A nurse in a stroke rehabilitation facility recognizes that the brain regulates swallowing. Damage to what area of the brain will most affect the patient's ability to swallow?
- A. Temporal lobe
- B. Medulla oblongata
- C. Cerebellum
- D. Pons
Correct Answer: B
Rationale: Swallowing is a voluntary act that is regulated by a swallowing center in the medulla oblongata of the central nervous system. Swallowing is not regulated by the temporal lobe, cerebellum, or pons.
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A nurse is caring for an 83-year-old patient who is being assessed for recurrent and intractable nausea. What age-related change to the GI system may be a contributor to the patient's health complaint?
- A. Stomach emptying takes place more slowly.
- B. The villi and epithelium of the small intestine become thinner.
- C. The esophageal sphincter becomes incompetent.
- D. Saliva production decreases.
Correct Answer: A
Rationale: Delayed gastric emptying occurs in older adults and may contribute to nausea. Changes to the small intestine and decreased saliva production would be less likely to contribute to nausea. Loss of esophageal sphincter function is pathologic and is not considered an age-related change.
A nurse is assessing the abdomen of a patient just admitted to the unit with a suspected GI disease. Inspection reveals several diverse lesions on the patient's abdomen. How should the nurse best interpret this assessment finding?
- A. Abdominal lesions are usually due to age-related skin changes.
- B. Integumentary diseases often cause GI disorders.
- C. GI diseases often produce skin changes.
- D. The patient needs to be assessed for self-harm.
Correct Answer: C
Rationale: Abdominal lesions are of particular importance, because GI diseases often produce skin changes. Skin problems do not normally cause GI disorders. Age-related skin changes do not have a pronounced effect on the skin of the abdomen when compared to other skin surfaces. Self-harm is a less likely explanation for skin lesions on the abdomen.
A patient has been brought to the emergency department with abdominal pain and is subsequently diagnosed with appendicitis. The patient is scheduled for an appendectomy but questions the nurse about how his health will be affected by the absence of an appendix. How should the nurse best respond?
- A. Your appendix doesn't play a major role, so you won't notice any difference after you recovery from surgery.
- B. The surgeon will encourage you to limit your fat intake for a few weeks after the surgery, but your body will then begin to compensate.
- C. Your body will absorb slightly fewer nutrients from the food you eat, but you won't be aware of this.
- D. Your large intestine will adapt over time to the absence of your appendix.
Correct Answer: A
Rationale: The appendix is an appendage of the cecum (not the large intestine) that has little or no physiologic function. Its absence does not affect digestion or absorption.
A nurse is caring for a patient with biliary colic and is aware that the patient may experience referred abdominal pain. Where would the nurse most likely expect this patient to experience referred pain?
- A. Midline near the umbilicus
- B. Below the right nipple
- C. Left groin area
- D. Right lower abdominal quadrant
Correct Answer: B
Rationale: Patients with referred abdominal pain associated with biliary colic complain of pain below the right nipple. Referred pain above the left nipple may be associated with the heart. Groin pain may be referred pain from ureteral colic.
A patient presents at the walk-in clinic complaining of recurrent sharp stomach pain that is relieved by eating. The nurse suspects that the patient may have an ulcer. How would the nurse explain the formation and role of acid in the stomach to the patient?
- A. Hydrochloric acid is secreted by glands in the stomach in response to the actual or anticipated presence of food.
- B. As digestion occurs in the stomach, the stomach combines free hydrogen ions from the food to form acid.
- C. The body requires an acidic environment in order to synthesize pancreatic digestive enzymes; the stomach provides this environment.
- D. The acidic environment in the stomach exists to buffer the highly alkaline environment in the esophagus.
Correct Answer: A
Rationale: The stomach, which stores and mixes food with secretions, secretes a highly acidic fluid in response to the presence or anticipated ingestion of food. The stomach does not turn food directly into acid and the esophagus is not highly alkaline. Pancreatic enzymes are not synthesized in a highly acidic environment.
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