MCQ AND ANSWER FOR DIGESTIVE SYSTEM

BY GLORY ABASA

1. The physiological term for eating and drinking is:

a. Ingestion.
b. Propulsion.
c. Absorption.
d. Digestion.

Rationale: The physiological term for eating and drinking is ingestion.

2. The layers forming the walls of the alimentary tract include:

a. The mucosa.
b. The submucosa.
c. The serosa.
d. All of the above.

Rationale All of the layers above are present in the walls of the alimentary tract.

3. The accessory organs of digestion do NOT include the:

a. Salivary glands.
b. Pancreas.
c. Duodenum.
d. Liver.

Rationale: The duodenum is not an accessory organ of digestion, it is part of the digestive tract.

4. The serous membrane that lines the abdominal wall is the:

a. Visceral peritoneum.
b. Parietal peritoneum.
c. Mesentery.
d. Greater omentum.

Rationale: The parietal peritoneum lines the abdominal wall.

5. Which organ is retroperitoneal?

a. Liver.
b. Stomach.
c. Kidney.
d. Small intestine.

Rationale: The kidneys are retroperitoneal (lie behind the peritoneum).

6. In the alimentary tract, the muscle layer:

a. Is arranged with the circular fibres outside the longitudinal fibres.
 b. Has its plexus outermost.
c. Produces peristalsis through contraction and relaxation of the longitudinal muscle fibres.
d. Has thickened rings of circular muscle known as sphincters.

Rationale: Sphincters are rings of thickened circular muscle.

7. The myenteric plexus is located in the:

a. Mucosa.
b. Submucosa.
c. Muscle layer.
d. Serosa.

Rationale: The myenteric plexus contains sympathetic and parasympathetic nerves that supply
the muscle layer and is located between the circular and longitudinal fibres

8. What are the effects of parasympathetic stimulation on the alimentary tract?

a. Increased muscular activity.
b. Increased glandular secretion.
c. Both a. and b.
d. Neither a. nor b.

Rationale: Parasympathetic stimulation of the alimentary tract increases both muscular activity
and glandular secretion.

9. Goblet cells secrete:

a. Mucus.
b. Saliva.
c. Amylase.
d. Bile.
10. Which of the following is NOT a boundary of the oral cavity?
a. The lips.
b. The palate.
c. The tongue.
d. The oesophagus.

Rationale: The oesophagus is not a boundary of the oral cavity. The oral cavity is bounded by
the lips anteriorly, the palate superiorly, the tongue inferiorly and is continuous with the
oropharynx posteriorly.

11. Which nerve supplies the voluntary tongue muscles?

a. The hypoglossal nerve.
b. The mandibular nerve.
c. The facial nerve.
d. The glossopharyngeal nerve.
 Rationale: The hypoglossal nerve supplies the voluntary muscles of tongue

12. The sensory receptors for taste are present in:

a. The soft palate.
b. The pharynx.
c. The epiglottis.
d. All of the above.

Rationale: The sensory receptors (nerve endings) of taste are present in the papillae and widely
distributed in the epithelium of the tongue, soft palate, pharynx and epiglottis.

13. All the deciduous teeth should be visible by the age of:
a. 6 months.
b. 24 months.
c. 6 years.
d. 21 years.

Rationale: All deciduous teeth should be present by the age of 24 months.

14. What secures a tooth in its socket?

a. The pulp cavity.
b. The dentine.
c. The enamel.
d. The cementum.

Rationale: The root of a tooth is covered by a substance resembling bone, called cementum,
which secures it in its socket.

15. The ducts of which salivary glands open into the mouth beside the second upper molar tooth?
a. The parotid glands.
b. The submandibular glands.
c. The sublingual glands.
d. The adrenal glands.

Rationale: The parotid ducts open into the mouth beside the second upper molar tooth.

16. The facial artery supplies the:

a. Tongue.
b. Teeth.
c. Pharynx.
d. Oesophagus.

Rationale: The pharynx is supplied by several branches of the facial arteries.

17. The oesophagus passes through the diaphragm at the level of which vertebra?
 a. T8.
b. T10.
c. T11.
d. T12.

Rationale: The oesophagus passes between muscle fibres of the diaphragm behind the central
tendon at the level of the 10th thoracic vertebra.

