The University of Alabama
Capstone College of Nursing
NUR 529 Exam 3 Blueprint
Pages referred to below are from Porth’s Pathophysiology: Concepts of Altered States, 11th ed.,
and the current e-book on coursepoint. Older versions are not included, this course does not
utilize older textbook versions. Format for page numbers below is Porth 10th ed “hard copy”
book/ Course Point Porth E-Book. Example: p. 967/975. If the pages correlate between editions
then only one will be listed.
---------------------------------------------------------------------------------------------------------------------
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.
a. Colonic (colon) microorganisms play a role in vitamin synthesis and in the
absorption of calcium. The colonic flora synthesizes vitamin K.
2. Chapter 37. Disorders of Gastrointestinal Function. Alterations in intestinal
absorption. Celiac disease. What are the dietary recommendations for celiac disease?
Pg. 1107.
a. Malabsorption is the failure to transport dietary constituents, such as fats,
carbohydrates, proteins, vitamins, and minerals, from the opening of the
intestine into the ECF compartment for transport to the various parts of the
body.
b. Celiac Disease: An autoimmune disease that is triggered by dietary gluten-
containing grains (wheat, barley, and rye). Removal of these results in
resolution of symptoms.
c. The primary treatment consists of removal of gluten and related proteins from
the diet. Gluten is the primary protein in wheat, barley, and rye. Oat products
may be contaminated with wheat during the process. Many gluten-free types
of products are available. Meats, vegetables, fruits, and dairy products are free
of gluten as long as they are not contaminated during the process. Complete
exclusion of dietary gluten generally results in rapid and complete healing of
the intestinal mucosa.
(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).
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.
a. NSAIDs (ex: aspirin) are commonly used for relieving pain and inflammation.
Frequent usage is associated with GI lesions (peptic ulcers) because the drug
, is able to cross the lipid bilayer and causes damage to the superficial cells,
which can result in acute erosions.
b. Gastric irritation and occult bleeding (d/t gastric irritation) occur in people
who take aspirin on a regular basis.
4. Chapter 38. Disorders of Hepatobiliary and Exocrine Pancreas Function. Bilirubin
elimination and jaundice. How do we get rid of bilirubin? Pg. 1122.
a. Bilirubin is the final product of the breakdown of heme and is contained in
aged red blood cells. Bilirubin gives bile its color. In the process of
degradation, the hemoglobin from the red blood cell is broken down to form
biliverdin, which is quickly converted to free bilirubin. Free bilirubin, which
is insoluble in plasma, is transported in the blood attached to plasma albumin.
As it passes through the liver, free bilirubin is absorbed through the
hepatocyte’s cell membrane and released from its albumin carrier molecule.
Inside the hepatocytes, free bilirubin is converted to conjugated bilirubin,
making it soluble in bile. Conjugated bilirubin is secreted as a part of bile, and
in this form, it passes through the bile ducts into the small intestine. In the
intestine, ½ of the bilirubin is converted into a highly soluble substance called,
urobilinogen, by the intestinal flora. Some of the urobilinogen is absorbed into
the portal circulation and remainder is excreted into the feces. Most of the
urobilinogen that is absorbed is returned to the liver to be re-excreted into the
bile. Only a small amount of bilirubin is found in the blood.
5. Chapter 38. Disorders of Hepatobiliary and Exocrine Pancreas Function. Bile
production and cholestasis. How does the body break down and digest fat? Pg. 1122.
a. The secretion of bile and with the help of GI accessory organs such as the
liver, pancreas and gallbladder.
6. Chapter 38. Disorders of Hepatobiliary and Exocrine Pancreas Function. Bile
production and cholestasis. What is the function/role of bile? Pg. 1122.
a. The secretion of bile is essential for digestion of dietary fats, and absorption
of fats and fat-soluble vitamins from the intestine.
7. Chapter 38. Disorders of Hepatobiliary and Exocrine Pancreas Function. Page 1127-
1130. Compare and contrast the transmission of hepatitis A, B, and C.
a. Hepatitis is inflammation of the liver
b. All can cause acute hepatitis
c. Hepatitis A: transmitted primarily by the fecal-oral route. It has a brief
incubation period of 14-28 days. The virus replicates in the liver, excreted in
the bile, and shed in the stool. Drinking contaminated water or milk & eating
shellfish from infected waters are fairly common routes of transmission.
Children are asymptomatic, so they play an important role in the spread of the
disease. Oral behavior and lack of toilet training promote viral infection. It is
NOT transmitted by transfusion of blood or plasma derivatives.
