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A 55-year-old female client comes to the clinic for a physical examination. Which of the following screening tests would the nurse recommend the client have beginning at the age of 50 and every 10 years after?
- A. Colonoscopy
- B. Ultrasound of the kidney
- C. Mammogram
- D. Pap smear
Correct Answer: A
Rationale: The correct answer is A: Colonoscopy. Beginning at age 50, it is recommended every 10 years to screen for colorectal cancer. This screening test is essential for early detection and prevention of colon cancer. Colonoscopy allows for direct visualization of the colon and removal of any precancerous polyps.
Choice B: Ultrasound of the kidney is not a recommended screening test for a 55-year-old female. Kidney ultrasound is typically used for evaluating specific kidney conditions, not as a routine screening test.
Choice C: Mammogram is typically recommended for breast cancer screening in women starting at age 40, not every 10 years after age 50.
Choice D: Pap smear is used for cervical cancer screening, typically starting at age 21 and continuing every 3-5 years, not every 10 years after age 50.
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A nurse is teaching a client about strategies to manage gastroesophageal reflux disease (GERD). Which of the following statements should the nurse include?
- A. Elevate the head of your bed by 18 inches.'
- B. Avoid snacking between meals.'
- C. Limit foods that are high in fiber.'
- D. Avoid eating 2 to 3 hours before bedtime.'
Correct Answer: D
Rationale: The correct answer is D: Avoid eating 2 to 3 hours before bedtime. This is because lying down after eating can worsen GERD symptoms by allowing stomach acid to flow back up into the esophagus. By avoiding eating close to bedtime, the client can reduce the risk of acid reflux.
A: Elevating the head of the bed helps reduce nighttime symptoms, but it is not the most essential strategy.
B: Avoiding snacking between meals can help, but the timing of meals is more crucial for managing GERD.
C: Limiting foods high in fiber is not directly related to managing GERD; it is more about avoiding trigger foods like citrus, caffeine, and fatty foods.
Which of the following structures forms a cavity or pocket between the layers of mesenteries?
- A. visceral pleura
- B. parietal pleura
- C. omental bursa
- D. retroperitoneum
Correct Answer: C
Rationale: The correct answer is C: omental bursa. The omental bursa is a potential space located behind the stomach and in front of the pancreas, forming a cavity or pocket between the layers of mesenteries. This structure allows for movement and accommodation of the stomach during digestion.
A: Visceral pleura and B: Parietal pleura are layers of the pleural membrane in the thoracic cavity, not related to mesenteries or cavity formation. D: Retroperitoneum refers to the space behind the peritoneum, not specifically forming a cavity or pocket between mesenteries.
Which of the following hydrolytic enzymes act in low pH?
- A. Peroxidases
- B. Hydrolases
- C. Amylases
- D. Proteases
Correct Answer: D
Rationale: The correct answer is D: Proteases. Proteases are enzymes that break down proteins, and they are known to function optimally in low pH environments, such as the acidic environment of the stomach. This is because the acidic pH helps in the activation and stability of proteases, allowing them to efficiently break down proteins into smaller peptides and amino acids.
Rationale for why the other choices are incorrect:
A: Peroxidases catalyze oxidation reactions and are not specifically known to act in low pH environments.
B: Hydrolases are a broad category of enzymes that catalyze the hydrolysis of various molecules but are not specifically tailored for low pH conditions.
C: Amylases are enzymes that break down carbohydrates and typically work best in neutral to slightly alkaline pH conditions, not in low pH environments like proteases.
Corticosteroid medications are associated with the development of peptic ulcers because of which probable pathophysiologic mechanism?
- A. The enzyme urease is produced.
- B. Secretion of hydrochloric acid is increased.
- C. The rate of mucous cell renewal is decreased.
- D. The synthesis of mucus and prostaglandins is inhibited.
Correct Answer: D
Rationale: The correct answer is D because corticosteroids inhibit the synthesis of mucus and prostaglandins, which are important for protecting the stomach lining. Without enough mucus and prostaglandins, the stomach lining becomes more susceptible to damage from stomach acid, leading to the development of peptic ulcers.
Choice A is incorrect because the enzyme urease is associated with the development of Helicobacter pylori infection, not peptic ulcers directly. Choice B is incorrect because corticosteroids actually decrease hydrochloric acid secretion. Choice C is incorrect because a decreased rate of mucous cell renewal would lead to decreased mucus production, which could contribute to peptic ulcers, but it is not the primary mechanism associated with corticosteroids.
The nervous system or systems that can control peristalsis in the inferior esophagus, stomach, small intestine and large intestine is (are) the
- A. somatic motor nervous system.
- B. sympathetic nervous system.
- C. sympathetic and parasympathetic nervous systems.
- D. autonomic and somatic motor nervous systems.
Correct Answer: C
Rationale: The correct answer is C because peristalsis, the involuntary movement of the digestive tract, is controlled by both sympathetic and parasympathetic nervous systems. The parasympathetic nervous system stimulates peristalsis, while the sympathetic nervous system inhibits it. Choice A is incorrect because the somatic motor nervous system controls voluntary movements, not peristalsis. Choice B is incorrect because the sympathetic nervous system inhibits peristalsis. Choice D is incorrect because the somatic motor nervous system does not control peristalsis in the digestive tract; it controls skeletal muscle movements.