CHOOSE THE BEST ANSWER FROM THE FOUR OPTIONS GIVEN FOR EACH

QUESTION (MCQ)
1. The total surgical removal of the tongue is called:
a. Partial mandibulectomy
b. Hemiglossectomy
c. Glossectomy
d. Radical neck dissection.
2. Concerning the treatment of cancer of the mouth, palliative Treatment is
indicated for the following apart from:
a. The prognosis is poor
b. the cancer is inoperable
c. the patient decides against surgery
d. the cancer is in the early stage
3. The surgical removal of the stomach is called:
a. Gastrostomy
b. Gastrostectomy
c. Gastrectomy
d. Gastrojejustomy

4. Concerning treatment of Tooth decay, which of the following is not a surgical

intervention
a. Dental feeling
b. Dental implants
c. Dental extraction
d. Dental washout

5. Concerning the pouch opening out from the oesophagus, which statement bellow
is INCORRECT?
a. Above the upper oesophageal sphincter it is called Traction
diverticulum
b. Above the upper oesophageal sphincter it is Zenker’s diverticum.
c. Near the oesophageal midpoint it is called Traction diverticulum.
d. Above the lower oesophageal it is called sphincter epiphrenic.

6. Oesophageal achalasia is also called

a. Gastrostomy
b. Cardio spasm.
c. Cardio diverticulum
d. Cardio gastrectomy

1
7. The dilated, tortuous veins occurring in the lower portion of the oesophagus as a
result of portal hypertension are called.
a. Oesophageal hernias
b. Oesophageal Varices
c. Oesophageal structure
d. Oesophageal valves

8. A diaphragmatic hernia in which a portion of the stomach is herniated through the

oesophageal hiatus of the diaphragm is called
a. Abdominal hernia
b. Incision hernia
c. Hiatal hernia
d. Gastric hernia

9. Oesophagogastrostomy refers to:

a. Removal of part of the oesophagus without anastomoses to the stomach.
b. Removal of a portion of oesophagus and anastomose the new portion to
the stomach.
c. Removal of the portion of the stomach and anastomose to the oesophagus
d. Removal of the oesophagus anastomoses the new portion to the stomach.

10. The surgical dividing of the nerves that are known to stimulate gastric acid in the
treatment of peptic ulcer is called:
a. Antrectomy
b. Vasectomy
c. Gastrectomy
d. Vagotomy

2
11. Sudden onset of severe abdominal pain is termed as
a. Acute abdomen
b. Peptic ulcers
c. Peritonitis
d. Appendicitis
.
12. Which of the following is NOT a sign of intestinal obstruction?
a. Nausea and vomiting due to gastrointestinal disturbance and excessive
peristalsis.
b. Boborygymy (exaggerated bowel sounds – mumbling sounds)
c. Abdominal tenderness on examination due to the disease process
d. Soft woody abdomen due to hyper excited peritoneum

13. the chronic inflammatory disease of the mucosa and less frequently submucosa of
the colon, rectum and the distal ileum is termed as:
a. Ulcerative colitis
b. Cancer of the colon
c. Acute appendicitis
d. Acute peritonitis
14. The stage of cancer of the colon in which the tumour extends more deeply into or
through the wall of the colon or rectum and may have invaded nearby tissue, but
cancer cells have not spread to the lymph nodes is
a. Stage I:
b. Stage II:
c. Stage III:
d. Stage IV:
15. An artificial opening made into the large bowel in order to divert faeces (and flatus)
to the exterior, where they may be collected in an adhesive bag is termed as.
a. Colostomy
b. Volvulus
c. diverticulum
d. Vesicle abdominal fistula

16. Which of the following is the principle earliest symptoms of Haemorrhoids

a. Prolapse
b. Discharge
c. Anaemia
d. Bleeding

17. The injecting of a chemical irritant into the tissues surrounding the Haemorrhoids to
reduce inflammation and eventual fibrosis and scarring.

