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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The stomach:
- A. Secretes pepsinogen, intrinsic factor and pepsin.
- B. Secretion increase following total vagus nerve cut.
- C. PH is always 7.2.
- D. Secretes intrinsic factor which is essential for vitamin B12 absorption.
Correct Answer: D
Rationale: The correct answer is D because the stomach secretes intrinsic factor, which is essential for vitamin B12 absorption in the small intestine. This is crucial for preventing vitamin B12 deficiency and maintaining neurological health. The other choices are incorrect because A is partially true but not the main function of the stomach, B is false as total vagus nerve cut decreases stomach secretion, and C is false as the stomach pH varies from acidic (around 1.5-3.5) depending on food intake.
Which is the only area that can digest a double sugar?
- A. jejunum
- B. stomach
- C. duodenum
- D. pancreas
Correct Answer: C
Rationale: The correct answer is C: duodenum. The duodenum is the first part of the small intestine where digestion of double sugars, like disaccharides, occurs. Enzymes such as sucrase, lactase, and maltase are secreted in the duodenum to break down double sugars into simple sugars for absorption. The other choices are incorrect because the stomach primarily digests proteins, the jejunum is mainly involved in nutrient absorption, and the pancreas secretes enzymes into the duodenum but does not directly digest double sugars.
A 68-yr-old male patient with a stroke is unconscious and unresponsive to stimuli. After learning
- A. , what should the nurse plan to assess more frequently than is routine?
- B. Apical pulse
- C. Bowel sounds
- D. Breath sounds
Correct Answer: D
Rationale: The correct answer is D: Breath sounds. In an unconscious stroke patient, airway patency and adequate oxygenation are critical. Assessing breath sounds more frequently than routine helps monitor for respiratory distress, such as aspiration or pneumonia. Apical pulse (B) may be important but not as immediately life-threatening as respiratory status. Bowel sounds (C) may indicate bowel function but are not as urgent as assessing breathing. By prioritizing breath sounds, the nurse can ensure timely intervention in case of respiratory compromise.
Concerning deglutition (swallowing):
- A. Pharyngeal phase of swallowing is voluntary.
- B. Normally the lower esophageal sphincter (LES) is open.
- C. Dysphagia is caused by a lesion in the swallowing reflex.
- D. In the esophageal stage of swallowing, if the bolus is liquid it travels by peristalsis.
Correct Answer: C
Rationale: The correct answer is C because dysphagia, which is difficulty swallowing, can be caused by various factors such as neurological disorders affecting the swallowing reflex or physical obstructions in the esophagus. This is a key point in understanding the causes of swallowing difficulties.
Choice A is incorrect because the pharyngeal phase of swallowing is actually involuntary, not voluntary. Choice B is incorrect as the lower esophageal sphincter (LES) is normally closed to prevent acid reflux and only opens during swallowing. Choice D is incorrect because in the esophageal stage of swallowing, both liquid and solid boluses travel through the esophagus by peristalsis, not just liquid boluses.
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.