Hypotension in acute pancreatitis is mainly caused by;
a) Profuse vomiting
b) Loss of large amounts of protein rich fluid into tissues and peritoneal cavity.
c) Bleeding into the tissues and peritoneal cavity.
d) Profuse sweating and anxiety
Prior to a barium swallow, a patient should;
a) Fast for 8 hours before the test-enema
b) Eat a regular supper and breakfast-
c) Continue to take all oral medications as scheduled
d) Monitor own bowel movement pattern for constipation
The following assessment technique follows inspection, during abdominal assessment;
a) Palpation of the abdomen for size
b) Palpation of the liver at the right rib margin
c) Auscultation of bowel sounds in all for quadrants
d) Percussion of the right lower abdominal quadrant
A T tube has drained 750 mL of green-brown drainage in 24 hours the first day post cholecystectomy. The appropriate nursing intervention is;
a) Clamp the T tube
b) Irrigate the T tube
c) Notify the physician
d) Document the findings
The gall bladder does not:-:-
a) Produce bile
b) Concentrate bile
c) Store bile
d) All of the above
The absorption of nutrients from food is:-
a) Gluconeogenesis
b) Digestion
c) Metabolism
d) Nutrition
Because the small intestine needs bile only a few times a day, bile is stored and concentrated in the:
a. Pancreas
b. Gall bladder
c. Liver
d. Small intestine
The diet that should be implemented by the nurse while caring for patient with pancreatitis is:
(a) Low carbohydrate diet.
(b) High fat diet.
(c) Low fat diet.
(d) High protein diet.
Hepatic encephalopathy occurs due to:
(a) Viral inflammation of the brain tissues.
(b) Nitrogen compounds and ammonia acting s false neurotransmitters.
(c) Capillary bleeding due to increased portal vein pressure.
(d) Reduced blood supply to the brain tissue.
Functions of gastric juice include:
(a) Kills ingested pathogens, provide acidic environment needed for effective digestion of proteins.
(b) Digestion of carbohydrates and fats.
(c) Activates trypsin, initiates digestion of carbohydrates.
(d) Emulsify fats, digestion of proteins.
The most common cause of small bowel obstruction is:
(a) Adhesions.
(b) Hernias.
(c) Neoplasm.
(d) Diverticulitis.
The most common complication of peritonitis is:
(a) Ascitis.
(b) Increased intestinal motility.
(c) Constipation.
(d) Paralytic ileus.
The procedure that involves surgical removal of the distal two thirds of the stomach is known as:
(a) Vugostomy.
(b) Gastrectomy.
(c) Gastrotomy.
(d) Gastroplasty.
Priority nursing interventions for a patient with peritoneal abscess is to:
(a) Administer analgesics for relief of pain.
(b) Administer intravenous fluids to maintain fluid volume balance.
(c) Reassure the patient to relieve anxiety and co-operate during pre-operative preparation.
(d) Administer parenteral nutrition to obtain optimum weight gain while the gut is rested.
Indicate true or false for Q.8.
(a) Hepatitis A is mainly transmitted through the fecal-oral route.
(b) Persons with hepatitis A also have hepatitis B infection.
Predominant signs and symptoms in ulcerative colitis include:
(a) Fever, constipation, abdominal pain.
(b) Constipation, rectal bleeding, weight loss.
(c) Vomiting, diarrhoea, constipation.
(d) Diarrhoea, abdominal pain, rectal bleeding.
Mechanical cause of intestinal obstruction include:
(a) Trauma, infection, malignant tumours.
(b) Mesenteric ischaemia, intussusceptions, gallstones.
(c) Volvulus, strangulated hernia, peritoneal adhesions.
(d) Volvulus, paralytic ileus, strangulated hernia.
An inflammation of the gums which leads to loss of teeth is known as:
(a) Stomatitis.
(b) Periodonatitis.
(c) Gingivitis.
(d) Candidiasis.
Dental hygiene is maintained by:
(a) Brushing teeth after meals, visiting the dentist every six months.
(b) Eating high proteins diet, brushing teeth every morning.
(c) Drinking mineral water, visiting dentist every three months.
(d) Brushing teeth every morning, visiting dentist once a year.
The mineral salt essential for prevention of dental carries is:
(a) Iodine.
(b) Calcium.
(c) Phosphorus.
(d) Chloride.
Dental plague comprises of:
(a) Food debris, dead epithelium, micro-organisms.
