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A patient receives atropine, an anticholinergic drug, in preparation for surgery. The nurse expects this drug to affect the GI tract by doing what?
- A. Increasing gastric emptying
- B. Relaxing pyloric and ileocecal sphincters
- C. Decreasing secretions and peristaltic action
- D. Stimulating the nervous system of the GI tract
Correct Answer: C
Rationale: The correct answer is C: Decreasing secretions and peristaltic action. Atropine, as an anticholinergic drug, inhibits the action of acetylcholine, leading to decreased secretions and peristaltic movement in the GI tract. This results in reduced motility and secretion production.
A: Increasing gastric emptying - This is incorrect because atropine actually slows down gastric emptying by reducing peristaltic action.
B: Relaxing pyloric and ileocecal sphincters - This is incorrect because atropine does not directly relax these sphincters.
D: Stimulating the nervous system of the GI tract - This is incorrect because atropine inhibits the parasympathetic nervous system, leading to decreased GI tract activity.
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What test will be done before prescribing treatment for the patient with positive testing for HCV?
- A. Anti-HCV
- B. HCV RNA quantitation
- C. HCV genotyping
- D. Recombinant immunoblot assay (RIBA)
Correct Answer: C
Rationale: The correct answer is C: HCV genotyping. Before prescribing treatment for a patient with positive HCV testing, genotyping is essential to determine the specific strain of HCV present. This information guides treatment decisions as different HCV genotypes respond differently to antiviral medications. Anti-HCV (choice A) is used for initial screening but does not provide genotype information. HCV RNA quantitation (choice B) measures viral load but does not identify the genotype. Recombinant immunoblot assay (RIBA) (choice D) is an older confirmatory test and is not typically used for initial treatment decision-making.
Which of these enzymes is responsible for the digestion of lipids?
- A. Amylase
- B. Pepsin
- C. Lipase
- D. Trypsin
Correct Answer: C
Rationale: The correct answer is C: Lipase. Lipase is responsible for the digestion of lipids because it breaks down fats into fatty acids and glycerol. Amylase (A) digests carbohydrates, Pepsin (B) digests proteins, and Trypsin (D) also digests proteins but in the small intestine. Lipase is the only enzyme that specifically targets lipids for digestion, making it the correct choice in this scenario.
Gastric secretion composed of all of the following Except:
- A. HCL.
- B. IF.
- C. Mucous.
- D. Amylase.
Correct Answer: D
Rationale: The correct answer is D: Amylase. Gastric secretion does not contain amylase. Amylase is an enzyme produced by the pancreas and salivary glands to break down carbohydrates. In the stomach, gastric secretions mainly consist of hydrochloric acid (HCl) for digestion, intrinsic factor (IF) for vitamin B12 absorption, and mucous to protect the stomach lining. Therefore, amylase is not a component of gastric secretion.
Which statement about intestinal 'brakes' and 'accelerators' is FALSE?
- A. Dietary starch is a potent stimulator of small intestinal motility because it causes insulin release from the pancreas
- B. Food in the stomach causes gastrin release, which stimulates acid secretion
- C. Short-chain fatty acids which move from colon to caecum (reflux) promote ileo-caecal motility
- D. The arrival of lipid in the duodenum causes an immediate reduction in motility and a switch from the 'fasting' to the 'feeding' pattern.
Correct Answer: A
Rationale: The correct answer is A because dietary starch does not cause insulin release from the pancreas, but rather stimulates the release of incretin hormones like glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). These incretins help regulate blood sugar levels postprandially and do not directly affect intestinal motility.
Incorrect choices:
B: Food in the stomach causing gastrin release is true and stimulates acid secretion.
C: Short-chain fatty acids moving from colon to caecum promoting ileo-caecal motility is true.
D: The arrival of lipid in the duodenum causing a reduction in motility is true.
A client with proctitis needs a rectal suppository. A senior nursing student assigned to this client tells you that she is afraid to insert the suppository because she has never done it before. What is the most appropriate action in supervising this student?
- A. You give the medication and report the student to the instructor.
- B. Ask the student to leave the clinical area for being unprepared.
- C. Reassign the client to an LPN/LVN.
- D. Show the student how to insert the suppository and talk to the instructor.
Correct Answer: D
Rationale: Correct Answer: D
Rationale:
1. Supervising students is part of the nursing role.
2. As a tutor, your responsibility is to guide and teach students.
3. Showing the student how to insert the suppository will help build their skills and confidence.
4. Talking to the instructor ensures proper supervision and support for the student's learning.
5. Reporting or dismissing the student is not constructive and goes against the principles of education and mentorship.