3
 a. Cryotherapy
b. heamodilution
c. Sclerotherapy
d. Chemicalisation

18. An elongated ulcer in the long axis of the lower anal canal.
a. Fissure in ano
b. Anal in fistula
c. Ano in fissure
d. Fistula in anal

19. The investigations that involves the insertion of the fingers in the anus to diagnose
haemarrhoids is called
a. Rectoscopy
b. Digital rectal examination
c. Anoscopy
d. None of the above

20. The perforated peptic ulcer can complicated into the following EXCEPT
a. Peritonitis
b. Aneamia
c. Internal abdominal haemorrhage
d. Cancer of the stomach

21. The colostomy bag is emptied when it is

a. Three quarters full
b. One quarter full
c. Four quarters full
d. Half full

22. The patient with peptic ulcer can be fed on the following type of the diet EXCEPT
a. Bland diet
b. Spiced diet
c. Fluid diet
d. High protein diet

23.Which of the following is correct about splenic abscess

4
 a. Most of the abscess in spleen occur through local spread such as from kidneys,
colon
b. In one third of adults splenic abscess is multilocular
c. Unilocular splenic abscess has a high mortality rate more than 50%
d. Splenomegaly is typically seen in splenic abscess
24.During your hospital day you arrive at the surgical ward and you meet Bonolo, a 16
year old young woman who has just been diagnosed with appendicitis and is
waiting to go for surgery. With your knowledge of the innervation of the appendix,
to which of the abdominal regions would you expect pain from the appendix to be
referred?
a. Epigastric
b. Left hypochondrium
c. Right hypochondrium
d. Umbilical
25.Thando is a 4 year old boy, who has just been rushed to the Trauma Unit because
his school nurse suspects that he might have accidentally swallowed a 20 cent coin.
At which part of the digestive tract is the coin most likely to be lodged?
a. Upper oesophageal sphincter
b. Midway through the esophagus
c. Pyloric antrum of the stomach
d. Descending part of the duodenum
26.Which of the following statements about epiphrenic diverticula of the esophagus is
correct?
a. They characteristically arise proximal to an esophageal reflux stricture.
b. The degree of dysphagia correlates with the size of the pouch.
c. They are best approached surgically through a right thoracotomy.
d. The operation of choice is a stapled diverticulectomy and long
esophagomyotomy

5
27.Concerning the diagnosis and treatment of esophageal leiomyomas, choose the
best answer bellow:
a. The majority are diagnosed after they cause dysphagia and chest pain.
b. Biopsy is indicated at the time of esophagoscopy, to rule out carcinoma.
c. Full-thickness elliptical excision of the esophageal wall is the preferred surgical
approach.
d . Endoscopic ultrasonography is a reliable means of following
leiomyomas conservatively.
28.A 50-year-old patient develops sudden left lower chest pain and epigastric pain
after vomiting. The patient shows diaphoresis, breath sounds are decreased on
the left, and there is abdominal guarding. The most appropriate diagnostic test
is:
a. chest x-ray
b. Aortography.
c. Esophagoscopy.
d. Electrocardiogram.
29. The situation where the ileum telescopes or prolapses into itself is called
a) Intussusception
b) Volvulus
c) Bowel regurgitation
d) Ileum prolapse

30.  Which of the following is NOT a precancerous for colon cancer

a. Crohn's disease
b. Bile acids
c. Fats
d. Carotene

6
31. The type of hiatal hernia where the junction of the stomach and oesophagus is
above the hiatus of the diaphragm, and a part of the stomach slides through the hiatal
opening in the diaphragm

a. Sliding hernia
b. Rolling hernia
c. Para esophageal hernia
d. Oesophageal hernia

32. Which of the following is NOT a predisposing factor for hiatal hernia
a) Weakening of muscles of the diaphragm around the oesophagogastric opening
b) Factors increasing intra-abdominal pressure
c) Intense physical exertion and heavy lifting of objects.
d) Young age, trauma and poor nutrition

33. Cancer of the lip can be diagnosed by the following investigations EXCEPT
a) Biopsy from affected site
b) Oral exfoliative cytology
c) Chest x-ray
d) Toluidine blue test
34. Concerning the management of oesophageal stricture, which statement below is
INCORRECT:
a. Strong acids or alkalis may help to relax the oesophageal muscles
b. Endoscopic dilatation of the affected part using bougies
c. Surgical excision with anastomosis may be performed.
d. The patient may have a temporary or permanent gastrostomy.