(b) Food debris, periodontal membrane, cellmentum.
(c) Death epithelium, micro-organisms, cellmentum.
(d) Periodontal membranes, food debris, death membranes
The following tests are done to rule out cancer of the oesophagus EXCEPT.
A. Esophagoscopy
B. Barium swallow
C. Oesophageal biopsy
D. Laparoscopy
Amoebic liver abscess is caused by.
A. Continuous destruction or hepatic cells
B. Poor sanitation and hygiene causing infestation with entamoeba historytica.
C. Diffuse fibrosis that disrupts the structure and function of the liver.
D. Infestation with amoebic histolytica.
Among the following patients who is likely to suffer from cholelithias.
A. 15 year old boy with sickle cell trait.
B. 45 year old woman with gall bladder disease.
C. 30 year old man with tobacco abuse.
D. 35 year old African – American man with hypertension.
The gold standard test used to diagnose cirrhosis is.
A. Liver function test
B. Biopsy
C. Ultrasound
D. Computer tomography sean.
The commonest cause of duodenal ulcers is:
A. Ingestion of non-steroids anti-inflammatory drugs.
B. Increased secretion or gastric juice.
C. Presence of helicobacter pylori bacteria in the stomach.
Primary causes of gall stones include:
A. Excessive concentration of bile pigments, thrombosis of the portal vein.
B. Portal vein tumors, infections of the gall bladder
C. Stagnation of bile due to blockage, excessive concentration of bile pigment.
Following haemorrhoidectomy pain is relieved by use of.
A. Sits baths, stool softeners, analgesic.
B. Strong analgesics, light diet, good perineal hygine.
C. Stool softeners, high fiber diet, lateral position in bed.
D. Liquid diet for the first three days, sits baths, laxatives.
Functions of gastric juice include:
A. Kills ingested pathogens, provide acidic environment needed for effective digestion of proteins.
B. Digestion of carbohydrates, digestion of fats.
C. Activates trypsin, iniate digestion of carbohydrates.
D. Emulsify fats, digestion or proteins.
Clinical manifestation of cancer of the head of the pancrease include.
A. Anorexia, weight loss, abdominal pain jaundice.
B. Vomiting, epigastric pain, fever, jaundice.
C. Raised blood pressure, anorexia, weight loss,glycosuria.
D. Epigastric pain, nausea, hypoglycaemia fever.
The most common cause of small bowel obstruction is
A. Adhesions
B. Hernias
C. Neoplasms
D. Dive-ticulitis
Mechanical causes of intestinal obstruction include:
(a) Muscular dystrophy, amyloidosis, intussusception.
(b) Hernia, intussusception, neoplasmas.
(c) Neoplasmas, intussusception, muscular, dystrophy.
(d) Amyloidosis, hernia, neoplasmas.
Endocrine function of the pancrease include:
(a) Secrete insulin, glucagon.
(b) Concentrate bile.
(c) Produce bile.
(d) Storage of undigested intestinal content.
In gastritis:
(a) Stomach lavage is encouraged.
(b) Neutralize acids with lemon juice or dilute vinegar.
(c) NSAIDs are the best analgesics to manage the pain.
(d) Dietary indiscretion can be the cause.
Which of the following is true about gastric ulcers:
(a) Hypersecretion of stomach hydro chronic acid.
(b) Abdominal pain is common 2 – 3 hours after meals.
(c) Hematemesis is common.
(d) Weight gain is common.
The most common complication of peritonitis is:
(a) Ascitis.
(b) Increased intestinal motility.
(c) Constipation.
(d) Paralytic ileus.
Predominant signs and symptoms in ulcerative colitis include:
(a) Vomiting, diarrhoea, constipation.
(b) Fever, constipation, abdominal pain.
(c) Diarrhoea, abdominal pain, rectal bleeding.
(d) Constipation, rectal bleeding, weight loss.
Following haemorrhoidectomy pain is relieved by use of:
(a) Site baths, stool softener, analgesics.
(b) Strong analgesics, light diet, good perineal hygiene.
(c) Stool softener, high fibre diet, lateral position in bed.
(d) Liquid diet for the first 3 days, site baths, laxatives.
All the following can be done to rule out cancer of the oesophagus except:
(a) Esophagogastroduodenoscopy.
(b) Barium swallow.
(c) CT scan.
(d) Laparascopy.