, d. Hepatitis B: Has a longer incubation period and represents a more serious
health problem than Hepatitis A. This virus is usually transmitted through
inoculation with infected blood or serum. This viral antigen can be found in
most body secretions and can be spread by oral or sexual contact. Most people
acquire Hepatitis B as adults or adolescents. It is highly prevalent among
injecting drug users, heterosexuals with multiple sex partners, and men who
have sex with men. Healthcare workers are at risk owing to blood exposure
and accidental needle stick injuries. It can be spread through transfusion or
administration of blood products and routine screening methods have reduced
transmission through this route. The risk of hepatitis B in infants born to
HBV-infected mothers depends on the mother’s HBV status.
e. Hepatitis C: Most people with HCV were infected via a percutaneous
exposure to infected blood. Sharing of injection equipment contaminated with
infected blood, such as needles and syringes, among people who inject drugs
frequently results in exposure and transmission. With implementation of HCV
testing in blood banks, the risk of HCV infection from blood transfusions are
almost nearly non-existent. Unsafe medical procedures and unscreened blood
transfusions may be the most important sources of HCV infections in less
developed countries. Currently, recreational injecting drug use is the most
common mode of HCV transmission in the United States. High-risk sexual
behavior (having sex with multiple sexual partners or sex with an HCV-
infected partner) is the second most common risk factor in the United States.
Children whose mothers were infected with HCV are at an increased risk for
Hepatitis C. HCV also can be spread through exposure in the healthcare
setting, primarily through needle-stick injuries. There is also concern that
transmission of small amounts of blood during tattooing, acupuncture and
body piercing may facilitate the transmission of HCV.
8. Chapter 39. Alterations in Nutritional Status. Malnutrition and Starvation. What
diagnostic labs support a malnutrition diagnosis? Pg. 1167.
a. No single diagnostic measure is sufficiently accurate to serve as a reliable test
for malnutrition. Techniques of nutritional assessment include evaluation of
dietary intake, anthropometric measurements, nutrition-focused physical
examination and lab tests. Evaluation of body composition can be assessed
with weight, edema, muscle wasting, and subcutaneous fat loss. Pre-albumin
is used in the diagnosis of protein-calorie malnutrition. Albumin, which has
historically been used as a determinant of protein-calorie malnutrition, is less
sensitive to changes in nutrition than pre-albumin.
9. Chapter 39. Alterations in Nutritional Status. Energy storage. Adipose tissue is an
endocrine organ and controls appetite, how does it do this? Pg. 1155.
a. Adipose tissue is now recognized as an endocrine and paracrine organ that
secretes a number of important factors (adipokines) and it includes: leptin,
Capstone College of Nursing
NUR 529 Exam 3 Blueprint
Pages referred to below are from Porth’s Pathophysiology: Concepts of Altered States, 11th ed.,
and the current e-book on coursepoint. Older versions are not included, this course does not
utilize older textbook versions. Format for page numbers below is Porth 10th ed “hard copy”
book/ Course Point Porth E-Book. Example: p. 967/975. If the pages correlate between editions
then only one will be listed.
---------------------------------------------------------------------------------------------------------------------
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.
a. Colonic (colon) microorganisms play a role in vitamin synthesis and in the
absorption of calcium. The colonic flora synthesizes vitamin K.
2. Chapter 37. Disorders of Gastrointestinal Function. Alterations in intestinal
absorption. Celiac disease. What are the dietary recommendations for celiac disease?
Pg. 1107.
a. Malabsorption is the failure to transport dietary constituents, such as fats,
carbohydrates, proteins, vitamins, and minerals, from the opening of the
intestine into the ECF compartment for transport to the various parts of the
body.
b. Celiac Disease: An autoimmune disease that is triggered by dietary gluten-
containing grains (wheat, barley, and rye). Removal of these results in
resolution of symptoms.
c. The primary treatment consists of removal of gluten and related proteins from
the diet. Gluten is the primary protein in wheat, barley, and rye. Oat products
may be contaminated with wheat during the process. Many gluten-free types
of products are available. Meats, vegetables, fruits, and dairy products are free
of gluten as long as they are not contaminated during the process. Complete
exclusion of dietary gluten generally results in rapid and complete healing of
the intestinal mucosa.
(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).
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.
a. NSAIDs (ex: aspirin) are commonly used for relieving pain and inflammation.
Frequent usage is associated with GI lesions (peptic ulcers) because the drug
, is able to cross the lipid bilayer and causes damage to the superficial cells,
which can result in acute erosions.
b. Gastric irritation and occult bleeding (d/t gastric irritation) occur in people
who take aspirin on a regular basis.
4. Chapter 38. Disorders of Hepatobiliary and Exocrine Pancreas Function. Bilirubin
elimination and jaundice. How do we get rid of bilirubin? Pg. 1122.
a. Bilirubin is the final product of the breakdown of heme and is contained in
aged red blood cells. Bilirubin gives bile its color. In the process of
degradation, the hemoglobin from the red blood cell is broken down to form
biliverdin, which is quickly converted to free bilirubin. Free bilirubin, which
is insoluble in plasma, is transported in the blood attached to plasma albumin.