7
35. Which statement below is CORRECT concerning achalasia?
a) It is a condition which affects the smooth muscles of the oesophagus.
b) Peristalsis of the upper two thirds of the oesophagus is absent.
c) Lower oesophagus sphincter pressure is decreased
d) There is altered peristalsis due to impairment of the central nervous system
36. Which is not a recommended procedure for carcinoma esophagus in the thoracic
cavity?

a) McKeown approach
b) Lewis Tanner approach
c) Transhiatal esophagectomy
d) single right thoracotomy incision

37. In Achalasia all are possible etiological theories except

a) Trauma
b) Drastic weight loss
c) Emotional stress
d) Epiphrenic diverticulum

38. Which one bellow is NOT TRUE about the etiology of Achalasia
a) It is a familial disease
b) Allgrove's disease is a rare condition associated with achalasia
c) HSV-1, HSV-2, Polio virus
d) Association with class II MHC antigen

39. One of the following is NOT A HALLMARK of end stage Achalasia

a) Severe dysphagia or regurgitation
b) Hypertensive Lower esophageal sphincter tone

c) Mega esophagus or sigmoid esophagus

d) Reduction of ganglion cells  with fibrosis of Myenteric plexus

8
40. It is important for the student nurse to know anatomic course of the esophagus is
in order to manage the patient post operatively.

Which statement below is CORRECT?

a) The thoracic esophagus enters the posterior mediastinum anterior to the aortic
arch.
b) The thoracic esophagus passes behind the right main stem bronchus and the
pericardium.
c) The esophagus enters the diaphragmatic hiatus at the level of T8.
d) The esophagus deviates anteriorly and to the left as
it enters the abdomen.

41. Which of the following statements about achalasia is CORRECT?

a) Chest pain and regurgitation are the usual symptoms.

b) Distal-third esophageal adenocarcinomas may occur in as many as 20% of
patients within 10 years of diagnosis.
c) Manometry demonstrates failure of LES relaxation on swallowing and
absent or weak simultaneous contractions in the esophageal body
after swallowing.
d) In most cases in Africa the cause is a parasitic infestation by Trypanosoma
cruzi.

42. Manometry in a patient with achalasia will reveal all EXCEPT:

a) Abnormally high pressure in the esophageal body

b) High resting LES pressure
c) Decreased peristalsis
d) Incomplete relaxation of LES

9
 43. Which of the following statements about epiphrenic diverticula of
the esophagus is CORRECT?
a. They are traction diverticula that arise close to the tracheobronchial tree.
b. They characteristically arise proximal to an esophageal reflux stricture.
c. The degree of dysphagia correlates with the size of the pouch.
d. The operation of choice is a stapled diverticulectomy, long
esophagomyotomy, and partial fundoplication.

44. Which of the following statements about pathology encountered at esophagoscopy

is CORRECT?
a) An esophageal reflux stricture with a 2-mm. lumen is not dilatable and is best
treated with resection.
b) A newly diagnosed radiographic distal esophageal stricture warrants dilation
and antireflux medical therapy.
c) In patients with Barrett's mucosa, the squamocolumnar epithelial
junction occurs 3 cm. or more proximal to the anatomic
esophagogastric junction.
d) Reflux esophagitis should be graded as mild, moderate, or severe, to promote
consistency among different observers.
45. Which of the following statements about the diagnosis and treatment of
esophageal leiomyomas is/are correct?
a. The majority are diagnosed after they cause dysphagia and chest pain.
b. Biopsy is indicated at the time of esophagoscopy, to rule out carcinoma.
c. Full-thickness elliptical excision of the esophageal wall is the preferred surgical
approach.
d. Endoscopic ultrasonography is a reliable means of following leiomyomas
conservatively.

10
46. Which of the following statements regarding the pathology of esophageal
carcinoma is CORRECT?
a. worldwide, adenocarcinoma is the most common esophageal malignancy.
b. squamous cell carcinoma is most common in the distal esophagus, whereas
adenocarcinoma predominates in the middle third.
c. patients with barrett's metaplasia are 40 times more likely than the
general population to develop adenocarcinoma.
d. metastases from esophageal carcinoma are characteristically localized to regional
mediastinal lymph nodes adjacent to the tumor.