The procedure that involves surgical removal of the distal two thirds of the stomach is:
(a) Vagostomy.
(b) Gastroectomy.
(c) Gastrotomy.
(d) Gastroplasty.
The most common cause of duodenal ulcers is:
(a) Ingestion of non-steroids anti-inflammatory drugs.
(b) Increased secretion of gastric juice.
(c) Presence of helicobacter pylori bacteria in the stomach.
(d) Presence of colon commensals in the duodenum.
Mr J, 40 years old was admitted in the ward with liver cirrhosis.
(a) Define liver cirrhosis. 1 mark
(b) Explain the four (4) functions of the liver. 4 marks
(c) Explain four (4) nursing diagnosis for this patient. 4 marks
(d) Describe management of Mr J while in the ward. 11marks
The following is the management of oesophageal disease except:
(a) Eating small frequent meals.
(b) High protein diet.
(c) Patient to lie flat immediately after meals.
(d) Encourage smoking and beverages that contain caffeine.
Para-oesophageal hernia occurs in:
(a) Upper stomach at gastroesophageal junction.
(b) Any part of the diaphragm besides the oesophagus.
(c) Occurs in the umbilicus.
(d) All of the above.
The predisposing factors for peptic ulcer disease include all the following except?
(a) Zollinger Ellison syndrome.
(b) People with chronic disease.
(c) Habitual use of NSAIDS.
(d) Prolonged use of antacids.
The complications associated with stomach surgery include:
(a) Dumping syndrome, paralytic ileus.
(b) Peptic ulcer, pneumonia.
(c) Cardiac tymponade renal failure.
(d) Bowel obstruction, hepatic encephalopathy.
The two types of liver abscess are:
(a) Amoebic and pyogenic.
(b) Pyogenic and traumatic.
(c) Capsulated and non-capsulated abscess.
(d) Amoebic and non-capsulated.
Write true or false for Q.6.
(a) Morphine is an analgesic of choice in pancreatitis.
(b) Hepatitis D always occurs in patients with hepatitis B.
The management of cholelithiasis include the following except:
(a) Pain management.
(b) Antibiotics.
(c) High cholesterol diet.
(d) Surgical removal of gallstones.
The signs and symptoms of ruptured appendicitis is:
(a) Sudden sharp abdominal pain at the MC Burney point.
(b) Sudden sharp pain at the epigastrium.
(c) Low grade fever.
(d) Constipation.
The causes of intrahepatic jaundice include:
(a) Malaria, sickle cell anaemia.
(b) Thalassaemia, viral hepatitis.
(c) Viral hepatitis, liver cancer.
(d) Gallstones, pancreatitis.
The cause of acute abdomen are:
(a) Amoebic dysentery, appendicitis.
(b) Pesitonilits, bowel obstruction.
(c) Cholelithiasis, liver cirrhosis.
(d) Typhoid, ruptured abdominal aneurysm.
The main course of liver diseases are:
(a) Fungus and virus
(b) Bacterial and protozoa
(c) Bacterial, virus and protozoa
(d) Fungus, virus, bacteria
Enlarged virus around the anal orifice is:
(a) Anal warts
(b) Anal fissure
(c) Varicose veins
(d) Haemorrhoids
The microorganism that causes peptic ulcer disease is:
(a) Eschierichia coli
(b) Helicobacter pylori
(c) Staphylococci
(d) Klebsiella pneumonia
The following are the characteristics of icteric stage in hepatitis except:
(a) Dark amber urine
(b) Jaundice appears
(c) Pruritus
(d) Fatigue
Hepatitis A is transmitted through
(a) Blood
(b) Blood products
(c) Body secretions
(d) Fecal oral route
The factors that predispose to portal hypertension include
(a) Abdominal trauma, biliary surgery, Oesophageal stricture
(b) Cirrhosis of the liver, schistosomiasis, pancreatitis
(c) Cystic liver disease, oral contraceptives, ulcerative colitis
(d) Schistomiasis , Oesophageal stricture, cirrhosis of the liver
Which of the following is a complication of liver cirrhosis.
(a) Gynaecomastia
(b) Haemorrhoids
(c) Testicular hypertrophy
(d) Portal hypertension
Portal circulation blood from digestive organs drain directly into:
(a) Hepatic veins
(b) Hepatic artery
(c) Portal artery
(d) Portal vein
The formation of stones in the biliary tract is
(a) Cholecystitis
(b) Hepatitis
(c) Pancreatitis
(d) Cholesthiasis
The condition of the digestive system that presents with reddening edema and hematemesis
(a) Duodenal ulcer
(b) Gastric ulcer
(c) Gastritis
(d) Peptic ulcer
Which of the following is not a risk factor for cholelithiasis:
(a) Obesity.