18. Dysphagia is:

a. Difficulty swallowing.
b. Vomiting blood.
c. Passing blood in the faeces.
d. Feeling of sickness.
19. Which anatomical feature(s) minimises gastric reflux?
a. The attachment of the stomach to the diaphragm.
b. The acute angle at the junction of the oesophagus and the diaphragm.
c. Increased tone of the lower oesophageal sphincter during increased intra-abdominal
pressure.
d. All of the above.

Rationale: All of the above are responsible for minimising gastric reflux.

20. Which organ has three layers of muscle fibres?

a. The oesophagus.
b. The stomach.
c. The small intestine.
d. The large intestine.

Rationale: The stomach has three layers (longitudinal, circular and oblique) of muscle fibres.

21. Pepsinogen is secreted by:

a. Mucous neck cells.
b. Parietal cells.
c. Chief cells.
d. All of the above.

Rationale: Chief cells secrete pepsinogen.

22. The condition where part of the stomach protrudes though the oesophageal opening in the
diaphragm is known as a(n):
a. Hiatus hernia.
b. Inguinal hernia.
c. Umbilical hernia.
d. Peritoneal hernia.
23. Secretin is released in which phase(s) of gastric secretion?
a. The cephalic phase.
b. The gastric phase.
c. The intestinal phase.
d. All of the above.

Rationale: Secretin and cholecystokinin are secreted in the intestinal phase.

24. A meal high in which of the following remains longest in the stomach?
a. Carbohydrate.
b. Protein.
c. Fat.
d. Fibre.

Rationale: A fatty meal remains in the stomach for longest.

25. Vomiting:
a. . Is a voluntary process.
b. Is accompanied by strong reverse waves of gastric peristalsis.
c. Can lead to serious acidosis.
d. Is coordinated by the cerebrum.
26. Which is the longest?
a. The large intestine.
b. The duodenum.
c. The jejunum.
d. The ileum.

Rationale: The ileum is the longest, at about 3 m

27. In ulcerative colitis:

a. There is a high risk of malignancy developing.
b. Any part of the digestive tract can be affected and the terminal ileum is typically involved.
c. The entire thickness of the intestinal wall is affected.
d. Ulcers and fistulae are common.
28. The hepatopancreatic sphincter is located in the:
a. Stomach.
b. Duodenum.
c. Jejunum.
d. Ileum.

RationaleL The duodenal papilla is guarded by a ring of smooth muscle, the hepatopancreatic
sphincter (of Oddi).

29. Aggregated lymph follicles (Peyer’s patches) are found in the:

 a. Duodenum.
b. Jejunum.
c. Ileum.
d. Large intestine.

Rationale: The distal end of ileum has collections of larger lymph nodes called aggregated
lymphoid follicles (Peyer’s patches).

30. How many days does replacement of the entire epithelium of the small intestine take?
a. 2–3 days.
b. 3–5 days.
c. 5–8 days.
d. 8–12 days.

Rationale: The epithelium of the entire small intestine is replaced every 3–5 days.

31. Which condition predisposes to malignancy in the alimentary tract?

a. Tropical sprue.
b. Coeliac disease.
c. Diverticular disease.
d. Barrett’s oesophagus.

Rationale: Barrett’s oesophagus is regarded as a premalignant condition

32. Which is a constituent of pancreatic juice?

a. Trypsinogen.
b. Cholecystokinin.
c. Pepsinogen.
d. Intrinsic factor.

Rationale: Trypsinogen is an inactive enzyme precursor present in pancreatic juice.

33. Hepatitis B:
a. Is spread by the faecal-oral route.
b. Has a carrier state.
c. Has an incubation period of 5 to 18 days.
d. Is a mild illness.
34. Which vitamin is absorbed into the lacteals?
a. B.
b. C.
c. D.
d. Folic acid

Rationale: Vitamin D is fat soluble and absorbed into lacteals with lipids.
35. Vitamin B12 is absorbed in the:
a. Stomach.
b. Duodenum.
c. Terminal ileum.
d. Large intestine.

Rationale: Vitamin B12 combines with intrinsic factor in the stomach and is actively absorbed in
the terminal ileum

36. Which part of the large intestine has an S-shaped curve?

a. The caecum.
b. The sigmoid colon.
c. The rectum.
d. The anal canal.

