Nokea
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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Which of the following will have the greatest implication on a client scheduled for a percutaneous liver biopsy?
- A. History of coagulation studies
- B. Allergy to iodine
- C. Family history of GI disorders
- D. Presence of radioactive material in the work environment
Correct Answer: A
Rationale: The correct answer is A: History of coagulation studies. This is because coagulation studies assess the client's ability to form blood clots, which is crucial for a percutaneous liver biopsy to prevent excessive bleeding. It helps determine the risk of bleeding complications during the procedure.
Choice B, Allergy to iodine, is incorrect because an allergy to iodine is more relevant in procedures involving contrast media, not typically in percutaneous liver biopsies.
Choice C, Family history of GI disorders, is incorrect as it does not directly impact the client's safety or outcome during a percutaneous liver biopsy.
Choice D, Presence of radioactive material in the work environment, is also incorrect as it is not directly related to the procedure or its implications on the client's safety during a percutaneous liver biopsy.
Na and other carrier ions facilitate absorption of
- A. amino acids and fructose
- B. fatty acids and glycerol
- C. fatty acids and glucose
- D. amino acids and glucose
Correct Answer: D
Rationale: The correct answer is D: amino acids and glucose. Na ions facilitate the absorption of these molecules in the small intestine through the process of co-transport with carrier proteins. Glucose and amino acids are primarily absorbed in the small intestine to be utilized by the body for energy and growth. Na ions help transport these molecules across the intestinal epithelium against their concentration gradients.
A: Amino acids and fructose - While Na ions do play a role in the absorption of amino acids, fructose is primarily absorbed through facilitated diffusion and does not require Na ions for absorption.
B: Fatty acids and glycerol - Fatty acids and glycerol are absorbed in the small intestine through a different mechanism called micelle formation and do not rely on Na ions for absorption.
C: Fatty acids and glucose - While Na ions do play a role in the absorption of glucose, fatty acids are primarily absorbed through micelle formation and do not require Na ions for absorption.
Which of the following teaching strategies would the nurse plan for a client with an anal fissure?
- A. Teach the client strategies to relieve diarrhea
- B. Instruct the client to not eat any fiber
- C. Teach the client how to insert a suppository
- D. Teach the client how to apply ice
Correct Answer: D
Rationale: The correct answer is D: Teach the client how to apply ice. Applying ice helps reduce inflammation and pain associated with anal fissures. It constricts blood vessels, decreases blood flow, and numbs the area, promoting healing.
A: Teaching strategies to relieve diarrhea is not directly related to managing anal fissures.
B: Instructing the client to not eat any fiber is incorrect because fiber helps soften stools and prevent constipation, which can worsen anal fissures.
C: Teaching the client how to insert a suppository may not be necessary for managing anal fissures unless prescribed by a healthcare provider for specific reasons.
Histamine stimulates the ______ cells to release ______.
- A. parietal; intrinsic factor
- B. chief; pepsinogen
- C. parietal; HCl
- D. mucous neck; mucus
Correct Answer: C
Rationale: Histamine stimulates the parietal cells in the stomach lining to release hydrochloric acid (HCl). This process plays a crucial role in the digestion of food. Parietal cells are responsible for producing stomach acid, which helps break down food and kill bacteria. Choice A is incorrect because intrinsic factor is not released by parietal cells in response to histamine. Choice B is incorrect because pepsinogen is released by chief cells, not parietal cells. Choice D is incorrect because mucous neck cells secrete mucus to protect the stomach lining, but they are not directly stimulated by histamine to release mucus.
In discussing long-term management with the patient with alcoholic cirrhosis, what should the nurse advise the patient?
- A. A daily exercise regimen is important to increase the blood flow through the liver.
- B. Cirrhosis can be reversed if the patient follows a regimen of proper rest and nutrition.
- C. Abstinence from alcohol is the most important factor in improvement of the patient's condition.
- D. The only over-the-counter analgesic that should be used for minor aches and pains is acetaminophen.
Correct Answer: C
Rationale: The correct answer is C: Abstinence from alcohol is the most important factor in improvement of the patient's condition. This is because alcohol is the primary cause of alcoholic cirrhosis, and continued consumption can worsen liver damage. Abstinence allows the liver to heal and potentially improve function.
Explanation of why the other choices are incorrect:
A: A daily exercise regimen is important for overall health but may not specifically increase blood flow through the liver in alcoholic cirrhosis.
B: Cirrhosis is irreversible, although proper rest and nutrition can help manage symptoms and prevent further damage.
D: Acetaminophen can be harmful to the liver in high doses and should be used cautiously in patients with cirrhosis.