Nokea
Donald is a 61 y.o. man with diverticulitis. Diverticulitis is characterized by:
- A. Periodic rectal hemorrhage.
- B. Hypertension and tachycardia.
- C. Vomiting and elevated temperature.
- D. Crampy and lower left quadrant pain and low-grade fever.
Correct Answer: D
Rationale: The correct answer is D because diverticulitis typically presents with crampy pain in the lower left quadrant of the abdomen and a low-grade fever. This is due to inflammation or infection of the diverticula.
A: Periodic rectal hemorrhage is more characteristic of diverticular bleeding, not diverticulitis.
B: Hypertension and tachycardia are not typically associated with diverticulitis but may occur in severe cases or with complications.
C: Vomiting and elevated temperature can occur but are not as specific to diverticulitis as the combination of symptoms described in option D.
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Which of the following tubes is surgically inserted into the abdomen but goes to the small intestine?
- A. Orogastric tube
- B. Nasogastric tube
- C. Jejunostomy tube
- D. Gastrostomy tube
Correct Answer: C
Rationale: A jejunostomy tube is placed directly into the small intestine for enteral feeding in clients who cannot tolerate gastric feedings.
The home health nurse is caring for a patient with tuberculosis who is taking rifampin and isoniazid (INH). The nurse should carefully monitor the patient for which potential side effect?
- A. Gallstones
- B. Liver disorders
- C. Bleeding ulcers
- D. Esophagitis
Correct Answer: B
Rationale: The correct answer is B: Liver disorders. Rifampin and isoniazid are known to cause hepatotoxicity as a potential side effect. The combination of these two medications can lead to liver damage, making it crucial for the nurse to monitor liver function tests regularly. Gallstones (A), bleeding ulcers (C), and esophagitis (D) are not typically associated with rifampin and isoniazid therapy. Monitoring for liver disorders is essential due to the risk of hepatotoxicity with these medications.
A physician just told a patient that she has a volvulus. When the patient asks the nurse what this is, what is the best description for the nurse to give her?
- A. Bowel folding on itself
- B. Twisting of bowel on itself
- C. Emboli of arterial supply to the bowel
- D. Protrusion of bowel in weak or abnormal opening
Correct Answer: B
Rationale: A volvulus is the twisting of the bowel, which can cause obstruction and is a medical emergency.
Secretin hormone:
- A. Released in response to acidic gastric juice.
- B. Stimulates stomach mobility.
- C. Stimulates HCL secretion.
- D. All of the above are correct.
Correct Answer: A
Rationale: The correct answer is A because secretin hormone is released in response to acidic gastric juice, acting to neutralize the acidity by stimulating pancreatic bicarbonate secretion. Choice B and C are incorrect as secretin does not stimulate stomach mobility or HCL secretion. Therefore, the correct answer is A as it aligns with the function of secretin in regulating pH balance in the digestive system.
A patient with an obstruction of the common bile duct has clay-colored fatty stools, among other manifestations. What is the pathophysiologic change that causes this clinical manifestation?
- A. Soluble bilirubin in the blood excreted into the urine
- B. Absence of bile salts in the intestine and duodenum, preventing fat emulsion and digestion
- C. Contraction of the inflamed gallbladder and obstructed ducts, stimulated by cholecystokinin when fats enter the duodenum
- D. Obstruction of the common duct prevents bile drainage into the duodenum, resulting in congestion of bile in the liver and subsequent absorption into the blood
Correct Answer: B
Rationale: The absence of bile salts in the intestine due to obstruction prevents fat emulsification and digestion, leading to fatty stools (steatorrhea).