Rationale: The sigmoid colon located in the pelvic cavity has an S-shaped curve.

37. In adults, the approximate length of the anal canal is:

a. 6.2 cm.
b. 5.8 cm.
c. 4.8 cm.
d. 3.8 cm.

Rationale: The anal canal is a short passage about 3.8 cm long in adults.

38. The arterial supply to the caecum is via the:

a. Superior mesenteric artery.
b. Inferior mesenteric artery.
c. Middle rectal artery.
d. Inferior rectal artery.

Rationale: The superior mesenteric artery supplies the caecum, ascending colon and most of the
transverse colon.

39. Which is the largest gland?

a. The pancreas.
b. The liver.
c. The parotids.
d. The adrenals.

Rationale: The liver is the largest gland in the body, weighing between 1 and 2.3 kg.

40. Which is the largest lobe of the liver?

a. Right.
b. Left.
 c. Caudate.
d. Quadrate.
41. How is the liver related to the diaphragm anatomically?
a. Anteriorly.
b. Posteriorly.
c. Laterally.
d. All of the above.

Rationale: The liver is related to the diaphragm anteriorly, posteriorly and laterally.

42. Which of the following are bile acids?

a. Cholic acid.
b. Chenodeoxycholic acid.
c. Both of the above.
d. Neither of the above..

Rationale: Both cholic acid and chenodeoxycholic acid are bile acids synthesized in the liver and
contribute to the composition of bile. They aid in emulsification of fats during digestion.

43. Uric acid is a breakdown product of:

a. Linoleic acid.
b. Deoxyribonucleic acid.
c. Amino acids.
d. Creatinine.

Rationale: Uric acid is a byproduct of the breakdown of purines, which are components of
nucleic acids (DNA, RNA) and some amino acids.

44. Intrahepatic jaundice can be caused by:

a. Viral hepatitis.
b. Impacted gallstones.
c. Excessive haemolysis.
d. A tumour of the head of the pancreas.
45. In the biliary tract:
a. The right and left hepatic ducts join just before passing out of the portal fissure.
b. The hepatic duct is joined by the cystic duct from the liver.
c. The right and left hepatic ducts merge forming the common bile duct.
d. The common bile duct joins the pancreatic duct at the hepatopancreatic ampulla.

Rationale: The right and left hepatic ducts join to form the common hepatic duct, which then
joins with the cystic duct from the gallbladder to form the common bile duct.

46. A gallstone lodged in the biliary tract will cause jaundice if it is impacted in the:
a. Gall bladder.
 b. Cystic duct.
c. Common bile duct.
d. All of the above.

Rationale: If a gallstone becomes lodged in the common bile duct, it can obstruct the flow of
bile, leading to jaundice due to the buildup of bilirubin in the bloodstream.

47. What is/are the function(s) of the gall bladder?

a. A reservoir for bile.
b. Concentration of bile.
c. Release of stored bile.
d. All of the above.

Rationale: The gallbladder serves as a reservoir for bile, concentrates bile by removing water,
and releases stored bile into the digestive system when needed for fat digestion.

48. Metabolic rate:

a. Is higher in women than men.
b. Increases with age.
c. Increases during starvation.
d. Increases during a fever.

Rationale: During a fever, the metabolic rate increases as the body attempts to generate more
heat to fight off the infection, leading to an increased metabolic demand.

49. Which is NOT a central metabolic pathway?

a. The citric acid cycle.
b. Glycolysis. C
c. Deamination.
d. Oxidative phosphorylation.

Rationale: Deamination is a process involving the removal of an amino group from amino acids
and is not a central metabolic pathway like glycolysis, the citric acid cycle, or oxidative
phosphorylation, which are involved in energy production and biosynthesis.

50. An example of an anaerobic metabolic pathway is:

a. The citric acid cycle.
b. Glycolysis.
c. Deamination.
d. Oxidative phosphorylation.

Rationale: Glycolysis does not require oxygen and is therefore an anaerobic pathway.

51. Which hepatitis virus is primarily transmitted through contaminated food or water?
a. Hepatitis A
 b. Hepatitis B
c. Hepatitis C
d. Hepatitis D

Rationale: Hepatitis A is primarily transmitted through the fecal-oral route due to contaminated
food or water.