47. Which of the following statements about the surgical treatment of esophageal
carcinoma is CORRECT?
a. the finding of severe dysphagia in association with barrett's mucosa is an indication
for an antireflux operation to prevent subsequent development of carcinoma.
b. long-term survival is improved by radical en bloc resection of the esophagus with its
contained tumor, adjacent mediastinal tissues, and regional lymph nodes.
c. the morbidity and mortality rates for cervical esophagogastric
anastomotic leak are substantially less than those associated with
intrathoracic esophagogastric anastomotic leak.
d. the leading complications of transthoracic esophagectomy and intrathoracic
esophagogastric anastomosis are bleeding and wound infection.

11
48. The best management for a 48-hour-old distal esophageal perforation is:
a. antibiotics and drainage.
b. division of the esophagus and exclusion of the perforation.
c. resection with cervical esophagostomy, gastrostomy, and jejunostomy.
d. Primary repair with buttressing.

49. The following statements about the influence of diet and lifestyle on lower
esophageal sphincter (LES) function are true EXCEPT ONE.
a. cigarette smoking produces no significant changes in LES pressures.
b high-protein diet increases LES pressure.
c. a fat meal results in sustained decrease in LES pressure.
d. chocolate ingestion causes a decrease in LES pressure.

50. When assessing gastro esophageal reflux disease by Manometry each of the
following statements is correct except one. Identify the INCORRECT ONE.
a. absent or extremely low les pressures have predictive value in identifying more
severe reflux.
b. peristaltic dysfunction increases with increasing severity of esophagitis.
c. with established reflux disease the upper esophageal sphincters is
hypertensive.
d. esophageal functional changes are worst in patients with a circumferential
columnar-lined esophagus.

51. Which of the following is most reliable for confirming the occurrence of a
significant esophageal caustic injury?
A. History of the event.
B. Physical examination of the patient.
C. Barium esophagraphy.
D. Endoscopy.

12
52. Which one of the following is NOT indication for surgical reconstruction of the
esophagus includes which of the following?
A. Continuing requirement for frequent dilation of an extensive esophageal
stricture for a minimum of 2 years.
B. Failure or refusal of the patient to comply with a treatment regimen of regular
dilation.
C. Development of a fistula between the esophagus and tracheobronchial tree.
D. Iatrogenic perforation of the esophagus during attempted dilation.

53. First-line therapy for routine peptic duodenal ulcer disease includes:
A. Vagotomy and antrectomy.
B. Upper endoscopy and biopsy to rule out tumor.
C. Evaluation for Helicobacter pylori.
D. Serum gastrin determination.

54. Appropriate management of severe vomiting associated with gastric outlet

obstruction from peptic ulcer disease includes all of the following EXCEPT:
A. Nasogastric suction.
B. Oral antacid therapy.
C. Nutritional assessment; upper endoscopy to rule out malignancy.
D. Intravenous H 2 antagonist.

55. All of the following are complications of peptic ulcer surgery EXCEPT:
A. Duodenal stump blowout.
B. Dumping.
C. Steatorrhea.
D. Delayed gastric emptying.

13
56. The presentation of Zollinger-Ellison syndrome includes all of the following except:
A. Migratory rash.
B. Diarrhea.
C. Jejunal ulcers.
D. Duodenal ulcers.

57. All are true about the dumping syndrome EXCEPT:

A. Symptoms can be controlled with a somatostatin analog.
B. Diarrhea is always part of the dumping syndrome.
C. Flushing and tachycardia are common features of the syndrome.
D. Separating solids and liquids in the patient's oral intake alleviates some of the
symptoms of the syndrome.

58. In patients with bleeding duodenal ulcers, the endoscopic finding associated with
the highest incidence of rebleeding is:
A. Visible vessel.
B. Cherry-red spot.
C. Clean ulcer bed.
D. Duodenitis.

