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.
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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.
Which of the following is not part of the large intestines?
- A. Transverse colon
- B. Appendix
- C. Cecum
- D. Duodenum
Correct Answer: D
Rationale: The correct answer is D: Duodenum. The duodenum is the first part of the small intestine, not the large intestine. The transverse colon, appendix, and cecum are all parts of the large intestine. The duodenum plays a crucial role in the digestion process, receiving partially digested food from the stomach and further breaking it down with the help of enzymes from the pancreas and bile from the liver. It is important to differentiate between the small and large intestines to understand their distinct functions within the digestive system.
A patient asks the nurse about taking phentermine and topiramate (Qsymia) for weight loss. To avoid side effects
- A. it is important for the nurse to determine whether the patient has a history of
- B. glaucoma.
- C. hypertension.
- D. valvular heart disease.
Correct Answer: A
Rationale: The correct answer is A because it is essential to determine if the patient has a history of certain conditions before prescribing Qsymia. This medication can worsen glaucoma (not just a history of it) making option B incorrect. Option C is incorrect because Qsymia can actually help manage hypertension. Option D is incorrect because while valvular heart disease can be a concern, it is not the primary factor to consider before prescribing this medication.
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.
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.