52. What is a common route of transmission for hepatitis B virus (HBV)?

a. Fecal-oral route
b. Sharing eating utensils
c. Percutaneous exposure to infected blood or body fluids
d. Casual contact like handshakes
Rationale: HBV is transmitted through percutaneous exposure to infected blood or body
fluids, such as through sharing needles or unprotected sex.
53. Which hepatitis virus can cause chronic infection and is a leading cause of liver cirrhosis and liver
cancer?
a. Hepatitis A
b. Hepatitis B
c. Hepatitis C
d. Hepatitis E

Rationale: Hepatitis C can lead to chronic infection, potentially causing liver cirrhosis and
hepatocellular carcinoma.

54. Which hepatitis virus is primarily a coinfection with hepatitis B and is dependent on HBV for its
replication?
a. Hepatitis A
b. Hepatitis B
c. Hepatitis C
d. Hepatitis D

Rationale: Hepatitis D is a coinfection with HBV and requires HBV for its replication. It cannot
exist without HBV.

55. Which immunoglobulin is administered for post-exposure prophylaxis against hepatitis A?

a. IgA
b. IgD
c. IgE
d. IgG

Rationale: Hepatitis A post-exposure prophylaxis involves the administration of immune

globulin (IgG) for short-term protection.
56. A patient presents with jaundice, fatigue, and dark urine. Which hepatitis virus infection is most
likely?
a. Hepatitis A
b. Hepatitis B
c. Hepatitis C
d. Hepatitis E

Rationale: These symptoms are characteristic of hepatitis B infection, which can present with
jaundice, fatigue, and dark urine

57. How is hepatitis C primarily diagnosed?

a. Hepatitis C antigen test
b. Hepatitis C antibody test
c. Liver biopsy
d. Blood culture

Rationale: The primary diagnostic test for hepatitis C is detecting antibodies against the virus
using serologic tests.

58. Which hepatitis virus is associated with a high mortality rate in pregnant women, particularly in
the third trimester?
a. Hepatitis A
b. Hepatitis B
c. Hepatitis C
d. Hepatitis E

Rationale: Hepatitis E can have a high mortality rate in pregnant women, especially in the third
trimester.

59. What is the first-line vaccine for preventing hepatitis B infection?

a. Hepatitis A vaccine
b. Hepatitis B vaccine
c. Hepatitis C vaccine
d. Hepatitis D vaccine

Rationale: The hepatitis B vaccine is the primary method for preventing hepatitis B infection.

60. Which precaution is essential for healthcare workers to prevent hepatitis B transmission?
a. Contact precautions
b. Droplet precautions
c. Airborne precautions
d. Standard precautions
 Rationale: Standard precautions, including hand hygiene, use of personal protective equipment,
and safe handling of sharps, are crucial for preventing hepatitis B transmission among
healthcare workers.

61. What is the primary cause of acute gastritis?

a. Excessive alcohol consumption
b. Chronic use of NSAIDs (nonsteroidal anti-inflammatory drugs)
c. Helicobacter pylori infection
d. Prolonged stress

Rationale: Helicobacter pylori (H. pylori) infection is a common cause of acute gastritis, leading
to inflammation of the stomach lining.

62. Which symptom is commonly associated with chronic gastritis?

a. Hematemesis (vomiting blood)
b. Severe abdominal pain immediately after eating
c. Episodic nausea
d. Heartburn after fatty meals

Rationale: Chronic gastritis can lead to erosion of the stomach lining and, in severe cases, cause
bleeding leading to hematemesis.

63. What dietary modification is typically recommended for individuals with gastritis?
a. Increasing spicy food intake
b. Consuming carbonated beverages
c. Avoiding acidic foods and beverages
d. Eating large meals infrequently

Rationale:Acidic foods and beverages can irritate the stomach lining, exacerbating gastritis
symptoms.

64. Which medication is commonly used to treat H. pylori-related gastritis?

a. Antacids
b. Proton pump inhibitors (PPIs)
c. H2 blockers
d. Antibiotics

Rationale: Antibiotics are used to eradicate H. pylori infection, which is often the cause of
gastritis.

