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A nurse is providing discharge teaching to a client who has gastroesophageal reflux disease. Which of the following statements by the client indicates an understanding of the teaching?
- A. The type of foods I eat does not affect this condition.'
- B. I will sleep on my left side.'
- C. I will eat a snack just before going to bed.'
- D. I will sleep with the head of my bed elevated.'
Correct Answer: D
Rationale: The correct answer is D. Elevating the head of the bed helps prevent acid reflux by keeping the stomach acid from flowing back into the esophagus while sleeping. This position helps gravity keep the acid in the stomach. Choice A is incorrect because certain foods can indeed trigger or worsen GERD symptoms. Choice B is incorrect as sleeping on the left side may worsen symptoms due to the position of the stomach. Choice C is incorrect as eating right before bed can increase the risk of acid reflux.
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What is the function of bile salts?
- A. emulsifying fats
- B. breaking down carbohydrates
- C. activating pepsin
- D. digesting proteins
Correct Answer: A
Rationale: The correct answer is A: emulsifying fats. Bile salts help emulsify fats by breaking them into smaller droplets, increasing the surface area for enzymes to act upon during digestion. This aids in the absorption of fats in the small intestine. Choices B, C, and D are incorrect because bile salts do not have a direct role in breaking down carbohydrates (choice B), activating pepsin (choice C), or digesting proteins (choice D). These functions are carried out by other digestive enzymes in the gastrointestinal tract.
A tumor producing large amounts of the intestinal hormone GIP may result in:
- A. Hyperglycemia
- B. Hypoglycemia
- C. Diarrhea
- D. Intestinal colic
Correct Answer: A
Rationale: The correct answer is A: Hyperglycemia. GIP (gastric inhibitory polypeptide) is released in response to food intake to stimulate insulin release and inhibit glucagon secretion, leading to reduced blood glucose levels. Excessive GIP production from a tumor can result in excessive insulin release, causing hypoglycemia. This is why the correct answer is hyperglycemia. Choices B, C, and D are incorrect as they do not align with the physiological effects of GIP.
A patient calls the clinic to report a new onset of severe diarrheWhat should the nurse anticipate that the patient will need to do?
- A. Collect a stool specimen.
- B. Prepare for colonoscopy.
- C. Schedule a barium enema.
- D. Have blood cultures drawn.
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Stool specimen collection helps identify the cause of diarrhea (e.g., infection).
2. It assists in determining appropriate treatment.
3. It helps rule out serious conditions.
4. Colonoscopy (B) and barium enema (C) are invasive procedures not typically indicated for acute diarrhea.
5. Blood cultures (D) are not the first-line investigation for diarrhea without systemic signs of infection.
Jason, a 22 y.o. accident victim, requires an NG tube for feeding. What should you immediately do after inserting an NG tube for liquid enteral feedings?
- A. Aspirate for gastric secretions with a syring
- C. Begin feeding slowly to prevent cramping.
- D. Get an X-ray of the tip of the tube within 24 hours.
Correct Answer: A
Rationale: The correct answer is A because aspirating for gastric secretions ensures proper tube placement in the stomach, reducing the risk of aspiration pneumonia. Choice B is irrelevant and doesn't address the immediate post-insertion step. Choice C is incorrect as starting feeding immediately can lead to complications if the tube is not in the correct position. Choice D is incorrect as X-ray verification is not needed immediately after insertion.
In which of the following segments of the gastrointestinal tract is primary carcinoma least common?
- A. esophagus
- B. stomach
- C. small intestine
- D. colon
Correct Answer: C
Rationale: The correct answer is C: small intestine. Primary carcinoma is least common in the small intestine due to its relatively lower exposure to carcinogens and slower cellular turnover compared to other segments like the colon. The esophagus is prone to carcinoma due to chronic irritation from acid reflux. The stomach is susceptible due to factors like Helicobacter pylori infection and dietary habits. The colon is at higher risk due to frequent exposure to fecal carcinogens. In summary, the small intestine has the least incidence of primary carcinoma due to lower exposure to risk factors.