59. All of the following are contraindications for highly selective vagotomy except:
A. Intractable duodenal ulcer disease.
B. Peptic ulcer disease causing gastric outlet obstruction.
C. Fundic peptic ulceration.
D. Cigarette chain smoking.

14
60. All of the following measures have been recommended for control of acid secretion
in patients with Zollinger-Ellison syndrome except:
A. Antrectomy.
B. Highly selective vagotomy.
C. Total gastrectomy.
D. Vagotomy and pyloroplasty.

61. All of the following contribute to peptic ulcer disease EXCEPT:

A. Cigarette smoking.
B. Nonsteroidal anti-inflammatory drugs.
C. Helicobacter pylori.
D. Spicy foods.

62. Which of the following statements about gastric leiomyomas is INCORRECT

A. They are the most common type of gastric tumor of the stomach at autopsy.
B. The leiomyoblastoma cell type reflects malignant transformation of
gastric leiomyomas.
C. A conservative surgical approach is indicated for their resection since regional
lymphadenectomy has not been proved reliable even when they turn out to be
malignant.
D. Severe hemorrhage may occur from deep ulcerations overlying the intramural tumor

39. Which of the following risk factors have been shown to increase significantly the
incidence of gastrointestinal bleeding from stress gastritis in intensive care unit (ICU)
patients?
A. Glucocorticoid administration.
B. Coagulopathy.
C. Organ transplantation.
D. Jaundice.

15
64. Which of the following measures is NOT effective in preventing stress gastritis
bleeding in critically ill patients?
A. Improving systemic circulation by correcting any shock like state resulting from
blood loss or sepsis.
B. Correcting systemic acid-base abnormality.
C. Maintaining adequate nutrition.
D. None of the above

65. Numerous epidemiologic associations have been made between (1) environmental
and dietary factors and (2) the incidence of gastric cancer, including all except:
A. Dietary nitrites.
B. Dietary salt.
C. Helicobacter pylori infection.
D. Dietary ascorbic acid.

66. All of the following benign conditions are associated with increased rates of gastric
cancer EXCEPT:
A. Pernicious anemia.
B. Multiple endocrine neoplasia type I (MEN 1).
C. Adenomatous polyps.
D. Chronic atrophic gastritis.

16
67. Which of the following statements concerning the pathology of gastric cancer is
TRUE?
A. Distal gastric cancers are becoming more common.
B. Intestinal-type gastric tumors resemble colon carcinomas and have a
better prognosis than diffuse type.
C. Early gastric cancers are confined to the mucosa and are lymph node negative.
D. Broders' histologic grading system correlates well with survival: patients with grade
IV tumors have 5-year survival rates around 65%.

68. Which of the following statements about the surgical treatment of gastric cancer is
FALSE?
A. Patients with tumors of the middle and proximal thirds should undergo
total gastrectomy.
B. Adenocarcinoma of the cardia-gastroesophageal junction may require reconstruction
in the abdomen, chest, or neck.
C. Palliative resection yields better results than palliative bypass.
D. Japanese patients who undergo gastric resection are, on average, 10 years younger
and much leaner than their Western counterparts.

69. Factors associated with the development of complications of gastro esophageal

reflux disease include:
a. The presence of a defective lower esophageal sphincter
b. Inadequate esophageal clearance
c. The presence of a hiatal hernia
d. All the above

17
70. Which of the following statement(s) is TRUE concerning tracheoesophageal
fistulas?
a. The majority of acquired tracheoesophageal fistulas are due to malignant
disease
b. A water-soluble contrast esophogram should be obtained for diagnosis
c. Malignant tracheoesophageal fistulas does not represent one of the few indications
for an endoesophageal prosthesis
d. A benign tracheoesophageal fistula from an endotracheal intubation injury often
requires a thoracotomy for repair

72. Which of the following statement(s) is NOT TRUE concerning the pathology of
squamous cell carcinoma of the esophagus?
a. Carcinoma in situ will gradually progress to invasive squamous cell carcinoma over a
period of two to four years
b. The most common location for squamous cell carcinoma of the esophagus is the
upper and mid-thoracic segment
c. Esophageal carcinoma tends to be multifocal
d. Macroscopically, ulcerative lesions with extensive infiltration of the adjacent
esophageal wall are most common