65. What diagnostic test is commonly performed to confirm H. pylori infection in patients with
suspected gastritis?
a. Complete blood count (CBC)
b. Stool antigen test
c. Electrocardiogram (ECG)
 d. Chest X-ray

Rationale: Stool antigen testing is a non-invasive method used to detect H. pylori antigens in the
stool, confirming the presence of the infection.

66. What lifestyle modification is recommended for individuals with gastritis to alleviate symptoms?
a. Regular exercise regimen
b. Smoking cessation
c. Increased caffeine intake
d. High-fat diet

Rationale: Smoking can exacerbate gastritis symptoms, and quitting smoking is advised to help
alleviate symptoms and promote healing of the stomach lining.

67. Which bacterium is most commonly associated with the development of peptic ulcers?
a. Helicobacter pylori
b. Streptococcus mutans
c. Escherichia coli
d. Staphylococcus aureus

Rationale: Helicobacter pylori infection is a primary cause of peptic ulcers, especially duodenal
ulcers.

68. What is a typical symptom of a gastric peptic ulcer?

a. Pain worsening on an empty stomach
b. Pain improving after eating
c. Radiating pain to the back
d. Pain unaffected by food intake

Rationale: Gastric ulcers tend to cause pain that worsens on an empty stomach or at night when
the stomach is devoid of food to buffer gastric acid.

69. Which medication is commonly used in the treatment of peptic ulcers to suppress gastric acid
production?
a. Antacids
b. Antibiotics
c. Proton pump inhibitors (PPIs)
d. Antiemetics

Rationale: PPIs are frequently prescribed to inhibit the production of stomach acid, aiding in the
healing of peptic ulcers.

70. What lifestyle modification is beneficial in managing peptic ulcers?

a. Regular consumption of spicy foods
b. Frequent consumption of carbonated beverages
 c. Smoking cessation
d. Increased caffeine intake

Rationale: Smoking can delay ulcer healing and increase the risk of ulcer recurrence; hence,
quitting smoking is recommended.

71. Which diagnostic test is often used to confirm the presence of Helicobacter pylori in patients
suspected of having peptic ulcers?
a. Complete blood count (CBC)
b. Stool culture
c. Urea breath test
d. Electrocardiogram (ECG)

Rationale: The urea breath test is a common diagnostic method for detecting Helicobacter
pylori by measuring the presence of labeled carbon dioxide in the breath after ingestion of a
urea solution.

72. What complication can arise from a perforated peptic ulcer?

a. Gastritis
b. Hemorrhoids
c. Peritonitis
d. Cholecystitis

Rationale: A perforated peptic ulcer can cause the contents of the stomach or intestine to spill
into the abdominal cavity, leading to peritonitis, a serious and potentially life-threatening
condition characterized by inflammation of the peritoneum.

73. What is the primary cause of early dumping syndrome?

a. Rapid emptying of undigested food into the small intestine
b. Excessive secretion of gastric acid
c. Inadequate bile production
d. Delayed gastric emptying

Rationale: Early dumping syndrome occurs due to the swift movement of food from the
stomach into the small intestine, causing a rapid influx of fluids, leading to symptoms.

74. Which symptom is commonly associated with early dumping syndrome?

a. Hypertension
b. Bradycardia
c. Abdominal pain and cramping
d. Increased appetite

Rationale: Abdominal pain and cramping are typical symptoms of early dumping syndrome,
often occurring shortly after eating.
75. What dietary advice should be given to a patient experiencing dumping syndrome?
a. Increase simple carbohydrates intake
b. Consume small, frequent meals
c. Avoid protein-rich foods
d. Encourage large meals at regular intervals

Rationale: Eating smaller, more frequent meals helps reduce the volume of food entering the
small intestine at one time, potentially minimizing dumping syndrome symptoms.

76. Which intervention can help manage late dumping syndrome?

a. Lie down immediately after meals
b. Consume high-carbohydrate meals
c. Increase fluid intake during meals
d. Focus on protein-rich meals

Rationale: Protein-rich meals can help stabilize blood sugar levels and reduce the risk of
hypoglycemia, which is associated with late dumping syndrome.

