Nokea
A nurse is teaching a client about strategies to manage gastroesophageal reflux disease (GERD). Which of the following statements should the nurse include?
- A. Elevate the head of your bed by 18 inches.'
- B. Avoid snacking between meals.'
- C. Limit foods that are high in fiber.'
- D. Avoid eating 2 to 3 hours before bedtime.'
Correct Answer: D
Rationale: The correct answer is D: Avoid eating 2 to 3 hours before bedtime. This is because lying down after eating can worsen GERD symptoms by allowing stomach acid to flow back up into the esophagus. By avoiding eating close to bedtime, the client can reduce the risk of acid reflux.
A: Elevating the head of the bed helps reduce nighttime symptoms, but it is not the most essential strategy.
B: Avoiding snacking between meals can help, but the timing of meals is more crucial for managing GERD.
C: Limiting foods high in fiber is not directly related to managing GERD; it is more about avoiding trigger foods like citrus, caffeine, and fatty foods.
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Water transport can occur from the lumen of the intestine to the blood stream, or from the blood stream to the intestinal lumen. Which single statement about this phenomenon, below, is actually correct?
- A. A 'flip-flop' mechanism efficiently transports water directly across the enterocyte membrane
- B. Water flows into the gut from the mucosa, during digestion of starch and protein, in order to reduce luminal osmolality
- C. Water is mostly absorbed by movement between the cells lining the gut (enterocytes) via tight junctions
- D. Dietary intake of water is always greater than water movement in the small intestine
Correct Answer: C
Rationale: The correct answer is C because water is indeed mostly absorbed by movement between the cells lining the gut (enterocytes) via tight junctions. This is known as paracellular transport. Water moves through the spaces between the cells due to osmotic gradients and is then taken up by blood vessels. A: The 'flip-flop' mechanism is not a recognized mechanism for water transport in the intestine. B: Water does not flow into the gut from the mucosa during digestion, rather it moves from the gut lumen into the blood. D: Dietary intake of water can vary and may not always be greater than water movement in the small intestine.
Parasympathetic stomach impulses cause all of the following except which one?
- A. secretion of somatostatin
- B. inhibition of somatostatin
- C. secretion of gastrin
- D. promotes histamine
Correct Answer: A
Rationale: The correct answer is A because parasympathetic impulses do not lead to the secretion of somatostatin. Somatostatin is released in response to low pH in the stomach to inhibit further acid secretion. Parasympathetic impulses stimulate the secretion of gastrin, promote histamine release, and inhibit somatostatin secretion. This is important for enhancing gastric acid secretion and promoting digestion. Therefore, choices B, C, and D are incorrect as they are effects of parasympathetic stomach impulses.
The ileocecal valve prevents chyme from entering the _____.
- A. large intestine
- B. small intestine
- C. stomach
- D. duodenum
Correct Answer: A
Rationale: The correct answer is A: large intestine. The ileocecal valve is located between the ileum (part of the small intestine) and the cecum (part of the large intestine). Its primary function is to prevent the backflow of contents from the large intestine into the small intestine, specifically preventing chyme from entering the large intestine prematurely. This allows for proper digestion and absorption of nutrients in the small intestine before the remaining waste material enters the large intestine for further processing. Choices B, C, and D are incorrect as the ileocecal valve specifically regulates the flow of material between the small and large intestines, not other parts of the digestive system such as the stomach or duodenum.
Priority Decision: During the treatment of the patient with bleeding esophageal varices, what is the most important thing the nurse should do?
- A. Prepare the patient for immediate portal shunting surgery.
- B. Perform guaiac testing on all stools to detect occult blood.
- C. Maintain the patient's airway and prevent aspiration of blood.
- D. Monitor for the cardiac effects of IV vasopressin and nitroglycerin.
Correct Answer: C
Rationale: Rationale: The correct answer is C because maintaining the patient's airway and preventing aspiration of blood is the top priority in a patient with bleeding esophageal varices. This is crucial to prevent respiratory compromise and potential life-threatening complications. Immediate portal shunting surgery (A) is not the priority as stabilizing the patient comes first. Guaiac testing (B) is not the priority as it does not address the immediate risk of airway obstruction. Monitoring cardiac effects (D) is important but not as critical as ensuring the patient's airway is secure.
Which of these statements about the pharynx is true?
- A. It extends from the nasal and oral cavities superiorly to the esophagus anteriorly.
- B. The oropharynx is continuous superiorly with the nasopharynx.
- C. The nasopharynx is involved in digestion.
- D. The laryngopharynx is composed partially of cartilag
Correct Answer: B
Rationale: The correct answer is B because the oropharynx is indeed continuous superiorly with the nasopharynx, forming a passage for both air and food. This continuity allows for the passage of food and air between the oral and nasal cavities.
A is incorrect because the pharynx extends from the nasal and oral cavities superiorly to the esophagus posteriorly, not anteriorly.
C is incorrect because the nasopharynx is not involved in digestion; it primarily functions in respiration and contains the openings of the Eustachian tubes.
D is incorrect because the laryngopharynx is not composed partially of cartilage; it is a muscular passage that connects the oropharynx and the esophagus.