1. Mrs. James is 7 months pregnant and states that she has de eloped a problem ith constipation.
She eats a well-balanced diet and is usually regular. You should explain that constipation is common
during pregnancy because of changes in the colorectal areas, such as: a. decreased movement through
the colon and increased water absorption from the stool.
b. increased movement through the colon and increased salt taken from foods.
c. looser anal sphincter and fewer nutrients taken from foods.
d. tighter anal sphincter and less iron eliminated in the stool.
ANS: A
Constipation and flatus are more common during pregnancy because the colon is displaced, peristalsis
is decreased, and water absorption is increased. Movement through the colon is decreased during
pregnancy. The colon does not absorb nutrients. A tighter sphincter tone is not related to pregnancy.
2. The family history of a patient with diarrhea and abdominal pain should include inquiry about cystic
fibrosis because it is:
a. a common genetic disorder.
b. one cause of malabsorption syndrome. B.COM
c. a curable condition with medical intervention.
d. the most frequent cause of diarrhea in general practice.
ANS: B
Cystic fibrosis is an uncommon, chronic genetic disorder affecting multiple systems. In the
gastrointestinal tract, it causes malabsorption syndrome because of pancreatic lipase deficiency.
Steatorrhea and abdominal pain from increased gas production are frequent complaints.
3. When assessing abdominal pain in a college-age woman, one must include:
a. history of interstate travel.
b. food likes and dislikes.
c. age at completion of toilet training.
d. the first day of the last menstrual period.
ANS: D
Exploring abdominal pain complaints in a young woman can reveal multiple causes related to the
menstrual cycle, including menstrual pain, ovulation discomfort, and abnormal menses. Asking the
patient to tell you the first day of her last menstrual period can help discriminate among these factors.
, Histor of international tra el and tra eler s diarrhea can be related to abdominal pain, but interstate
travel usually does not. Food preferences and age at completion of toilet training are not relevant.
4. Infants born weighing less than 1500 g are at higher risk for:
a. hepatitis A.
b. necrotizing enterocolitis.
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