77. Which complication is associated with severe cases of dumping syndrome?

a. Hyperglycemia
b. Malnutrition
c. Hypotension
d. Osteoporosis

Rationale: Severe cases of dumping syndrome can lead to malnutrition due to inadequate
absorption of nutrients from rapid transit through the digestive system.

78. What is a recommended nursing intervention for a patient experiencing early dumping
syndrome?
a. Encourage the intake of sugary beverages
b. Provide antidiarrheal medications immediately after meals
c. Advise the patient to rest in a reclined position after eating
d. Encourage slow and thorough chewing of food

Rationale: Properly chewing food aids digestion and might help reduce the occurrence of early
dumping syndrome by slowing down the rate at which food enters the small intestine.

79. What is the primary cause of acute cholecystitis?

a. Gallstones obstructing the cystic duct
b. Chronic alcohol consumption
c. Bacterial infection of the gallbladder
d. Enlargement of the gallbladder

Rationale: Acute cholecystitis commonly occurs due to gallstones blocking the cystic duct,
leading to inflammation and ischemia of the gallbladder.
80. What clinical manifestation is typically associated with acute cholecystitis?
a. Left upper quadrant pain radiating to the back
b. Colicky pain in the lower abdomen
c. Sharp pain in the right upper quadrant radiating to the right shoulder
d. Epigastric discomfort worsening after meals

Rationale: The classic presentation of acute cholecystitis includes severe, steady, right upper
quadrant pain that may radiate to the right shoulder or scapula.

81. Which diagnostic test is most commonly used to confirm acute cholecystitis?
a. CT scan
b. Upper gastrointestinal (GI) endoscopy
c. Abdominal ultrasound
d. Magnetic Resonance Imaging (MRI)

Rationale: Abdominal ultrasound is often the initial imaging test of choice for diagnosing acute
cholecystitis due to its ability to visualize gallstones and signs of inflammation.

82. What dietary guideline is typically recommended for a patient experiencing an acute
cholecystitis episode?
a. Low-fat diet
b. High-protein diet
c. High-fiber diet
d. High-carbohydrate diet

Rationale: A low-fat diet is often advised during acute cholecystitis to reduce the workload on
the gallbladder and minimize the stimulation of gallbladder contraction.

83. Which complication may arise if acute cholecystitis is left untreated?

a. Pancreatitis
b. Hepatic encephalopathy
c. Cholelithiasis
d. Gallbladder perforation

Rationale: Untreated acute cholecystitis can lead to severe inflammation, increased pressure,
and eventual perforation of the gallbladder, causing peritonitis or abscess formation.

84. Which intervention is a primary treatment for acute cholecystitis?

a. Oral antibiotics
b. Intravenous fluids and analgesics
c. Surgical cholecystectomy
d. Antacid medication
 Rationale: Surgical removal of the gallbladder (cholecystectomy) is the primary treatment for
acute cholecystitis, particularly if symptoms persist or in cases of complications to prevent
recurrence.

85. What is a common cause of liver cirrhosis?

a. Viral hepatitis
b. Lung cancer
c. Diabetes mellitus
d. Hypothyroidism

Rationale: Chronic viral hepatitis infections, especially hepatitis B and C, are significant causes of
liver cirrhosis due to prolonged inflammation and liver damage.

86. Which laboratory finding is commonly elevated in liver cirrhosis?

a. Serum albumin
b. Platelet count
c. Serum bilirubin
d. Prothrombin time

Rationale: In liver cirrhosis, impaired liver function leads to the accumulation of bilirubin,
resulting in elevated serum bilirubin levels.

87. Which symptom is associated with advanced liver cirrhosis?

a. Jaundice
b. Hypertension
c. Hyperglycemia
d. Bradycardia

Rationale: Jaundice, characterized by yellowing of the skin and eyes due to increased bilirubin, is
a common manifestation of advanced liver cirrhosis.

88. What dietary modification is recommended for a patient with liver cirrhosis and ascites?
a. High sodium intake
b. Low protein intake
c. Fluid restriction
d. Increased potassium intake

Rationale: Fluid restriction is advised in patients with liver cirrhosis and ascites to reduce fluid
buildup and manage the condition effectively.

89. Which complication is associated with portal hypertension in liver cirrhosis?

a. Increased urine output
b. Esophageal varices
c. Decreased blood ammonia levels
d. Low serum creatinine
 Rationale: Portal hypertension in liver cirrhosis can cause the development of esophageal
varices, which are dilated blood vessels in the esophagus prone to rupture and bleeding.

