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TEST BANK FOCUS ON NURSING PHARMACOLOGY (8TH EDITION BY KARCH) CHAPTERS 56-59

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TEST BANK FOCUS ON NURSING PHARMACOLOGY (8TH EDITION BY KARCH) CHAPTERS 56-59 Chapter 56 Introduction to the Gastrointestinal System Chapter 57 Drugs Affecting Gastrointestinal Secretions Chapter 58 Drugs Affecting Gastrointestinal Motility Chapter 59 Antiemetic Agents

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Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch)

1. What is a unique characteristic of the gastrointestinal (GI) system?
a. It contains multiple organs that work together.
b. It is lined with epithelial tissue.
c. It is the only system open to the external environment.
d. The GI tract is sterile and contains no bacteria.

Ans: C
Feedback:
The GI system is the only system that is open to the external environment. The
definition of a system is multiple organs working together to perform a function or
functions. Many systems are lined with epithelial tissue. The GI tract is not sterile and
does contain bacteria.

2. What is the purpose of the peritoneum?
a. Help propel the GI contents down the tract
b. Help keep the GI tract in place and prevent friction with movement
c. Decrease the muscle tone to slow the GI tract from moving too fast
d. Serve as a supportive layer and helps the tube maintain its shape

Ans: B
Feedback:
The peritoneum lines the abdominal wall and viscera and helps keep the GI tract in
place and prevents a buildup of friction with movement. The muscularis mucosa layer
helps propel the GI contents downward. The nerve plexus helps to slow the GI tract
when digestion is not a priority or stimulates it for digestion. The adventitia serves as

, a supportive layer and helps the tube maintain its shape.

3. A patient complains of frequent acid indigestion. The nurse instructs the patient to
increase intake of what to reduce stimulation of acid production?
a. Protein
b. Calcium
c. Fiber
d. Alcohol

Ans: C
Feedback:
Fiber does not promote acid production so it would be a safe food for patients to eat to
avoid stimulating more acid in the stomach. Acid production in the stomach is
stimulated by gastrin which increases in the presence of protein, calcium, caffeine, or
alcohol in the stomach.

4. When the nurse administers a medication that stimulates the parasympathetic
nervous system the drug will have what impact on the GI system?
a. Decrease sphincter tone
b. Decrease muscle tone
c. Decrease contractions
d. Decrease secretions

Ans: A
Feedback:
The effect of the parasympathetic nervous system is that of rest and digest. It
stimulates the GI tract causing increased muscle tone, secretions and contractions, and
decreased sphincter tone allowing for easy movement.

5. What reflex causes an increase in small intestine activity when the stomach is
stimulated by stretching, the presence of food, or cephalic stimulation?
a. Duodenalcolic
b. Gastroenteric
c. Gastrocolic
d. Ileogastric

Ans: B
Feedback:
The gastroenteric reflex is stimulation of the stomach, which causes an increase in
activity in the small intestine. The duodenalcolic reflex stimulates colon activity and
mass movement. The gastrocolic reflex is stimulation in the stomach, which increases
activity in the colon. The ileogastric reflex is the introduction of chyme or stretch to
the large intestine and slow stomach activity.

,6. The nurse expects to find that the major activities of the GI tract decrease in a
patient experiencing what?
a. A stress reaction
b. A medication regimen including cholinergic drugs
c. A local irritation of the small intestine
d. Thoughts of food

Ans: A
Feedback:
Stimulation of the sympathetic nervous system will decrease all activity in the GI
tract, and stress is a trigger for stimulating the sympathetic nervous system.
Parasympathetic stimulation caused by cholinergic drugs, local irritation of the
intestine, and the thought of food will all increase GI activity.

7. The nurse assesses the postoperative patient who had abdominal surgery and finds
a complete absence of bowel sounds caused by what reflex?
a. Gastrocolic reflex
b. Renointestinal reflex
c. Intestinalintestinal reflex
d. Somatointestinal reflex

Ans: C
Feedback:
After the intestinal irritation that occurs with handling the bowel during abdominal
surgery, the risk of paralytic ileus is high because of the intestinalintestinal reflex. The
gastrocolic reflex increases GI movement when food is in the stomach. The
renointestinal reflex slows GI activity in response to renal capsule swelling. The
somatointestinal reflex slows GI activity in response to tight stretching of skin across
the abdominal wall.

8. The nurse is caring for a patient who is having difficulty swallowing tablets. What
action will the nurse implement to help the patient swallow their medication?
a. Turn the patient’s head to one side
b. Place a warm cloth on the back of the patient’s neck
c. Have the patient suck on a Popsicle
d. Give the patient a copious amount of water to drink with the tablet

Ans: C
Feedback:
Have the patient suck on a Popsicle, which will block external nerve impulses and
allow the basic reflex to respond. The patient’s head should be straight to allow the
muscle pairs to work together. A cold cloth can be placed on the back of the neck or
the sternum to stimulate the reflex, but a warm cloth is not indicated. Textured food,
not liquids, can also help with swallowing a tablet.

, 9. What does the nurse anticipate will happen first when the chemoreceptor trigger
zone (CTZ) is stimulated?
a. Salivation increases
b. Gastric acid production decreases
c. Sweating increases
d. Heart rate increases

Ans: A
Feedback:
When the CTZ is stimulated, salivation is stimulated first, which leads to a decrease in
gastric acid production and then an increase in sweating and heart rate.

10. What is the most basic type of movement that occurs in the esophagus?
a. Peristalsis
b. Mass movement
c. Churning
d. Segmentation

Ans: A
Feedback:
Peristalsis is the basic movement of the esophagus. The large intestine uses mass
movement, the stomach uses churning, and the small intestine uses segmentation.

11. Which substance is required for digestion and absorption of fats and fat-soluble
vitamins?
a. Hydrochloric acid
b. Bile
c. Pancreatic enzymes
d. Gastric juice

Ans: B
Feedback:
Bile is an alkaline secretion that is formed continuously in the liver, carried to the
gallbladder by the bile ducts, and stored there. Bile salts are required for digestion and
absorption of fats, including fat- soluble vitamins. Hydrochloric acid is produced in
the stomach and begins the process of digestion. Pancreatic enzymes include
chymotrypsin and trypsin that break down proteins, lipases to break down fat, and
amylases to break down sugars. Gastric juice includes hydrochloric acid.

12. The nurse, caring for a patient about to undergo gastric bypass surgery, explains
that the majority of nutrients are absorbed where?
a. Sigmoid colon
b. Stomach

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