18
73. A 54-year-old woman experiences pain in both the anterior and posterior left chest
and the epigastrium following balloon dilatation performed for achalasia. Which of the
following statement is true concerning this patient’s diagnosis and management?
a. A normal chest x-ray will rule out an esophageal perforation
b. Barium should never be used in performance of a contrast study with a diagnosis of
esophageal perforation
c. Conservative, nonoperative treatment may be indicated
d. Surgical repair is never necessary; the patient should never undergo
esophagomyotomy and a partial gastric repair

74. Which of the following statement(s) is CORRECT concerning the diagnostic studies
for esophageal carcinoma?

a. A chest and upper abdominal CT scan is useful for both staging and predicting
resectability
b. A barium swallow is an unnecessary test in a patient with dysphagia
c. Bronchoscopy should be performed in all patients with carcinoma of the
upper and middle thirds of the esophagus
d. Bone and brain scans should be obtained routinely to rule out distant metastasis

75. Which of the following conditions are associated with the development of
esophageal carcinoma?
a. Caustic esophageal stricture
b. Achalasia of the esophagus
c. Plummer-Vinson syndrome
d. All the above

19
76. Which of the following statement(s) is NOT TRUE concerning esophageal
diverticula?
a. A Zenker’s diverticulum characteristically occurs in older patients
b. Mediastinal granulomatous disease usually results in a mid-esophageal traction
diverticulum which is usually asymptomatic
c. An epiphrenic diverticulum that presents to the right of the esophagus should be
managed via left thoracotomy
d. Minimally symptomatic epiphrenic diverticula should not be operated upon

77. Which of the following statement(s) is TRUE concerning caustic injury to the
esophagus?
a. Alkaline injury is less destructive than acid injury
b. Acid ingestion is not injurious to the stomach due to its normal acidic pH
c. Ingested caustic agents rapidly pass through the esophagus and stomach into the
small intestine
d. Unless perforation occurs, clinical manifestations resolve quickly with
initial clinical management

78. Benign tumors of the esophagus are rare constituting less than 1% of esophageal
neoplasms. Which of the following statement(s) is/are true concerning benign
esophageal neoplasms?
a. Most esophageal polyps are located just above the gastroesophageal junction
b. Malignant degeneration of leiomyomas of the esophagus is a frequent occurrence
c. An asymptomatic leiomyoma can be safely observed and followed with
periodic barium esophograms and endoscopic ultrasonography
d. Most leiomyomas of the esophagus require esophagectomy

20
79. A 24-year-old woman develops epigastric pain and has a diagnosis of duodenal
ulcer confirmed by esophagogastroduodenoscopy. The patient is in the third month of
a pregnancy. The most appropriate treatment would be:
a. Proximal gastric vagotomy
b. Misoprostol 400 mg b.i.d.
c. Sucralfate 1 gm q.i.d.
d. Cimetidine 400 mg b.i.d.

80. Helicoabacter pylori has been investigated as a possible etiologic agent in duodenal
ulceration. Which of the following statement(s) regarding H pylori infection in humans
is/are correct?

a. H pylori may be isolated from antral gastric mucosa in nearly 100% of patients with
active duodenal ulceration but only 1–2% of normal volunteers
b. H pylori possess cell surface receptors that bind to small intestinal mucous cells
c. Therapeutic regimens for duodenal ulcer that eliminate the organism are associated
with higher ulcer recurrence rates than those in which the organism persists
d. The incidence of the organism in the normal population increases with
age

81. Development of duodenal ulceration is dependent upon gastric acid secretion.

Which of the following statements correctly characterizes acid secretion in duodenal
ulcer patients?
a. Groups of duodenal ulcer patients demonstrate decreased basal acid secretion
b. Maximal acid output to histamine averages 40 mEq/h in duodenal ulcer
patients, twice that of normal
c. Tissue gastrin levels, on average, are twice normal in patients with active ulceration
d. Exogenously administered somatostatin is ineffective in suppressing acid secretion in
patients with active ulceration

