Nokea
A client with a GI disorder has to undergo a barium swallow test. Which of the following diet restrictions are required prior to the test?
- A. NPO for 8 to 12 hours before the test
- B. NPO for 6 to 8 hours before the test
- C. Maintain normal fluid intake 1 or 2 hours before the test
- D. Avoidance of red meat 3 days prior to testing
Correct Answer: A
Rationale: The correct answer is A: NPO for 8 to 12 hours before the test. This is necessary to ensure the client's stomach is empty, allowing for clear visualization of the GI tract during the barium swallow test. NPO for a longer duration helps prevent any interference from food or liquids.
Choice B is incorrect because 6-8 hours might not be sufficient for complete emptying of the stomach. Choice C is incorrect as maintaining normal fluid intake may lead to residual fluids in the stomach, affecting test accuracy. Choice D is unrelated to the test and does not impact the visualization of the GI tract.
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The role of parietal cells is to:
- A. Secretes hydrogen ions and chloride ions into lumen and are responsible for maintaining the acidic pH
- B. alkaline mucous for shielding the epithelium from hydrochloric acid
- C. Secretes histamine which stimulates gastric acid secretion
- D. Secretes gastric lipase
Correct Answer: A
Rationale: The correct answer is A because parietal cells secrete hydrogen ions and chloride ions into the lumen, which combine to form hydrochloric acid, maintaining the acidic pH of the stomach essential for digestion. Option B is incorrect as alkaline mucous is produced by goblet cells, not parietal cells. Option C is incorrect as histamine is secreted by enterochromaffin-like cells, not parietal cells. Option D is incorrect as gastric lipase is primarily secreted by chief cells in the stomach.
The nurse cautions that constant stress can cause which alteration to the gastrointestinal (GI) system?
- A. Slowed GI mobility resulting in constipation
- B. Reversed peristalsis resulting in projectile vomiting
- C. Increased digestive juices resulting in a gastric ulcer
- D. Decreased digestive juices resulting in ineffective metabolism
Correct Answer: C
Rationale: The correct answer is C because constant stress triggers the release of excess digestive juices, leading to increased acid production and potentially causing a gastric ulcer. Stress activates the sympathetic nervous system, which in turn stimulates the release of stress hormones that can disrupt the balance of digestive juices. Slowed GI mobility (choice A) typically causes constipation, not directly related to stress. Reversed peristalsis (choice B) leading to projectile vomiting is more commonly associated with conditions such as food poisoning or intestinal blockages. Decreased digestive juices (choice D) would likely result in poor digestion and nutrient absorption, but it is not a common consequence of stress-induced alterations to the GI system.
When monitoring the food intake of a client with Crohn's disease, the nurse observes that the client does not eat most of the food serve The nurse learns that the client finds the food unappetizing. Which of the following steps should the nurse take to address this issue?
- A. Explain to the client the benefits of eating the prescribed food
- B. Request the dietitian to suggest more acceptable food
- C. Provide the client total parenteral nutrition and lipid infusions
- D. Provide the client elemental diet formula and 5-ASA medications
Correct Answer: B
Rationale: The correct answer is B. Request the dietitian to suggest more acceptable food. This step is appropriate because it involves seeking help from a professional who can provide tailored dietary recommendations based on the client's preferences and restrictions. The dietitian can work with the client to identify foods that are both appetizing and suitable for managing Crohn's disease.
Explanation for why the other choices are incorrect:
A: Explaining the benefits of eating the prescribed food may not address the client's issue of finding the food unappetizing.
C: Providing total parenteral nutrition and lipid infusions is an extreme measure and should only be considered when all other options have been exhausted.
D: Providing elemental diet formula and 5-ASA medications may not address the client's immediate concern of finding the food unappetizing.
Mucosal necrosis is an essential part of:
- A. blind loop syndrome
- B. pseudomembranous enterocolitis
- C. both
- D. neither
Correct Answer: B
Rationale: The correct answer is B: pseudomembranous enterocolitis. Mucosal necrosis is a key characteristic of pseudomembranous enterocolitis, a condition caused by Clostridium difficile infection. The bacteria release toxins that lead to inflammation and damage to the mucosal lining of the intestines, resulting in mucosal necrosis. Blind loop syndrome (choice A) does not specifically involve mucosal necrosis, while pseudomembranous enterocolitis (choice B) does. Choice C is incorrect because only pseudomembranous enterocolitis involves mucosal necrosis. Choice D is incorrect as pseudomembranous enterocolitis does involve mucosal necrosis.
The accessory digestive organs include all of the following, EXCEPT:
- A. tongue
- B. liver
- C. pancreas
- D. stomach
Correct Answer: D
Rationale: The correct answer is D, stomach. The stomach is not considered an accessory digestive organ as it is part of the gastrointestinal tract. The accessory digestive organs aid in the digestion process but are not part of the tract itself. The tongue, liver, and pancreas are all considered accessory digestive organs as they play crucial roles in digestion, such as producing enzymes and bile. The stomach's main function is to store and break down food through mechanical and chemical digestion, making it a primary organ in the digestive system rather than an accessory one.