Nokea
A client underwent an exploratory laparotomy 2 days ago. The physician should be called immediately for which physical assessment finding?
- A. Abdominal distention and rigidity
- B. NG tube intentionally displaced by client
- C. Absent or hypoactive bowel sounds
- D. Nausea and occasional vomiting
Correct Answer: A
Rationale: Abdominal rigidity and distention suggest peritonitis or internal bleeding, both of which require urgent medical intervention.
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The tunica submucosa and mucosa of the stomach are thrown into large folds called
- A. epiploic appendages.
- B. rugae.
- C. plicae cirulares.
- D. villi.
Correct Answer: B
Rationale: The correct answer is B: rugae. Rugae are large folds in the tunica submucosa and mucosa of the stomach that allow for expansion when the stomach is full. Epiploic appendages (A) are fatty projections on the serosa of the large intestine. Plicae circulares (C) are circular folds in the small intestine for increasing surface area. Villi (D) are finger-like projections in the small intestine for absorption. Rugae specifically refer to the folds in the stomach lining, making them the correct answer.
The nurse should urge a client with an ileoanal anastomosis to do perineal exercises four to six times a day for how many repetitions?
- A. 5
- B. 10
- C. 15
- D. 20
Correct Answer: C
Rationale: Perineal exercises help strengthen muscles and improve bowel control, typically recommended at 15 repetitions.
Urea is synthesized by the liver following _____ metabolism.
- A. carbohydrate
- B. protein
- C. lipid
- D. nucleic acid
Correct Answer: B
Rationale: The correct answer is B: protein. Urea is a waste product formed during the breakdown of proteins in the liver. Amino acids from protein metabolism are deaminated, leading to the formation of ammonia, which is then converted to urea in the urea cycle. Carbohydrates are not directly involved in urea synthesis. Lipids are primarily metabolized to produce energy and do not contribute to urea formation. Nucleic acids are broken down into nucleotides, not amino acids, and are not directly related to urea synthesis.
Which one of the following enzymes is not part of the enzymatic component of the pancreatic juice?
- A. amylase
- B. lipase
- C. nucleases
- D. chymotrypsin
Correct Answer: D
Rationale: The correct answer is D: chymotrypsin. Chymotrypsin is not part of the enzymatic component of pancreatic juice. Pancreatic juice contains amylase for carbohydrate digestion, lipase for fat digestion, and nucleases for nucleic acid digestion. Chymotrypsin is produced in the pancreas but is not secreted directly into the pancreatic juice. It is released in an inactive form that is activated in the small intestine. Therefore, chymotrypsin is not directly involved in the initial breakdown of nutrients in the pancreatic juice.
Chewing or mastication reflex originates in the ______ and the ability to initiate or stop chewing originates in the ______.
- A. pons; cerebrum.
- B. medulla oblongata; cerebrum.
- C. spinal cord; medulla oblongata.
- D. medulla oblongata; midbrain.
Correct Answer: B
Rationale: The correct answer is B. The chewing reflex originates in the medulla oblongata, which controls basic life functions like breathing and swallowing. The ability to voluntarily initiate or stop chewing comes from the cerebrum, the part of the brain responsible for conscious thoughts and movements. The pons (choice A) is involved in regulating breathing, not chewing. The spinal cord (choice C) is responsible for reflex actions but not specifically chewing. The midbrain (choice D) is more related to sensory processing and motor function, not chewing reflex. Therefore, the correct answer is B based on the roles of the medulla oblongata and cerebrum in chewing.