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A nurse is assessing a client who is 3 days postoperative following abdominal surgery and notes the absence of bowel sounds, abdominal distention, and the client passing no flatus. Which of the following conditions should the nurse suspect?
- A. Ulcerative colitis
- B. Cholecystitis
- C. Paralytic ileus
- D. Wound dehiscence
Correct Answer: C
Rationale: The correct answer is C: Paralytic ileus. After abdominal surgery, the bowel can temporarily stop functioning due to anesthesia, handling of the intestines, or inflammation. This leads to absent bowel sounds, distention, and no flatus passage. Ulcerative colitis (A) is a chronic inflammatory bowel disease, not related to postoperative findings. Cholecystitis (B) is inflammation of the gallbladder, typically presenting with right upper quadrant pain. Wound dehiscence (D) is the separation of surgical incision edges, not related to bowel function.
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An individual has the following symptoms: jaundice, pale in color, liver with a buildup of connective tissue. This individual most likely has
- A. gastritis.
- B. pancreatitis.
- C. gall stones.
- D. cirrhosis.
Correct Answer: D
Rationale: The correct answer is D: cirrhosis. Jaundice, pale skin, and liver with connective tissue buildup are classic symptoms of cirrhosis - a condition characterized by scarring of the liver due to long-term damage. Jaundice occurs when the liver is unable to properly process bilirubin, leading to yellowing of the skin and eyes. The pale color can be due to anemia often seen in cirrhosis. The buildup of connective tissue is indicative of fibrosis and scarring in the liver. Gastritis (A) is inflammation of the stomach lining, pancreatitis (B) is inflammation of the pancreas, and gallstones (C) are solid particles that form in the gallbladder. These conditions do not typically present with the combination of symptoms described.
The pancreas produces all of the following except which one?
- A. amylase
- B. lipase
- C. insulin
- D. bile
Correct Answer: D
Rationale: The correct answer is D: bile. The pancreas produces digestive enzymes such as amylase and lipase to break down carbohydrates and fats. It also produces insulin to regulate blood sugar levels. Bile, however, is produced by the liver and stored in the gallbladder, not by the pancreas. Therefore, the pancreas does not produce bile. This makes option D the correct answer.
A two-week-old boy develops persistent projectile vomiting. The most likely diagnosis is:
- A. pyloric stenosis
- B. esophageal atresia
- C. annular pancreas
- D. incomplete rotation of the gut
Correct Answer: A
Rationale: The correct answer is A: pyloric stenosis. In pyloric stenosis, there is hypertrophy of the pyloric sphincter muscle, leading to gastric outlet obstruction and projectile vomiting. This typically presents in infants around 2-6 weeks of age. Other choices (B) esophageal atresia presents with difficulty feeding and choking, (C) annular pancreas with duodenal obstruction, and (D) incomplete rotation of the gut with volvulus or obstruction due to malrotation. Pyloric stenosis is the most likely diagnosis in this scenario based on the age of the infant and the symptom of projectile vomiting.
The alkaline tide occurs when _____ is excreted into the urine.
- A. HCl
- B. H+
- C. bicarbonate ions
- D. phosphate ions
Correct Answer: C
Rationale: The correct answer is C: bicarbonate ions. During the alkaline tide, the stomach secretes hydrochloric acid (HCl) to aid digestion, which leads to an increase in bicarbonate ions (HCO3-) in the blood to maintain pH balance. These excess bicarbonate ions are then excreted into the urine, resulting in an alkaline pH. Choice A (HCl) is incorrect because HCl is not excreted into the urine during the alkaline tide. Choice B (H+) is incorrect as it does not directly relate to the process of the alkaline tide. Choice D (phosphate ions) is incorrect as they are not the primary ions excreted to produce an alkaline urine during the alkaline tide.
After eating, a patient with an inflamed gallbladder experiences pain caused by contraction of the gallbladder. What is the mechanism responsible for this action?
- A. Production of bile by the liver
- B. Production of secretin by the duodenum
- C. Release of gastrin from the stomach antrum
- D. Production of cholecystokinin by the duodenum
Correct Answer: D
Rationale: The correct answer is D: Production of cholecystokinin by the duodenum. Cholecystokinin (CCK) is released by the duodenum in response to the presence of fatty acids and amino acids. It stimulates the gallbladder to contract, causing the release of bile into the small intestine to aid in digestion. This is directly related to the patient's symptoms of gallbladder pain after eating, as the contraction of the gallbladder is triggered by CCK.
A: Production of bile by the liver is not the mechanism responsible for the gallbladder contraction.
B: Production of secretin by the duodenum is involved in regulating the pH of the duodenum, not gallbladder contraction.
C: Release of gastrin from the stomach antrum is related to stomach acid secretion, not gallbladder contraction.
In summary, the correct answer, D, is directly related to the mechanism responsible for gallbladder pain after eating,