21
82. A 45-year-old man undergoes proximal gastric vagotomy for treatment of
intractable duodenal ulceration. What physiologic alterations might be anticipated as a
consequence of the operation?
a. Reduction of basal acid secretion by approximately 25%
b. Accelerated gastric emptying of liquids
c. Accelerated gastric emptying of solids
d. Postprandial hyperinsulinemia

83. Type I gastric ulcers are located in the gastric body, usually along the lesser
curvature. Which of the following statements correctly characterize type I gastric
ulcers?
a. Normal to high acid secretion
b. Associated duodenal ulceration
c. High frequency of blood group A
d. Associated hypergastrinemia frequent

84. With regard to benign gastric ulceration, the most common location of disease is
which of the following?
a. Along the greater curvature
b. Immediately distal to the esophagogastric junction along the lesser curvature
c. In the area of the incisura angularis along the lesser curvature
d. Within the gastric antrum

22
85. Which of the following conditions is NOT considered to increase the risk of gastric
cancer?
a. Pernicious anemia
b. Prior partial gastrectomy
c. Gastric hyperplastic polyps
d. Gastric adenomatous polyps

86. Its solid organs the gastrointestinal system includes all of the following EXCEPT:
a. liver
b. gall bladder
c. stomach
d. pancreas

87. Student Nurse Jacqueline is going to perform an abdominal examination to Mr.

Kamocha who was admitted due to on and off pain since yesterday.
How will she position Mr. Kamocha prior to procedure?
a. supine with knees flexed
b. prone
c. lying on back
d. sim’s

88. To identify any localized bulging, distention and peristaltic waves, Nurse Mwaka
must perform which of the following?
a. Auscultation
b. Inspection
c. Palpation

23
 d. Percussion

89. In order to identify areas of tenderness and swelling, Nurse Moonga must do:
a. deep palpation
b. light palpation
c. percussion
d. palpation

90. Mr. Limunga verbalized pain on the right iliac region. Nurse Mwamba knows that
the organ affected would be the:
a. liver
b. sigmoid colon
c. appendix
d. duodenum
91. Mrs. Linda Mwaka felt pain upon release of Nurse Dorian’s hand. This can be
referred as:
a. referred pain
b. rebound tenderness
c. direct tenderness
d. indirect tenderness

92. Situation 3: Mrs. Cruz was admitted in the surgical ward due to pyrosis, dyspepsia
and difficulty of swallowing.
Based from the symptoms presented, Nurse Yoshi might suspect:
a. Esophagitis
b. Hiatal hernia
c. GERD
d. Gastric Ulcer
93. What diagnostic test would confirm the diagnosis of GERD?
a. barium enema
b. barium swallow
c. colonoscopy
d. lower GI series

24
94. Mrs. Kanda Kanda complained of pain and difficulty in swallowing. This term is
referred as:
a. Odynophagia
b. Dysphagia
c. Pyrosis
d. Dyspepsia
95. To avoid acid reflux, Nurse Yoshi should advise the patient to avoid which type of
diet?
a. cola, coffee and tea
b. high fat, carbonated and caffeinated beverages
c. beer and green tea
d. lechon paksiw and bicol express

96. What symptoms will validate the diagnosis of gastric ulcer?

a. right epigastric pain
b. pain occurs when stomach is empty
c. pain occurs immediately after meal
d. pain not relieved by vomiting
97. What diagnostic test would yield good visualization of the ulcer crater in a patient
with peptic ulcer?
a. Endoscopy
b. Gastroscopy
c. Barium Swallow
d. Histology
98. Peptic ulcer disease particularly gastric ulcer is thought to be caused by which of
the following microorganisms?
a. E. coli
b. H. pylori
c. S. aureus
d. K. pneumoniae
99. The patient is suspected of cancer of the colon and she is for occult blood test,
what specimen will you collect?
a. Blood
b. Urine

25
 c. Stool
d. Gastric Juice

100. When progressive enlargement of a Multinodular goiter causes symptomatic

tracheal compression, the preferred management in otherwise good-risk patients is:
a. Iodine treatment.
b. Thyroid hormone treatment.
c. Surgical resection of the abnormal thyroid.
d. Radioactive iodine treatment.

26