Nokea
A patient has been on a 1000-calorie diet with a daily exercise routine. In 2 months
- A. the patient has lost 20 lb (9 kg) toward a goal of 50 lb (23 kg) but is now discouraged that no weight has been lost in the last 2 weeks. What should the nurse tell the patient about this?
- B. Plateaus where no weight is lost normally occur during a weight-loss program.
- C. A weight considered by the body to be most efficient for functioning has been reached.
- D. A return to former eating habits is the most common cause of not continuing to lose weight.
Correct Answer: A
Rationale: Weight loss plateaus are common as the body adapts to changes in diet and exercise. It is important to remain consistent and patient during this phase.
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The most common cause of upper gastrointestinal hemorrhage (hematemesis or melena) is:
- A. esophageal varices
- B. gastric carcinoma
- C. peptic ulcer
- D. gastritis
Correct Answer: C
Rationale: The correct answer is C: peptic ulcer. Peptic ulcers are a common cause of upper gastrointestinal hemorrhage due to erosion of the stomach lining. The acidic environment in the stomach can lead to ulcer formation. Esophageal varices are associated with liver cirrhosis, not a common cause of hemorrhage. Gastric carcinoma may cause bleeding but is less common than peptic ulcers. Gastritis is inflammation of the stomach lining and can cause bleeding but is not as common as peptic ulcers.
A patient's serum liver enzyme tests reveal an elevated aspartate aminotransferase (AST). The nurse recognizes what about the elevated AST?
- A. It eliminates infection as a cause of liver damage.
- B. It is diagnostic for liver inflammation and damage.
- C. Tissue damage in organs other than the liver may be identified.
- D. Nervous system symptoms related to hepatic encephalopathy may be the cause.
Correct Answer: C
Rationale: Elevated AST may indicate damage in the liver or other organs as AST is not liver-specific.
Where are most fat-digesting enzymes produced?
- A. small intestine
- B. gallbladder
- C. liver
- D. pancreas
Correct Answer: D
Rationale: The correct answer is D: pancreas. The pancreas produces most fat-digesting enzymes, such as lipase, which help break down fats in the small intestine. The liver produces bile, stored in the gallbladder, which aids in fat digestion but doesn't directly produce fat-digesting enzymes. The small intestine primarily absorbs nutrients rather than producing fat-digesting enzymes. Therefore, the pancreas is the main source of fat-digesting enzymes in the digestive system.
A nurse is planning care for a client who is to start receiving total parenteral nutrition (TPN). Which of the following interventions should the nurse include in the plan of care?
- A. Use a 1.2 micron filter when infusing TPN with fat emulsions added.
- B. Allow 18 hr for the lipids to infuse when not mixed with the TPN solution.
- C. Change the TPN solution after 36 hr.
- D. Change the TPN tubing every 48 hr.
Correct Answer: D
Rationale: The correct answer is D: Change the TPN tubing every 48 hr. This is essential to prevent bacterial growth and infection, maintaining the integrity of the TPN solution. Regular tubing changes reduce the risk of contamination and ensure patient safety.
A: Using a 1.2 micron filter is not directly related to tubing changes and is not a primary concern for TPN administration.
B: Allowing 18 hr for lipids to infuse is not a standard practice and does not address the need for tubing changes.
C: Changing the TPN solution after 36 hr is not a standard guideline and may not be necessary unless specific factors indicate a need for a change.
A large number of children at a public school have developed profuse diarrhea and bloody stools. The school nurse suspects food poisoning related to food from the school cafeteria and requests analysis and culture of which food?
- A. Chicken
- B. Ground beef
- C. Commercially canned fish
- D. Salads with mayonnaise dressing
Correct Answer: B
Rationale: Ground beef is commonly associated with foodborne illnesses caused by E. coli, which can result in bloody diarrhea.