As it passes through the liver, free bilirubin is absorbed through the
hepatocyte’s cell membrane and released from its albumin carrier molecule.
Inside the hepatocytes, free bilirubin is converted to conjugated bilirubin,
making it soluble in bile. Conjugated bilirubin is secreted as a part of bile, and
in this form, it passes through the bile ducts into the small intestine. In the
intestine, ½ of the bilirubin is converted into a highly soluble substance called,
urobilinogen, by the intestinal flora. Some of the urobilinogen is absorbed into
the portal circulation and remainder is excreted into the feces. Most of the
urobilinogen that is absorbed is returned to the liver to be re-excreted into the
bile. Only a small amount of bilirubin is found in the blood.
5. Chapter 38. Disorders of Hepatobiliary and Exocrine Pancreas Function. Bile
production and cholestasis. How does the body break down and digest fat? Pg. 1122.
a. The secretion of bile and with the help of GI accessory organs such as the
liver, pancreas and gallbladder.
6. Chapter 38. Disorders of Hepatobiliary and Exocrine Pancreas Function. Bile
production and cholestasis. What is the function/role of bile? Pg. 1122.
a. The secretion of bile is essential for digestion of dietary fats, and absorption
of fats and fat-soluble vitamins from the intestine.
7. Chapter 38. Disorders of Hepatobiliary and Exocrine Pancreas Function. Page 1127-
1130. Compare and contrast the transmission of hepatitis A, B, and C.
a. Hepatitis is inflammation of the liver
b. All can cause acute hepatitis
c. Hepatitis A: transmitted primarily by the fecal-oral route. It has a brief
incubation period of 14-28 days. The virus replicates in the liver, excreted in
the bile, and shed in the stool. Drinking contaminated water or milk & eating
shellfish from infected waters are fairly common routes of transmission.
Children are asymptomatic, so they play an important role in the spread of the
disease. Oral behavior and lack of toilet training promote viral infection. It is
NOT transmitted by transfusion of blood or plasma derivatives.
, d. Hepatitis B: Has a longer incubation period and represents a more serious
health problem than Hepatitis A. This virus is usually transmitted through
inoculation with infected blood or serum. This viral antigen can be found in
most body secretions and can be spread by oral or sexual contact. Most people
acquire Hepatitis B as adults or adolescents. It is highly prevalent among
injecting drug users, heterosexuals with multiple sex partners, and men who
have sex with men. Healthcare workers are at risk owing to blood exposure
and accidental needle stick injuries. It can be spread through transfusion or
administration of blood products and routine screening methods have reduced
transmission through this route. The risk of hepatitis B in infants born to
HBV-infected mothers depends on the mother’s HBV status.
e. Hepatitis C: Most people with HCV were infected via a percutaneous
exposure to infected blood. Sharing of injection equipment contaminated with
infected blood, such as needles and syringes, among people who inject drugs
frequently results in exposure and transmission. With implementation of HCV
testing in blood banks, the risk of HCV infection from blood transfusions are
almost nearly non-existent. Unsafe medical procedures and unscreened blood
transfusions may be the most important sources of HCV infections in less
developed countries. Currently, recreational injecting drug use is the most
common mode of HCV transmission in the United States. High-risk sexual
behavior (having sex with multiple sexual partners or sex with an HCV-
infected partner) is the second most common risk factor in the United States.
Children whose mothers were infected with HCV are at an increased risk for
Hepatitis C. HCV also can be spread through exposure in the healthcare
setting, primarily through needle-stick injuries. There is also concern that
transmission of small amounts of blood during tattooing, acupuncture and
body piercing may facilitate the transmission of HCV.
8. Chapter 39. Alterations in Nutritional Status. Malnutrition and Starvation. What
diagnostic labs support a malnutrition diagnosis? Pg. 1167.
a. No single diagnostic measure is sufficiently accurate to serve as a reliable test
for malnutrition. Techniques of nutritional assessment include evaluation of
dietary intake, anthropometric measurements, nutrition-focused physical
examination and lab tests. Evaluation of body composition can be assessed
with weight, edema, muscle wasting, and subcutaneous fat loss. Pre-albumin
is used in the diagnosis of protein-calorie malnutrition. Albumin, which has
historically been used as a determinant of protein-calorie malnutrition, is less
sensitive to changes in nutrition than pre-albumin.
9. Chapter 39. Alterations in Nutritional Status. Energy storage. Adipose tissue is an
endocrine organ and controls appetite, how does it do this? Pg. 1155.
a. Adipose tissue is now recognized as an endocrine and paracrine organ that
secretes a number of important factors (adipokines) and it includes: leptin,
