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What should the nurse admitting a patient with acute diverticulitis plan for initial care?
- A. Administer IV fluids.
- B. Prepare for colonoscopy.
- C. Encourage a high-fiber diet.
- D. Give stool softeners and enemas.
Correct Answer: A
Rationale: The correct answer is A: Administer IV fluids. Initial care for acute diverticulitis involves IV fluids to maintain hydration and electrolyte balance, as patients often have nausea, vomiting, and decreased oral intake. IV fluids help prevent dehydration and support the body during the acute phase of the condition. Options B, C, and D are incorrect. Colonoscopy is contraindicated during acute diverticulitis due to the risk of perforation. High-fiber diet and stool softeners/enemas are not recommended initially as they can worsen symptoms and increase the risk of complications.
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Which statement about intestinal 'brakes' and 'accelerators' is FALSE?
- A. Dietary starch is a potent stimulator of small intestinal motility because it causes insulin release from the pancreas
- B. Food in the stomach causes gastrin release, which stimulates acid secretion
- C. Short-chain fatty acids which move from colon to caecum (reflux) promote ileo-caecal motility
- D. The arrival of lipid in the duodenum causes an immediate reduction in motility and a switch from the 'fasting' to the 'feeding' pattern.
Correct Answer: A
Rationale: The correct answer is A because dietary starch does not cause insulin release from the pancreas, but rather stimulates the release of incretin hormones like glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). These incretins help regulate blood sugar levels postprandially and do not directly affect intestinal motility.
Incorrect choices:
B: Food in the stomach causing gastrin release is true and stimulates acid secretion.
C: Short-chain fatty acids moving from colon to caecum promoting ileo-caecal motility is true.
D: The arrival of lipid in the duodenum causing a reduction in motility is true.
What is the function of bile salts?
- A. emulsifying fats
- B. breaking down carbohydrates
- C. activating pepsin
- D. digesting proteins
Correct Answer: A
Rationale: The correct answer is A: emulsifying fats. Bile salts help emulsify fats by breaking them into smaller droplets, increasing the surface area for enzymes to act upon during digestion. This aids in the absorption of fats in the small intestine. Choices B, C, and D are incorrect because bile salts do not have a direct role in breaking down carbohydrates (choice B), activating pepsin (choice C), or digesting proteins (choice D). These functions are carried out by other digestive enzymes in the gastrointestinal tract.
A client is admitted to the hospital for a hemorrhoidectomy. Postoperatively, which of the following would a client's nurse be most concerned about?
- A. Pain at the incision site
- B. White blood count of 6.5
- C. Client's refusal of a stool softener
- D. Excessive bloody drainage on the external gauze dressing
Correct Answer: D
Rationale: The correct answer is D because excessive bloody drainage on the external gauze dressing could indicate hemorrhage, a serious complication post-hemorrhoidectomy. This requires immediate medical attention to prevent further complications.
A: Pain at the incision site is expected postoperatively and can be managed with pain medication.
B: A white blood count of 6.5 is within the normal range and not a cause for concern.
C: Client's refusal of a stool softener is important for bowel movement management but is not the most immediate concern compared to excessive bloody drainage.
A patient has been receiving high doses of corticosteroids for an extended perioWhich side effect is most commonly seen in patients receiving long-term corticosteroid therapy?
- A. Hyperglycemia
- B. Bradycardia
- C. Diarrhea
- D. Decreased appetite
Correct Answer: A
Rationale: The correct answer is A: Hyperglycemia. Long-term corticosteroid therapy can lead to insulin resistance and increased blood glucose levels. This occurs due to the corticosteroids interfering with insulin action and glucose metabolism. Hyperglycemia is a common side effect that can potentially lead to diabetes. Bradycardia (B), diarrhea (C), and decreased appetite (D) are not commonly associated with long-term corticosteroid therapy. Bradycardia is more commonly associated with medications such as beta-blockers, while diarrhea and decreased appetite are not typical side effects of corticosteroids.
A tumor producing large amounts of the intestinal hormone GIP may result in:
- A. Hyperglycemia
- B. Hypoglycemia
- C. Diarrhea
- D. Intestinal colic
Correct Answer: A
Rationale: The correct answer is A: Hyperglycemia. GIP (gastric inhibitory polypeptide) is released in response to food intake to stimulate insulin release and inhibit glucagon secretion, leading to reduced blood glucose levels. Excessive GIP production from a tumor can result in excessive insulin release, causing hypoglycemia. This is why the correct answer is hyperglycemia. Choices B, C, and D are incorrect as they do not align with the physiological effects of GIP.