Nokea
A nurse is reviewing the provider's prescriptions for a client experiencing a paralytic ileus following an appendectomy. Which of the following actions should the nurse expect to take?
- A. Administer an antacid.
- B. Provide a bulk-forming agent.
- C. Insert nasogastric tube.
- D. Apply a truss.
Correct Answer: C
Rationale: The correct answer is C: Insert nasogastric tube. In a paralytic ileus, the intestines are unable to contract and move contents, leading to bowel obstruction. Inserting a nasogastric tube helps decompress the intestines by removing gas and fluid, relieving discomfort and preventing further complications. Administering an antacid (A) is not indicated for paralytic ileus. Providing a bulk-forming agent (B) may exacerbate the obstruction. Applying a truss (D) is used for hernias, not for paralytic ileus.
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This blind tube is about 9 cm long, is filled with lymph nodules and attaches to the cecum. This blind tube is called the
- A. epiploic appendix.
- B. haustra.
- C. vermiform appendix.
- D. tenia coli.
Correct Answer: C
Rationale: The correct answer is C: vermiform appendix. The vermiform appendix is a blind tube, around 9 cm long, filled with lymph nodules, and attaches to the cecum. This anatomical description matches the characteristics of the vermiform appendix. The epiploic appendix (choice A) refers to small fatty projections on the colon's surface, not a blind tube. Haustra (choice B) are the pouches along the colon's length, not a blind tube. Tenia coli (choice D) are the three bands of longitudinal muscle in the colon, not a blind tube. Therefore, the vermiform appendix is the correct answer.
The home health nurse is caring for the patient with tuberculosis who is taking rifampin and isoniazid (INH). The nurse should carefully monitor the patient for which potential side effect?
- A. Gallstones
- B. Liver disorders
- C. Bleeding ulcers
- D. Esophagitis
Correct Answer: B
Rationale: The correct answer is B: Liver disorders. Rifampin and isoniazid are known to potentially cause hepatotoxicity. The nurse should monitor for signs of liver dysfunction such as jaundice, dark urine, abdominal pain, and elevated liver enzymes. Gallstones (A) are not commonly associated with these medications. Bleeding ulcers (C) are not a common side effect of rifampin and isoniazid. Esophagitis (D) is more commonly associated with other medications like bisphosphonates.
Mechanical digestion begins in the:
- A. mouth
- B. stomach
- C. small intestine
- D. large intestine
Correct Answer: A
Rationale: The correct answer is A: mouth. Mechanical digestion begins in the mouth where food is chewed and mixed with saliva, breaking down into smaller pieces for easier swallowing and digestion. This process increases the surface area of food for enzymes to act upon. The stomach (B) primarily performs chemical digestion, the small intestine (C) is where most chemical digestion and absorption occur, and the large intestine (D) is mainly responsible for water absorption and formation of feces. Thus, the mouth is the correct choice for the beginning of mechanical digestion.
What does the pancreas secrete to aid in digestion?
- A. insulin
- B. gastric acid
- C. digestive enzymes
- D. bile
Correct Answer: C
Rationale: The correct answer is C: digestive enzymes. The pancreas secretes digestive enzymes such as amylase, lipase, and protease to break down carbohydrates, fats, and proteins in the small intestine. Insulin (choice A) is a hormone that regulates blood sugar levels, not aid in digestion. Gastric acid (choice B) is produced by the stomach, not the pancreas. Bile (choice D) is produced by the liver and stored in the gallbladder to aid in fat digestion, not directly secreted by the pancreas for digestion.
Which of the following is an opening in the large bowel created by bringing a section of the large intestine out to the abdomen and fashioning a stoma?
- A. Continent ileostomy
- B. Colostomy
- C. Ileostomy
- D. Ileoanal reservoir
Correct Answer: B
Rationale: The correct answer is B: Colostomy. A colostomy is an opening in the large bowel created by bringing a section of the large intestine out to the abdomen to form a stoma. This procedure is typically done to divert stool in cases of colorectal diseases or surgeries.
A: Continent ileostomy - This choice is incorrect because a continent ileostomy involves creating a pouch inside the body to collect waste, rather than bringing a section of the large intestine out to the abdomen.
C: Ileostomy - This choice is incorrect because an ileostomy involves bringing the end of the small intestine out to the abdomen to create a stoma, not a section of the large intestine.
D: Ileoanal reservoir - This choice is incorrect as it refers to a surgical procedure where the colon and rectum are removed, and a pouch is created from the small intestine to restore bowel function, not to create a stoma in the large bowel.