmg/dL
5. Chapter jt38. jtDisorders jtof jtHepatobiliary jtand jtExocrine jtPancreas jtFunction. jtBile jtproduction jtand
cholestasis. jtHow jtdoes jtthe jtbody jtbreak jtdown jtand jtdigest jtfat? jtPg. jt1122.
• The jtsecretion jtof jtbile jtis jtnecessary jtfor jtdigestion jt& jtabsorption jtof jtdietary jtfats jtand
jtfat jtsoluble jtvitamins.
• Bile jtsalts jt(formed jtfrom jtcholesterol) jtare jtimportant jtin jtdigestion;
o they jthelp jtemulsify jtdietary jtfats
o they’re jtnecessary jtfor jtthe jtformation jtof jtthe jtmicelles jtthat jttransport jtfatty
jtacids jtand jtfat-soluble jtvitamins jtto jtthe jtsurface jtof jtthe jtintestinal jtmucosa jtfor
jtabsorption
6. Chapter jt38. jtDisorders jtof jtHepatobiliary jtand jtExocrine jtPancreas jtFunction. jtBile jtproduction
jtand jtcholestasis. jtWhat jtis jtthe jtfunction/role jtof jtbile? jtPg. jt1122.
• Bile jtis jta jtfluid jtmade jtby jtthe jtliver, jtstored jtin jtthe jtgallbladder jtand jthelps jtwith jtdigestion
jtby jtbreaking jtdown jtfats jtinto jtfatty jtacids jtso jtthey jtcan jtbe jtabsorbed jtby jtthe jtbody
jtthrough jtthe jtdigestive jttract
• Bile jtcontains jtwater, jtbile jtsalts, jtbilirubin, jtcholesterol, jtand jtcertain jtby-products
jtof jtmetabolism
7. Chapter jt38. jtDisorders jtof jtHepatobiliary jtand jtExocrine jtPancreas jtFunction. jtPage jt1127-
1130. jtCompare jtand jtcontrast jtthe jttransmission jtof jthepatitis jtA, jtB, jtand jtC.
• Hepatitis jtA jt(HAV) jt- jtfecal-oral jtroute, jtdrinking jtcontaminated jtmilk jtor jtwater
jtor jtshellfish jtfrom jtdirty jt water jtcan jtalso jtbe jtcommon
o 14-28 jtdays jtincubation, jtHAV jtreplicates jtin jtthe jtliver, jtexcreted jtin jtbild, jtshed
jtin jtfeces
o young jtkids jtare jtasymptomatic jt(epidemics jthappen jtwith jtkids; jtpoor
jtpotty jttraining)
• Hep jtB jt(HBV) jt– jtinfected jtblood jt(needle-stick) jtor jtserum jt(sexual), jtmore jtserious,
jtlonger jtincubation
• Hep jtC jt(HCV) jt– jtcontaminated jtblood jttransfusions/products jt(rare jtin jtthe jtUS)
8. Chapter jt39. jtAlterations jtin jtNutritional jtStatus. jtMalnutrition jtand jtStarvation. jtWhat
jtdiagnostic jtlabs jtsupport jta jtmalnutrition jtdiagnosis? jtPg. jt1167.
• Albumin jt(20 jtday jthalf-life), jtPrealbumin jt(shorter jthalf-life), jtevaluation jtof jtintake,
anthropometric jtmeasurements jt(BMI)
9. Chapter jt39. jtAlterations jtin jtNutritional jtStatus. j t Energy jtstorage. jtAdipose jttissue jtis jtan
jtendocrine jtorgan jtand jtcontrols jtappetite, jthow jtdoes jtit jtdo jtthis? jtPg. jt1155.
EXAM 3 FULL EXAM BLUEPRINT WITH
VERIFIED ANSWERS
The University of Alabama
NUR 529 Exam 3 Blueprint
Unit 11. Disorders of GI Function. Chapters 36-39. There are 10 questions from this unit.
1. Chapter 36. Intestinal flora, roles. Essential vitamins in clotting, what are they and how
are they made? Pg. 1067.
• Functions of the intestinal flora is:
o Metabolic activities that salvage energy & absorbable nutrients
o Trophic effects on intestinal epithelial cells
o Protection of the colonized host against invasion by pathogenic organisms
• Major metabolic function of colonic microflora is the fermentation of undigestible
dietary residue & endogenous mucus produced by the epithelial cells.
• Fermentation of carbohydrates, including resistant starches, cellulose, pectins,
unabsorbed sugars, is a major energy source in the colon
• Colonic microorganisms help with vitamin synthesis and absorption of calcium,
magnesium, and iron
o Colonic flora synthesizes vitamin K (essential for clotting & wound healing),
after first week of life
• Resident gut flora provides resistance to colonization by exogenous
microbes/pathogens
o Antibiotics can disrupt the microbial balance and allow overgrowth of species
with pathogenicity (i.e. C.diff)
• Probiotics (lactobacilli, bifidobacterial, escheria coli) can modify the composition of
enteral microflora & can help maintain remission in ulcerative colitis
,2. Chapter 37. Disorders of Gastrointestinal Function. Alterations in intestinal absorption.
Celiac disease. What are the dietary recommendations for celiac disease? Pg. 1107.
(note: I am not expecting you to learn Table 37.2 but I do recommend printing this table and
putting it in your notebook/clipboard for clinicals).
