Nokea
A nurse is giving discharge instructions to a client with pancreatitis. Which of the following instructions is correct?
- A. Eat two meals a day.
- B. If alcohol abuse is known, limit alcohol to one drink per day.
- C. Follow written instructions for a high-carbohydrate, high-fat diet.
- D. Follow the written instructions for a bland, low-fat calorie-controlled diet.
Correct Answer: D
Rationale: A bland, low-fat diet reduces pancreatic stimulation and minimizes symptom exacerbation.
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Intestinal motility is a complex process, orchestrated by nerves, hormones and the presence of food in the stomach. Which statement about this process is correct?
- A. The migrating motor complex is chiefly responsible for peristaltic movement of food after a meal has been consumed
- B. The release of insulin after eating a meal will slow the emptying of the stomach
- C. At the start of a meal, the stomach increases its 'tone' in order to develop pressure which will lead to expulsion of its contents, via the pylorus
- D. The presence of partially digested fat and starch in the duodenum, slows intestinal motility
Correct Answer: D
Rationale: The correct answer is D. When partially digested fat and starch enter the duodenum, it triggers the release of hormones like cholecystokinin and secretin, which slow down intestinal motility. This is important for proper digestion and absorption of nutrients. Choice A is incorrect because the migrating motor complex is responsible for clearing the stomach and small intestine of residual food and bacteria during fasting, not after a meal. Choice B is incorrect because insulin does not affect stomach emptying; rather, it regulates blood sugar levels. Choice C is incorrect because the stomach does not increase its tone at the start of a meal; instead, it relaxes to accommodate the incoming food.
A client who is scheduled for a barium swallow asks the nurse why a laxative is necessary following the procedure. Which of the following responses should the nurse make?
- A. The laxative will prevent the absorption of magnesium.'
- B. The laxative helps eliminate the barium.'
- C. The laxative is the protocol at this facility.'
- D. The laxative makes the barium turn brown.'
Correct Answer: B
Rationale: The correct answer is B: The laxative helps eliminate the barium. After a barium swallow, the client needs to expel the barium from their system to prevent barium toxicity. The laxative helps to move the barium through the digestive system and facilitate its elimination. Choices A, C, and D are incorrect because preventing magnesium absorption, facility protocol, and changing the color of barium are not reasons for the necessity of a laxative after a barium swallow.
Which of these is a hormone name?
- A. trypsin
- B. ribonuclease
- C. cholecystokinin
- D. chymotrypsinogen
Correct Answer: C
Rationale: The correct answer is C: cholecystokinin. It is a hormone released by the small intestine in response to the presence of fat and protein in the digestive tract. Cholecystokinin plays a role in the digestion and absorption of nutrients. Trypsin, ribonuclease, and chymotrypsinogen are enzymes involved in digestion, not hormones. Hormones are chemical messengers produced by glands and released into the bloodstream to regulate various physiological processes in the body.
Which part of the digestive system is primarily responsible for the absorption of water?
- A. small intestine
- B. large intestine
- C. stomach
- D. duodenum
Correct Answer: B
Rationale: The large intestine is primarily responsible for the absorption of water in the digestive system. It reabsorbs water and electrolytes from the indigestible food residue, forming feces. The small intestine is more involved in nutrient absorption. The stomach mainly digests food, while the duodenum is the initial segment of the small intestine where most digestion occurs. The large intestine's main role in water absorption makes it the correct answer.
The patient with gastroesophageal reflux disease should be taught:
- A. To avoid coffee, tea, or other caffeine-containing beverages.
- B. To take H2 blockers, such as ranitidine, as directed.
- C. To avoid acidic foods such as citrus or tomato.
- D. All of the above.
Correct Answer: D
Rationale: Patients with GERD should avoid foods and beverages that can irritate the esophagus, and taking H2 blockers can reduce acid production.