Chapter m01:mIntake:mGastrointestinal mDigestion,mAbsorption,mandmExcretionmofmNutrien
tsmRaymond:mKrause mandmMahan’smFoodmandmthemNutritionmCaremProcess,m16thmEditio
n
MULTIPLEmCHOICE
1. Pepsinogenmismconverted mtompepsinmwhenmit mcomesminmcontact mwith
a. enterokinase.
b. trypsinogen.
c. hydrochloricmacid.
d. peptidases.
ANS:m C
Pepsinogenmismsecreted minmthemstomachmand mconverted mtomitsmactivemformmbymthemacid menviron
ment mof mthemstomach.mEnterokinasemismsecreted mbymthembrushmbordermof mthemsmallmintestineminm
responsemtomthempresencemof mchyme.mTrypsinogenmismsecreted mbymthempancreasmand mactivated mb
ymenterokinase.mVariousmpeptidasesmaremsecreted mbymthemeithermbrushmbordermormthempancreas.
2. Whichmof mthemfollowingmismformed mbymbacterialmsynthesisminmthemcolon?
a. VitaminmK
b. VitaminmD
c. VitaminmB6
d. Niacin
ANS:m A
ColonicmbacteriamproducemvitaminmK,mvitaminmB12 ,mthiamin,mand mriboflavin.mVitaminmDmmaymb
emmetabolized mbymexposuremof mprecursormvitaminmDminmthemskinmtomultraviolet mlight.mThemhuma
nmbodymcanmsynthesizemniacinmfrommthemaminomacid mtryptophan.mVitaminmB6 mmust mbemobtained
mfrommdietarymsourcesmsuchmasmmeats,mwholemgrains,mvegetables,mand mnuts.
3. Aftermsurgicalmremovalmof mamlargemportionmof mthemsmallmintestine,mwhat mfunctionalmcomplicati
onmismmost mlikelymtomdevelop?
a. Changesminmdietarymhabits
b. Impaired mdigestion
c. Lossmof mabsorptivemtissue
d. Eliminationmof mdietarymresidue
ANS:m C
Themsmallmintestinemismthemprimarymsitemof mnutrient mabsorptionmbecausemof mitsm largemabsorptio
nmsurfacemarea.mSecretionsmfrommthemliver,mgallbladder,mand mpancreasmcanmstillmcontributemtomd
igestionmof mintestinalmcontents.mHowever,mdecreased mabsorptionmof mnutrientsmand mfood mcompo
nentsmmaymresult minmmoremintestinalmremainsmand mresidue.mAmpatient mmaymchangemdietarymhabi
tsmasmamresult mof mgastrointestinalmdiscomfort mexperienced maftermintestinalmresection,mbut mthismis
mnot mamfunctionalmcomplication.
4. Themsight mormsmellmof mfood mproducesmvagalmstimulationmof mthemparietalmcellsmof mthemgast
ricmmucosa,mresultingminmthemincreased mproductionmof mwhat?
a. Motilin
b. Gastrin
c. Cholecystokinin
, d. Secretin
ANS:m B
Parasympatheticminnervationmthat mcausesmsecretionmof mgastrinmand mreleasemof mhydrochloricmaci
d mhelpsmpreparemthemstomachmformthempotentialmof mreceivingmfood.mAftermfood mchymemismpassed m
intomthemsmallmintestinemfrommthemstomach,msecretinmand mcholecystokininmaremsecreted mtomstim
ulatempancreaticmsecretionmof mwatermand mbicarbonate.mTheymalsomsignalmgallbladdermcontractio
nsmand mcolonicmmotility,mallmresultingminmreductionsminm stomachmemptyingmand mduodenalmmotil
ity.
Motilinmismsecreted mfrommthemduodenalmmucosamduringmfastingmtomstimulatemgastricmemptyingmand mi
ntestinalmmotility.