90. What is a key nursing intervention to prevent complications in a patient with liver cirrhosis?
a. Encouraging alcohol consumption
b. Promoting a high-fat diet
c. Monitoring for signs of bleeding
d. Avoiding vaccination

Rationale: Patients with liver cirrhosis are at an increased risk of bleeding due to reduced
clotting factors, making close monitoring for signs of bleeding crucial in their care.:

91. What is the primary cause of esophageal varices?

a. Chronic alcoholism
b. High-fiber diet
c. Sedentary lifestyle
d. Vitamin deficiency

Rationale: Chronic alcoholism is a leading cause of liver cirrhosis, which can lead to portal
hypertension and subsequently result in the development of esophageal varices.

92. What complication is most concerning in a patient with esophageal varices?

a. Dysphagia
b. Esophageal bleeding
c. Heartburn
d. Abdominal pain

Rationale: Esophageal varices can rupture, leading to severe and potentially life-threatening
bleeding due to their fragile, enlarged vessels.

93. Which procedure is commonly performed to diagnose esophageal varices?

a. Colonoscopy
b. Upper gastrointestinal (GI) endoscopy
c. Magnetic Resonance Imaging (MRI)
d. Urinalysis

Rationale: Upper GI endoscopy is the gold standard for diagnosing esophageal varices, allowing
direct visualization of varices in the esophagus.

94. What medication is commonly used for the primary prevention of bleeding in patients with
esophageal varices?
a. Antibiotics
b. Proton pump inhibitors (PPIs)
c. Nonsteroidal anti-inflammatory drugs (NSAIDs)
d. Beta-blockers
 Rationale: Beta-blockers, such as propranolol or nadolol, are often used to reduce the risk of
bleeding by decreasing portal pressure in patients with esophageal varices.

95. Which nursing intervention is crucial for a patient with known esophageal varices to prevent
bleeding episodes?
a. Encouraging straining during bowel movements
b. Advising against physical activities
c. Instructing on the importance of maintaining a soft diet
d. Counseling against alcohol consumption

Rationale: Alcohol consumption can exacerbate liver damage and increase the risk of bleeding
in patients with esophageal varices, so advising against it is crucial.

96. Which sign/symptom might indicate an impending esophageal variceal bleed?

a. Weight gain
b. Bright red blood in vomit (hematemesis)
c. Increased appetite
d. Improved energy levels

Rationale: Hematemesis, particularly with bright red blood, can indicate active bleeding from
esophageal varices and requires immediate medical attention.

97. Which of the following is a common cause of acute pancreatitis?

a. Excessive alcohol consumption
b. Regular intake of probiotics
c. High-fiber diet
d. Vitamin D supplementation

Rationale: Acute pancreatitis is frequently associated with excessive alcohol intake, leading to
pancreatic inflammation.

98. Which laboratory finding is often elevated in acute pancreatitis?

a. Serum amylase
b. Platelet count
c. Serum calcium
d. ) Serum albumin

Rationale: Elevated serum amylase levels are a hallmark of acute pancreatitis due to pancreatic
cell injury.

99. What dietary intervention is typically recommended for a patient recovering from acute
pancreatitis?
a. High-fat diet
b. Low-carbohydrate diet
c. Low-fat diet
 d. High-protein diet

Rationale: A low-fat diet is commonly advised to reduce the workload on the pancreas during
recovery from acute pancreatitis.

100. Which complication is a potential consequence of severe acute pancreatitis?

a. Hypertension
b. Pleural effusion
c. Osteoporosis
d. Peripheral neuropathy

Rationale: Severe acute pancreatitis can lead to pleural effusion due to the inflammatory
process affecting adjacent structures.

101. A patient with chronic pancreatitis might experience:

a. Sudden onset of symptoms
b. Frequent episodes of acute abdominal pain
c. Resolution of symptoms after dietary changes
d. Elevated blood glucose levels

Rationale: Chronic pancreatitis often manifests with recurrent episodes of acute abdominal pain
due to ongoing inflammation and pancreatic damage.

