Nokea
A client with an ileostomy wants to know why to avoid fibrous vegetables. What should be the nurse's response?
- A. They cause gas formation.
- B. They cause stomal obstruction.
- C. They are difficult to digest.
- D. They increase the risk of diarrhea.
Correct Answer: B
Rationale: The correct answer is B because fibrous vegetables can potentially cause stomal obstruction in clients with an ileostomy due to their indigestible nature, leading to blockages in the stoma. This can result in severe complications and require medical intervention. Gas formation (choice A) is a common issue with high-fiber foods but is not specific to fibrous vegetables. Fibrous vegetables are not necessarily difficult to digest (choice C) for most individuals, although they may be harder for those with reduced gut function. While fibrous vegetables may contribute to loose stools, they do not directly increase the risk of diarrhea (choice D) in the same way they can cause stomal obstruction.
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Functions in the liver include production of:
- A. Digestive enzymes
- B. Secondary bile acids
- C. Stercobilinogen
- D. CCK
Correct Answer: A
Rationale: The correct answer is A: Digestive enzymes. The liver produces bile, which contains bile salts that help digest fats in the small intestine. Additionally, the liver produces various digestive enzymes like lipase, amylase, and proteases. These enzymes aid in breaking down carbohydrates, proteins, and fats during the digestion process. Choices B, C, and D are incorrect because secondary bile acids are produced in the intestine, stercobilinogen is a product of bilirubin breakdown in the intestine, and CCK (cholecystokinin) is a hormone produced by the small intestine to stimulate the release of bile and pancreatic enzymes but not directly produced by the liver.
This region of the large intestine has a simple columnar epithelium in its tunica mucosa, smooth muscle in its tunica muscularis, and epiploic appendages attach to its outer surface. This region is called the
- A. cecum.
- B. colon.
- C. rectum.
- D. anal canal.
Correct Answer: B
Rationale: The correct answer is B: colon. The colon is characterized by having a simple columnar epithelium in its tunica mucosa, smooth muscle in its tunica muscularis, and epiploic appendages attached to its outer surface. The cecum (A) is a pouch-like structure at the beginning of the large intestine. The rectum (C) is the final segment of the large intestine before the anal canal (D). The anal canal is lined by stratified squamous epithelium, not simple columnar epithelium like the colon.
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.
A hiatal hernia is a weakness in the _____ muscle, which allows a portion of the digestive tract to enter the thoracic cavity.
- A. diaphragm
- B. stomach
- C. intestinal
- D. thoracic wall
Correct Answer: A
Rationale: The correct answer is A: diaphragm. The diaphragm is a dome-shaped muscle that separates the thoracic and abdominal cavities. A hiatal hernia occurs when the stomach pushes through the opening in the diaphragm known as the esophageal hiatus, allowing a portion of the stomach to enter the thoracic cavity. The other choices, B: stomach, C: intestinal, and D: thoracic wall, are incorrect because a hiatal hernia specifically involves a weakness in the diaphragm muscle, not in these other structures. The stomach is the organ affected by the hernia, but the primary issue lies in the diaphragm's weakness. The intestinal and thoracic wall choices are not directly related to the development of a hiatal hernia.
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.