5. If mampatient mexperiencesmmalabsorptionmof mfat mresultingmfrommanmimpaired mabilitymtomprodu
cemadequatembilemsaltsmformmicellemformation,mhow mmaymfat mabsorptionmbemimproved?
a. Bymincreasingmshort-chainmfattymacidsminmthemdiet
b. Bymincreasingmmedium-
chainmfattymacidsminmthemdiet
c. Bymincreasingmlong-chainmfattymacidsminmthemdiet
d. Bymrestrictingmdietarymintakemof mcholesterol
ANS:m B
Medium-
chainmfattymacidsmof m8mtom12mcarbonsmcanmbemabsorbed mdirectlymbymmucosalmcellsmwithout mthem
presencemof mbile.mThemlong-
chainmfattymacidsmrequiremmicellemformationmformabsorption.mShort-
chainmfattymacidsmresult mfrommbacterialmfermentationmof mmalabsorbed mcarbohydratesmand mfiber
s.mAsmbilemismproduced mfrommcholesterol,mdietarymrestrictionmof mcholesterolmismnegligible minm re
gard mtomimprovementsminmfat mabsorption.
6. What mismthemfunctionmof msecretin?
a. Stimulationmof mgastricmsecretionsmand mincreased mmotility
b. Stimulationmof mgallbladdermcontractionmand mthemreleasemof mbil
e
c. Stimulationmof mthempancreasmtomsecretemwatermand mbicarbonat
e
d. Stimulationmof mthemparietalmcellsmtomsecretemgastrin
ANS:m C
Secretinmismthemhormonemthat mworksminmoppositionmtomgastrin.mWhereasmgastrin mstimulatesmsto
machmdigestionmactivities,msecretinmdecreasesmgastricmoutput mand mpromotesmpancreaticmsecretio
nsmtomneutralizemthemaciditymof mchyme.mCholecystokininmismalsomsecreted mwhenmchymementersmt
hemduodenum,mand mit mismresponsiblemformstimulatingmthemgallbladder.
7. Whichmof mthemfollowingmismamlist mof menzymesmreleased mfrommthempancreas?
a. Insulin,mtrypsin,mand msecretin
b. Lactase,misomaltase,mand mdextrinase
c. Protease,mpepsin,mand mgastrin
d. Trypsin,mchymotrypsin,mand mcarboxypeptidase
ANS:m D
Trypsin,mchymotrypsin,mand mcarboxypeptidasemaremthreemproteinmdigestivemenzymesmsecreted mb
ymthempancreas.mInsulinmismanmendogenousmhormonemsecreted mbymthempancreas.mSecretinmismamh
ormonemsecreted mbymthemsmallmintestine.mLactasemand misomaltasem(alsomknownmas mdextrinase)m
arembrush-
bordermenzymes.mPepsin,mwhichmismamprotease,mand mgastrinmaremhormonesmsecreted mbymthemsto
mach.
,8. Inmwhat mformmismdietarymfat mabsorbed m frommthemlumenmof mthemintestine?
, a. Chylomicron
b. Micelle
c. Triglyceride
d. Lipoprotein
ANS:m B
Fatsmmust mbememulsified mintommicellesmsomthat mtheymmaymcrossmthemunstirred mwatermlayermthat m
bordersmthembrush-
bordermmembranes.mThesemmicellesm leavemmonoglyceridesmand mfattymacidsmat mthembrushmborder
,mwheremtheymaremreabsorbed mand mreassembled masmtriglycerides.mThemtriglyceridesmarempackage
d mwithmcholesterol,mfat-
solublemvitamins,mand mphospholipidsmintomchylomicrons,mwhichmpass mintomthemlymphatic mcircu
lation.mWhenmthesemreachmthemliver,mthemchylomicronmcomponentsmarem repackaged mintomlow-
densitymlipoproteins.
9. Whichmof mthemfollowingmismtruemof mprobiotics?
a. Probioticsmaremlivemmicroorganisms mfound minmfood.
b. Probioticsmaremnondigestiblemcarbohydrates.
c. Probioticsmact mprimarilymonmbacteriaminmthemproximalm smallmintestine.
d. Probioticsmcannot mbemgivenmasmsupplementsmbecausemtheymreadilymdi
e.