(b) Diabetic mellitus.
(c) Treatment with high doses of oestrogen.
(d) Smoking.
Gallstones can be classified into how many types?
(a) 4.
(b) 2.
(c) 3.
(d) None of the above.
The incubation period for hepatitis C is?
(a) 15 – 160 days.
(b) 30 – 150 days.
(c) 15 – 65 days.
(d) None of the above.
Which amongst these is not a form of liver cirrhosis?
(a) Alcoholic cirrhosis.
(b) Infectious liver cirrhosis.
(c) Post necrotic cirrhosis.
(d) Biliary cirrhosis.
All these are functions of liver except:
(a) Conversion of ammonia into urea.
(b) Metabolism.
(c) Bile formation.
(d) Storage of all vitamins.
Write true or false for Q.6 – Q.10.
Colorectal cancer begins as adenomatous polyps that arise in the rectum and sigmoid.
Dumping syndrome occurs with total gastrectomy.
Hepatic cancers are always primary in origin.
Hepatitis D virus infection does not occur in some cases of hepatitis B.
Cholesterol stones accounts for 75% of the cases of gall bladder diseases
The following are causes of peritonitis except:
(a) Diverticulitis.
(b) Trauma.
(c) Peritoneal dialysis.
(d) G I blooding.
Which parts of G I that does Cohn’s disease affect:
(a) Rectum and sigmoid colon.
(b) Transverse and descending colon.
(c) Terminal ileum and ascending colon.
The following are risk factors for colorectal cancer except:
(a) Bowel obstruction.
(b) Family history.
(c) Inflammatory bowel disease.
(d) Diet high in fats.
Obstruction of the intestinal lumen as a mechanical cause of intestinal obstruction include:
(a) Tumours.
(b) Inflammatory bowel disease.
(c) Foreign bodies.
(d) Adhesions.
The following are complications of diverticular disease except?
(a) Peritonitis.
(b) Abscess formation.
(c) Constipation.
(d) Haemorrhage.
Write true or false for Q.6 – Q.10.
The gastro-intestinal tract is composed of 31 years.
Nutrients are reabsorbed along the jejunum and ileum.
Duodenal ulcers accounts for 15%,
Proton pump inhibitors block gastric secretion.
Chronic gastritis is associated with risk of gastric cancer.
The main cause of liver diseases are:
(a) Fungus and virus
(b) Bacterial and protozoa
(c) Bacterial, virus and protozoa
(d) Fungus, virus, bacteria
Enlarged virus around the anal orifice is:
(a) Anal warts
(b) Anal fissure
(c) Varicose veins
(d) Haemorrhoids
The microorganism that causes peptic ulcer disease is:
(a) Eschierichia coli
(b) Helicobacter pylori
(c) Staphylococci
(d) Klebsiella pneumonia
The following are the characteristics of icteric stage in hepatitis except:
(a) Dark amber urine
(b) Jaundice appears
(c) Pruritus
(d) Fatigue
Hepatitis A is transmitted through
(a) Blood
(b) Blood products
(c) Body secretions
(d) Fecal oral route
The factors that predispose to portal hypertension include
(a) Abdominal trauma, biliary surgery, Oesophageal stricture
(b) Cirrhosis of the liver, schistosomiasis, pancreatitis
(c) Cystic liver disease, oral contraceptives, ulcerative colitis
(d) Schistomiasis , Oesophageal stricture, cirrhosis of the liver
Which of the following is a complication of liver cirrhosis.
(a) Gynaecomastia
(b) Haemorrhoids
(c) Testicular hypertrophy
(d) Portal hypertension
Portal circulation blood from digestive organs drain directly into:
(a) Hepatic veins
(b) Hepatic artery
(c) Portal artery
(d) Portal vein
The formation of stones in the biliary tract is
(a) Cholecystitis
(b) Hepatitis
(c) Pancreatitis
(d) Cholesthiasis
The condition of the digestive system that presents with reddening edema and hematemesis
(a) Duodenal ulcer
(b) Gastric ulcer
(c) Gastritis
(d) Peptic ulcer