• Celiac disease (gluten-sensitive enteropathy) – immune-mediated disorder (T-cell)
triggered by ingestion of gluten containing grains (most common genetic diseases
today 1-6%)
o Inflammation reaction that results in the loss of absorptive villi from the
intestine impaired absorption of macronutrients (proteins, carbs, fats) and
micronutrients (vitamins, minerals)
o Exposure to gluten is most prominent in the proximal part of small intestine
o Dx is based on clinical manifestations (S&S), serologic tests, intestinal small
bowel biopsy, IgA antihuman tissue transgluaminase (TTG) and IgA
endomysial antibody immunofluorescence (EMA), common to get iron
deficiency anemia (IDA) if positive
o Dietary recommendations are complete elimination of gluten. Meats,
vegetables, fruits, and dairy are safe options provided they are not
contaminated during processing
3. Chapter 37. Disorders of the Stomach. Gastric mucosal layers. Which medications affect the
mucosal layer? Which ones increase the risk for GI bleeding? Pg. 1083.
• NSAIDS, ASA, and infections with H. Pylori cause gastric irritation
4. Chapter 38. Disorders of Hepatobiliary and Exocrine Pancreas Function. Bilirubin
elimination and jaundice. How do we get rid of bilirubin? Pg. 1122.
, •
Bilirubin jtis jtthe jtfinal jtproduct jtof jtthe jtbreakdown jtof jtheme jtcontained jtin jtaged jtRBCs
jtand jtit jtgives jtbile jtits jtcolor.
• free jtbilirubin jtis jttransported jtthrough jtblood jtattached jtto jtplasma jtalbumin jtuntil jtit
jtreaches jtthe jtliver jtwhere jt it jtis jtmade jtinto jtconjugated jtbilirubin jtand jtbecomes jtsoluble
jtin jtbile jtand jtthus jtsecreted jtas jta jtconstituent jtof jtbile jtwhich jtenables jtit jtto jtbass jtthrough
jtthe jtbile jtducts
into jtthe jtsmall jtintestine. jtIn jtthe jtinteresting jt~50% jtof jtbilirubin jtbecome jturobilinogen
jtby jtthe jtintestinal jtflora jtand jtis jtexcreted jtin jtthe jtfeces
• normal jt<1.5 jtmg/dL
5. Chapter jt38. jtDisorders jtof jtHepatobiliary jtand jtExocrine jtPancreas jtFunction. jtBile jtproduction jtand
cholestasis. jtHow jtdoes jtthe jtbody jtbreak jtdown jtand jtdigest jtfat? jtPg. jt1122.
• The jtsecretion jtof jtbile jtis jtnecessary jtfor jtdigestion jt& jtabsorption jtof jtdietary jtfats jtand
jtfat jtsoluble jtvitamins.
• Bile jtsalts jt(formed jtfrom jtcholesterol) jtare jtimportant jtin jtdigestion;
o they jthelp jtemulsify jtdietary jtfats
o they’re jtnecessary jtfor jtthe jtformation jtof jtthe jtmicelles jtthat jttransport jtfatty
jtacids jtand jtfat-soluble jtvitamins jtto jtthe jtsurface jtof jtthe jtintestinal jtmucosa jtfor
jtabsorption
6. Chapter jt38. jtDisorders jtof jtHepatobiliary jtand jtExocrine jtPancreas jtFunction. jtBile jtproduction
jtand jtcholestasis. jtWhat jtis jtthe jtfunction/role jtof jtbile? jtPg. jt1122.
• Bile jtis jta jtfluid jtmade jtby jtthe jtliver, jtstored jtin jtthe jtgallbladder jtand jthelps jtwith jtdigestion
jtby jtbreaking jtdown jtfats jtinto jtfatty jtacids jtso jtthey jtcan jtbe jtabsorbed jtby jtthe jtbody
jtthrough jtthe jtdigestive jttract
• Bile jtcontains jtwater, jtbile jtsalts, jtbilirubin, jtcholesterol, jtand jtcertain jtby-products
jtof jtmetabolism
7. Chapter jt38. jtDisorders jtof jtHepatobiliary jtand jtExocrine jtPancreas jtFunction. jtPage jt1127-
1130. jtCompare jtand jtcontrast jtthe jttransmission jtof jthepatitis jtA, jtB, jtand jtC.
• Hepatitis jtA jt(HAV) jt- jtfecal-oral jtroute, jtdrinking jtcontaminated jtmilk jtor jtwater
jtor jtshellfish jtfrom jtdirty jt water jtcan jtalso jtbe jtcommon
o 14-28 jtdays jtincubation, jtHAV jtreplicates jtin jtthe jtliver, jtexcreted jtin jtbild, jtshed
jtin jtfeces
o young jtkids jtare jtasymptomatic jt(epidemics jthappen jtwith jtkids; jtpoor
jtpotty jttraining)
• Hep jtB jt(HBV) jt– jtinfected jtblood jt(needle-stick) jtor jtserum jt(sexual), jtmore jtserious,
jtlonger jtincubation
• Hep jtC jt(HCV) jt– jtcontaminated jtblood jttransfusions/products jt(rare jtin jtthe jtUS)
8. Chapter jt39. jtAlterations jtin jtNutritional jtStatus. jtMalnutrition jtand jtStarvation. jtWhat
jtdiagnostic jtlabs jtsupport jta jtmalnutrition jtdiagnosis? jtPg. jt1167.
• Albumin jt(20 jtday jthalf-life), jtPrealbumin jt(shorter jthalf-life), jtevaluation jtof jtintake,
anthropometric jtmeasurements jt(BMI)
9. Chapter jt39. jtAlterations jtin jtNutritional jtStatus. j t Energy jtstorage. jtAdipose jttissue jtis jtan
jtendocrine jtorgan jtand jtcontrols jtappetite, jthow jtdoes jtit jtdo jtthis? jtPg. jt1155.