ANS:m A
Probioticsmaremlivemmicroorganisms,mwhich mwhenmadministered minmadequatemamountsmconferma
mhealthmbenefit monmthemhost.mTheymaremfound minmfermented mfoodsmlikemyogurt mand msauerkraut mo
rmasmamnutritionalmsupplement.mBacterialmactionmism most mintensem inmthemdistalmsmallmintestineman
d mlargemintestine.
10. Bymwhichmtransport mmechanismmaremmost mvitaminsmabsorbed mfrommthemsmallmintestinem intomt
hemblood?
a. Passivemdiffusion
b. Activemdiffusion
c. Facilitativemdiffusion
d. Passivemosmosis
ANS:m A
Passivemdiffusionmismlimited mbymthemnumbermof mchannelsmavailablemformnutrientsmtomrandomlymp
assmthrough.mFacilitated mdiffusionmrequiresmthempresencemof mcarriermproteins,mwhichmmaymbemli
mited mbymthemhealthmand mnutritionalmstatusmof mthemperson.mActivemtransport mrequiresmenergy,mw
hichmalsommaymbemlimited mbymthemperson’smhealthmand mnutritionalmstatus.mOsmosismoccursmin mre
gard mtomconcentrationmgradient mand monlyminvolvesmthemmovement mof mwater,mnot mvitamins.
11. What maremprimarilymabsorbed mbymthemlargemintestine?
a. Watermand mfats
b. Carbohydrates
c. Proteins
d. Watermand melectrolytes
ANS:m D
Watermand melectrolytesmaremusuallymthemonlymabsorbablemremnantsmof mdietarymintakemthat mreach
mthemlargemintestine.mFats,mcarbohydrates, mand mproteinsmfrommthemdiet maremabsorbed mthroughout m
themsmallmintestine.
12. What mhappensmtomcellulosemand mligninmasmtheymgomthroughmthemGI mtract?
tsmRaymond:mKrause mandmMahan’smFoodmandmthemNutritionmCaremProcess,m16thmEditio
n
MULTIPLEmCHOICE
1. Pepsinogenmismconverted mtompepsinmwhenmit mcomesminmcontact mwith
a. enterokinase.
b. trypsinogen.
c. hydrochloricmacid.
d. peptidases.
ANS:m C
Pepsinogenmismsecreted minmthemstomachmand mconverted mtomitsmactivemformmbymthemacid menviron
ment mof mthemstomach.mEnterokinasemismsecreted mbymthembrushmbordermof mthemsmallmintestineminm
responsemtomthempresencemof mchyme.mTrypsinogenmismsecreted mbymthempancreasmand mactivated mb
ymenterokinase.mVariousmpeptidasesmaremsecreted mbymthemeithermbrushmbordermormthempancreas.
2. Whichmof mthemfollowingmismformed mbymbacterialmsynthesisminmthemcolon?
a. VitaminmK
b. VitaminmD
c. VitaminmB6
d. Niacin
ANS:m A
ColonicmbacteriamproducemvitaminmK,mvitaminmB12 ,mthiamin,mand mriboflavin.mVitaminmDmmaymb
emmetabolized mbymexposuremof mprecursormvitaminmDminmthemskinmtomultraviolet mlight.mThemhuma
nmbodymcanmsynthesizemniacinmfrommthemaminomacid mtryptophan.mVitaminmB6 mmust mbemobtained
mfrommdietarymsourcesmsuchmasmmeats,mwholemgrains,mvegetables,mand mnuts.
