A male infant, who was normal for the first three weeks of life, develops projectile vomiting after feeding. The likely diagnosis is:
- A. Meckel's diverticulum
- B. esophageal atresia
- C. congenital diaphragmatic hernia
- D. congenital pyloric stenosis
Correct Answer: D
Rationale: The correct answer is D, congenital pyloric stenosis. This condition typically presents in male infants around 3-6 weeks of age with projectile vomiting due to hypertrophy of the pyloric muscle, leading to obstruction at the pylorus. This causes the infant to forcefully vomit shortly after feeding. Meckel's diverticulum (A) presents with painless rectal bleeding. Esophageal atresia (B) presents with drooling and choking with feeding. Congenital diaphragmatic hernia (C) presents with respiratory distress and scaphoid abdomen due to herniation of abdominal organs into the chest cavity.
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The patient asks the nurse why she needs to have surgery for a femoral, strangulated herni What is the best explanation the nurse can give the patient?
- A. The surgery will relieve her constipation.
- B. The abnormal hernia must be replaced into the abdomen.
- C. The surgery is needed to allow intestinal flow and prevent necrosis.
- D. The hernia is because the umbilical opening did not close after birth as it should have.
Correct Answer: C
Rationale: Surgery for a strangulated hernia is needed to prevent the intestines from becoming necrotic due to impaired blood flow.
What laboratory findings are expected in ulcerative colitis as a result of diarrhea and vomiting?
- A. Increased albumin
- B. Elevated white blood cells (WBCs)
- C. Decreased Na+, K+, Mg+, Cl'“, and HCO3'“
- D. Decreased hemoglobin (Hgb) and hematocrit (Hct)
Correct Answer: C
Rationale: In ulcerative colitis, diarrhea and vomiting lead to electrolyte imbalances, resulting in decreased levels of sodium, potassium, magnesium, chloride, and bicarbonate.
Following a Billroth II procedure
- A. a patient develops dumping syndrome. The nurse should explain that the symptoms associated with this problem are caused by
- B. distention of the smaller stomach by too much food and fluid intake.
- C. hyperglycemia caused by uncontrolled gastric emptying into the small intestine.
- D. irritation of the stomach lining by reflux of bile salts because the pylorus has been removed.
Correct Answer: D
Rationale: Dumping syndrome occurs when food moves too rapidly into the small intestine, causing fluid to shift into the bowel and leading to symptoms like nausea, diarrhea, and abdominal cramping.
During a morning assessment, the nurse observes that a patient displays bulging flanks when supine with the knees flexeWhich action should the nurse take next?
- A. Measure the patient's abdominal girth.
- B. Auscultate each quadrant of the abdomen for 5 minutes.
- C. Document the finding.
- D. Notify the charge nurse.
Correct Answer: A
Rationale: The correct answer is A: Measure the patient's abdominal girth. Bulging flanks could indicate ascites, which is an abnormal accumulation of fluid in the abdominal cavity. Measuring the abdominal girth can help assess for the presence and severity of ascites. This step is important for further evaluation and monitoring of the patient's condition. Auscultating the abdomen for 5 minutes (choice B) would not address the potential underlying issue of ascites. Simply documenting the finding (choice C) without further assessment could delay necessary interventions. Notifying the charge nurse (choice D) is premature without completing a thorough assessment first.
Relating to carbohydrate digestion:
- A. Cellulose can be digested by human amylases
- B. It occurs only if bile salts are present
- C. third of starch digestion occurs in the mouth and two-thirds occurs in the small gut
- D. It can only occur in the complete absence of protein digestion
Correct Answer: B
Rationale: The correct answer is B because bile salts are essential for the digestion and absorption of fats, not carbohydrates. Cellulose cannot be digested by human amylases, making choice A incorrect. Starch digestion starts in the mouth with salivary amylase, not one-third in the mouth and two-thirds in the small gut, so choice C is incorrect. Carbohydrate digestion can occur simultaneously with protein digestion, so choice D is also incorrect. Bile salts aid in emulsifying fats, facilitating their digestion and absorption in the small intestine.