102. Which diagnostic imaging study is often used to evaluate pancreatitis and its
complications?
a. Electrocardiogram (ECG)
b. Magnetic Resonance Imaging (MRI)
c. Computed Tomography (CT) scan
d. Bone scan

Rationale: CT scans are frequently used in diagnosing pancreatitis and its complications by
providing detailed images of the pancreas and surrounding structures.

103. Which part of the gastrointestinal tract is primarily affected by ulcerative colitis?
a. Small intestine
b. Stomach
c. Rectum and colon
d. Esophagus

Rationale: Ulcerative colitis is a type of inflammatory bowel disease (IBD) that predominantly
affects the rectum and colon, causing inflammation and ulcers.

104. What is a hallmark symptom of ulcerative colitis during periods of disease exacerbation?
a. Hemorrhoids
b. Constipation
 c. Abdominal pain and cramping
d. Frequent heartburn

Rationale: Abdominal pain and cramping are common symptoms during flare-ups of ulcerative
colitis due to inflammation and spasms in the colon.

105. Which diagnostic test is often utilized to confirm the diagnosis of ulcerative colitis?
a. Barium swallow
b. Colonoscopy with biopsy
c. Blood glucose test
d. Urinalysis

Rationale: Colonoscopy with tissue biopsy is considered the gold standard for diagnosing
ulcerative colitis, as it allows direct visualization of the colon and sampling of tissue for
examination.

106. Which medication class is frequently used as a first-line treatment for mild to moderate
ulcerative colitis?
a. Antibiotics
b. Antifungals
c. Corticosteroids
d. Antispasmodics

Rationale: Corticosteroids such as prednisone are commonly prescribed to induce remission in

mild to moderate cases of ulcerative colitis by reducing inflammation.

107. Which complication is associated with long-term ulcerative colitis?

a. Peptic ulcers
b. Diverticulitis
c. Colon cancer
d. Gallstones

Rationale: Individuals with long-standing ulcerative colitis have an increased risk of developing
colorectal cancer, especially after 8–10 years of the disease.

108. What dietary modification is often recommended to manage symptoms in individuals

with ulcerative colitis during flare-ups?
a. High-fiber diet
b. Low-residue diet
c. High-fat diet
d. Spicy food diet

Rationale: During flare-ups, a low-residue diet (low-fiber) is often recommended to reduce

bowel movements and minimize irritation to the inflamed colon:
109. What is the most common initial symptom of appendicitis?
a. Nausea and vomiting
b. Severe abdominal pain around the navel
c. Low-grade fever
d. Loss of appetite

Rationale: Initial pain in appendicitis often begins around the navel and then shifts to the right
lower quadrant as inflammation progresses.

110. Which sign is indicative of a possible ruptured appendix?

a. Rebound tenderness
b. Positive Rovsing's sign
c. Relief of pain with bending the right leg
d. Absence of fever

Rationale: Relief of pain with bending the right leg (Psoas sign) suggests irritation of the
inflamed appendix, possibly indicating a rupture.

111. What diagnostic test is often used to confirm the diagnosis of appendicitis?
a. Ultrasound
b. Chest X-ray
c. Electrocardiogram (ECG)
d. Lumbar puncture

Rationale: Ultrasound is commonly used to visualize the appendix and diagnose appendicitis,
especially in children and pregnant women.

112. Which intervention is contraindicated in suspected appendicitis?

a. Providing a heating pad for abdominal pain
b. Administering IV fluids
c. Administering analgesics as ordered
d. Applying direct pressure to the right lower quadrant

Rationale: Heat application might worsen inflammation and increase the risk of a ruptured
appendix; it's contraindicated in suspected appendicitis.

113. What is a classic clinical manifestation of appendicitis on physical examination?

a. Presence of bowel sounds
b. Positive McBurney's point tenderness
c. Increased appetite
d. Absence of rebound tenderness

Rationale: Tenderness at McBurney's point (located between the navel and the right iliac crest)
is a classic sign of appendicitis.
114. Which condition might mimic symptoms similar to appendicitis?
a. Gallstones
b. Gastroesophageal reflux disease (GERD)
c. Ovarian cyst rupture
d. Hypertension

Rationale: An ovarian cyst rupture can cause symptoms similar to appendicitis, including lower
abdominal pain and tenderness.