3. Aftermsurgicalmremovalmof mamlargemportionmof mthemsmallmintestine,mwhat mfunctionalmcomplicati
onmismmost mlikelymtomdevelop?
a. Changesminmdietarymhabits
b. Impaired mdigestion
c. Lossmof mabsorptivemtissue
d. Eliminationmof mdietarymresidue
ANS:m C
Themsmallmintestinemismthemprimarymsitemof mnutrient mabsorptionmbecausemof mitsm largemabsorptio
nmsurfacemarea.mSecretionsmfrommthemliver,mgallbladder,mand mpancreasmcanmstillmcontributemtomd
igestionmof mintestinalmcontents.mHowever,mdecreased mabsorptionmof mnutrientsmand mfood mcompo
nentsmmaymresult minmmoremintestinalmremainsmand mresidue.mAmpatient mmaymchangemdietarymhabi
tsmasmamresult mof mgastrointestinalmdiscomfort mexperienced maftermintestinalmresection,mbut mthismis
mnot mamfunctionalmcomplication.
4. Themsight mormsmellmof mfood mproducesmvagalmstimulationmof mthemparietalmcellsmof mthemgast
ricmmucosa,mresultingminmthemincreased mproductionmof mwhat?
a. Motilin
b. Gastrin
c. Cholecystokinin
, d. Secretin
ANS:m B
Parasympatheticminnervationmthat mcausesmsecretionmof mgastrinmand mreleasemof mhydrochloricmaci
d mhelpsmpreparemthemstomachmformthempotentialmof mreceivingmfood.mAftermfood mchymemismpassed m
intomthemsmallmintestinemfrommthemstomach,msecretinmand mcholecystokininmaremsecreted mtomstim
ulatempancreaticmsecretionmof mwatermand mbicarbonate.mTheymalsomsignalmgallbladdermcontractio
nsmand mcolonicmmotility,mallmresultingminmreductionsminm stomachmemptyingmand mduodenalmmotil
ity.
Motilinmismsecreted mfrommthemduodenalmmucosamduringmfastingmtomstimulatemgastricmemptyingmand mi
ntestinalmmotility.
5. If mampatient mexperiencesmmalabsorptionmof mfat mresultingmfrommanmimpaired mabilitymtomprodu
cemadequatembilemsaltsmformmicellemformation,mhow mmaymfat mabsorptionmbemimproved?
a. Bymincreasingmshort-chainmfattymacidsminmthemdiet
b. Bymincreasingmmedium-
chainmfattymacidsminmthemdiet
c. Bymincreasingmlong-chainmfattymacidsminmthemdiet
d. Bymrestrictingmdietarymintakemof mcholesterol
ANS:m B
Medium-
chainmfattymacidsmof m8mtom12mcarbonsmcanmbemabsorbed mdirectlymbymmucosalmcellsmwithout mthem
presencemof mbile.mThemlong-
chainmfattymacidsmrequiremmicellemformationmformabsorption.mShort-
chainmfattymacidsmresult mfrommbacterialmfermentationmof mmalabsorbed mcarbohydratesmand mfiber
s.mAsmbilemismproduced mfrommcholesterol,mdietarymrestrictionmof mcholesterolmismnegligible minm re
gard mtomimprovementsminmfat mabsorption.
6. What mismthemfunctionmof msecretin?
a. Stimulationmof mgastricmsecretionsmand mincreased mmotility
b. Stimulationmof mgallbladdermcontractionmand mthemreleasemof mbil
e
c. Stimulationmof mthempancreasmtomsecretemwatermand mbicarbonat
e
d. Stimulationmof mthemparietalmcellsmtomsecretemgastrin
ANS:m C
Secretinmismthemhormonemthat mworksminmoppositionmtomgastrin.mWhereasmgastrin mstimulatesmsto
machmdigestionmactivities,msecretinmdecreasesmgastricmoutput mand mpromotesmpancreaticmsecretio
nsmtomneutralizemthemaciditymof mchyme.mCholecystokininmismalsomsecreted mwhenmchymementersmt
hemduodenum,mand mit mismresponsiblemformstimulatingmthemgallbladder.
