Nokea
A nurse is providing the client with biliary obstruction a simple overview of the anatomy of the liver and gallbladder. The nurse tells the client that normally the liver stores bile in the gallbladder, which is connected to the liver by the?
- A. Liver canaliculi
- B. Common bile duct
- C. Cystic duct
- D. Right hepatic duct.
Correct Answer: C
Rationale: The correct answer is C: Cystic duct. The cystic duct connects the gallbladder to the common bile duct, through which bile flows from the liver to the gallbladder for storage. The liver canaliculi are tiny channels within the liver where bile is produced. The common bile duct is the main duct through which bile flows from the liver to the small intestine. The right hepatic duct is one of the ducts that collect bile from the liver but does not directly connect to the gallbladder. Therefore, the cystic duct is the correct choice as it specifically links the gallbladder to the common bile duct for bile transportation.
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A nurse is preparing to remove a nasogastric tube from a client. The nurse would instruct the client to do which of the following just before the nurse removes the tube?
- A. To perform Valsalva's maneuver
- B. To take hold and hold a deep breath
- C. To exhale
- D. To inhale and exhale quickly
Correct Answer: B
Rationale: The correct answer is B: To take hold and hold a deep breath. This is because holding a deep breath helps prevent the aspiration of gastric contents when removing the nasogastric tube. By taking a deep breath and holding it, the client creates positive pressure in the lungs, which can help prevent the contents from entering the airway.
Rationale for other choices:
A: Performing Valsalva's maneuver (straining while holding breath) can increase intra-abdominal pressure and potentially push gastric contents upward, increasing the risk of aspiration.
C: Exhaling does not provide the same protection against aspiration as holding a deep breath.
D: Inhaling and exhaling quickly does not create the same protective mechanism as holding a deep breath.
A client has been diagnosed with gastroesophageal reflux disease. The nurse interprets that the client has dysfunction of which of the following parts of the digestive system?
- A. Chief cells of the stomach
- B. Parietal cells of the stomach
- C. Lower esophageal sphincter
- D. Upper esophageal sphincter
Correct Answer: C
Rationale: The correct answer is C: Lower esophageal sphincter. Gastroesophageal reflux disease (GERD) involves the dysfunction of the lower esophageal sphincter (LES), which fails to close properly, allowing stomach acid to reflux into the esophagus. This leads to symptoms such as heartburn and regurgitation. Choices A and B (Chief cells and Parietal cells of the stomach) are not directly related to GERD, as they are involved in gastric acid secretion. Choice D (Upper esophageal sphincter) is responsible for preventing air from entering the esophagus during breathing and is not typically implicated in GERD.
The nurse is monitoring a client for the early signs and symptoms for dumping syndrome. Which symptom indicates this occurrence?
- A. Abdominal cramping and pain
- B. Bradycardia and indigestion
- C. Sweating and pallor
- D. Double vision and chest pain
Correct Answer: C
Rationale: The correct answer is C, sweating and pallor, for early signs of dumping syndrome. Dumping syndrome is characterized by rapid emptying of the stomach contents into the small intestine, leading to symptoms like diaphoresis (sweating) and pallor due to vasomotor instability. Abdominal cramping and pain (A) are more commonly associated with gastrointestinal issues, not specific to dumping syndrome. Bradycardia and indigestion (B) are not typical symptoms of dumping syndrome, as it usually presents with tachycardia due to fluid shifts. Double vision and chest pain (D) are not commonly associated with dumping syndrome.
Vasopressin (Pitressin) therapy is prescribed for a client with a diagnosis of bleeding esophageal varices. The nurse is preparing to administer the medication to the client. Which of the following essential items is needed during the administration of this medication?
- A. A cardiac monitor
- B. An intubation set
- C. A suction setup
- D. A tracheotomy set
Correct Answer: A
Rationale: The correct answer is A: A cardiac monitor. Vasopressin is a vasoconstrictor medication used to decrease blood flow to the bleeding esophageal varices. It can cause significant changes in blood pressure and heart rate, hence requiring close monitoring of the client's cardiac status. A cardiac monitor is essential to continuously monitor the client's heart rate and rhythm during vasopressin therapy.
B: An intubation set is not necessary for administering vasopressin to a client with bleeding esophageal varices.
C: A suction setup is not directly related to the administration of vasopressin for bleeding esophageal varices.
D: A tracheotomy set is not required for the administration of vasopressin for bleeding esophageal varices.
A nurse is inserting a nasogastric tube in an adult client. During the procedure, the client begins to cough and has difficulty breathing. Which of the following is the most appropriate nursing action?
- A. Remove the tube and reinsert when the respiratory distress subsides.
- B. Pull back on the tube and wait until the respiratory distress subsides.
- C. Quickly insert the tube.
- D. Notify the physician immediately.
Correct Answer: B
Rationale: The correct answer is B: Pull back on the tube and wait until the respiratory distress subsides. This action allows for the nurse to relieve the pressure on the airway caused by the nasogastric tube, potentially alleviating the client's difficulty in breathing. It is important to prioritize the client's respiratory status and ensure they can breathe comfortably before proceeding with the procedure.
A: Removing the tube may worsen the respiratory distress and delay appropriate intervention.
C: Quickly inserting the tube can further compromise the client's breathing and cause more distress.
D: While notifying the physician is important, immediate intervention to address the breathing difficulty is crucial before seeking further assistance.