7. Whichmof mthemfollowingmismamlist mof menzymesmreleased mfrommthempancreas?
a. Insulin,mtrypsin,mand msecretin
b. Lactase,misomaltase,mand mdextrinase
c. Protease,mpepsin,mand mgastrin
d. Trypsin,mchymotrypsin,mand mcarboxypeptidase
ANS:m D
Trypsin,mchymotrypsin,mand mcarboxypeptidasemaremthreemproteinmdigestivemenzymesmsecreted mb
ymthempancreas.mInsulinmismanmendogenousmhormonemsecreted mbymthempancreas.mSecretinmismamh
ormonemsecreted mbymthemsmallmintestine.mLactasemand misomaltasem(alsomknownmas mdextrinase)m
arembrush-
bordermenzymes.mPepsin,mwhichmismamprotease,mand mgastrinmaremhormonesmsecreted mbymthemsto
mach.
,8. Inmwhat mformmismdietarymfat mabsorbed m frommthemlumenmof mthemintestine?
, a. Chylomicron
b. Micelle
c. Triglyceride
d. Lipoprotein
ANS:m B
Fatsmmust mbememulsified mintommicellesmsomthat mtheymmaymcrossmthemunstirred mwatermlayermthat m
bordersmthembrush-
bordermmembranes.mThesemmicellesm leavemmonoglyceridesmand mfattymacidsmat mthembrushmborder
,mwheremtheymaremreabsorbed mand mreassembled masmtriglycerides.mThemtriglyceridesmarempackage
d mwithmcholesterol,mfat-
solublemvitamins,mand mphospholipidsmintomchylomicrons,mwhichmpass mintomthemlymphatic mcircu
lation.mWhenmthesemreachmthemliver,mthemchylomicronmcomponentsmarem repackaged mintomlow-
densitymlipoproteins.
9. Whichmof mthemfollowingmismtruemof mprobiotics?
a. Probioticsmaremlivemmicroorganisms mfound minmfood.
b. Probioticsmaremnondigestiblemcarbohydrates.
c. Probioticsmact mprimarilymonmbacteriaminmthemproximalm smallmintestine.
d. Probioticsmcannot mbemgivenmasmsupplementsmbecausemtheymreadilymdi
e.
ANS:m A
Probioticsmaremlivemmicroorganisms,mwhich mwhenmadministered minmadequatemamountsmconferma
mhealthmbenefit monmthemhost.mTheymaremfound minmfermented mfoodsmlikemyogurt mand msauerkraut mo
rmasmamnutritionalmsupplement.mBacterialmactionmism most mintensem inmthemdistalmsmallmintestineman
d mlargemintestine.
10. Bymwhichmtransport mmechanismmaremmost mvitaminsmabsorbed mfrommthemsmallmintestinem intomt
hemblood?
a. Passivemdiffusion
b. Activemdiffusion
c. Facilitativemdiffusion
d. Passivemosmosis
ANS:m A
Passivemdiffusionmismlimited mbymthemnumbermof mchannelsmavailablemformnutrientsmtomrandomlymp
assmthrough.mFacilitated mdiffusionmrequiresmthempresencemof mcarriermproteins,mwhichmmaymbemli
mited mbymthemhealthmand mnutritionalmstatusmof mthemperson.mActivemtransport mrequiresmenergy,mw
hichmalsommaymbemlimited mbymthemperson’smhealthmand mnutritionalmstatus.mOsmosismoccursmin mre
gard mtomconcentrationmgradient mand monlyminvolvesmthemmovement mof mwater,mnot mvitamins.
11. What maremprimarilymabsorbed mbymthemlargemintestine?
a. Watermand mfats
b. Carbohydrates
c. Proteins
d. Watermand melectrolytes
ANS:m D
Watermand melectrolytesmaremusuallymthemonlymabsorbablemremnantsmof mdietarymintakemthat mreach
mthemlargemintestine.mFats,mcarbohydrates, mand mproteinsmfrommthemdiet maremabsorbed mthroughout m
themsmallmintestine.
12. What mhappensmtomcellulosemand mligninmasmtheymgomthroughmthemGI mtract?
