Nokea
A patient with cirrhosis that is refractory to other treatments for esophageal varices undergoes a portacaval shunt. As a result of this procedure, what should the nurse expect the patient to experience?
- A. An improved survival rate
- B. Decreased serum ammonia levels
- C. Improved metabolism of nutrients
- D. Improved hemodynamic function and renal perfusion
Correct Answer: D
Rationale: The correct answer is D: Improved hemodynamic function and renal perfusion. A portacaval shunt is a surgical procedure that diverts blood flow from the portal vein directly into the vena cava, reducing portal hypertension. This leads to improved hemodynamic function by decreasing pressure in the portal system, which can improve renal perfusion. Choices A, B, and C are incorrect because a portacaval shunt may not necessarily improve survival rate, decrease serum ammonia levels, or improve metabolism of nutrients.
You may also like to solve these questions
Which structure is located where the esophagus penetrates the diaphragm?
- A. esophageal hiatus
- B. cardiac orifice
- C. upper esophageal sphincter
- D. lower esophageal sphincter
Correct Answer: A
Rationale: The correct answer is A: esophageal hiatus. This is the opening in the diaphragm through which the esophagus passes, connecting the thoracic and abdominal cavities. The esophageal hiatus is specifically located at the level of the tenth thoracic vertebra. The other choices are incorrect because:
B: Cardiac orifice refers to the opening of the stomach into the esophagus, not where the esophagus penetrates the diaphragm.
C: Upper esophageal sphincter is a muscular valve at the upper end of the esophagus, not related to its passage through the diaphragm.
D: Lower esophageal sphincter is located at the junction of the esophagus and stomach, not at the point where the esophagus penetrates the diaphragm.
Which of these cells in the stomach secrete mucus?
- A. parietal cells
- B. chief cells
- C. mucous neck cells
- D. enteroendocrine cells
Correct Answer: C
Rationale: The correct answer is C: mucous neck cells. These cells secrete mucus to protect the stomach lining from the acidic environment and aid in lubrication. Parietal cells secrete hydrochloric acid, chief cells secrete pepsinogen, and enteroendocrine cells secrete hormones like gastrin. Mucous neck cells are specifically responsible for mucus secretion in the stomach, making them the correct choice.
By the time food leaves the stomach it is:
- A. a creamy paste called chyme.
- B. rolled into a bolus.
- C. ready to be mixed with pepsin for protein digestion.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: a creamy paste called chyme. After food enters the stomach, it gets mixed with gastric juices and enzymes, forming a semi-liquid substance known as chyme. This chyme is then slowly released into the small intestine for further digestion and absorption of nutrients. Option B is incorrect as food is not rolled into a bolus in the stomach but rather churned into chyme. Option C is incorrect as pepsin, an enzyme for protein digestion, is already present in the stomach and starts working on digesting proteins before the food leaves the stomach. Option D is incorrect as chyme is the accurate description of the partially digested food leaving the stomach.
Which of the following ligaments attaches the liver to the anterior abdominal wall?
- A. coronary ligament
- B. falciform ligament
- C. quadrate ligament
- D. caudate ligament
Correct Answer: B
Rationale: The correct answer is B: falciform ligament. The falciform ligament attaches the liver to the anterior abdominal wall and separates the right and left lobes of the liver. It is a broad, thin ligament that resembles a sickle. The other choices are incorrect because:
A: The coronary ligament attaches the liver to the diaphragm, not the abdominal wall.
C: The quadrate ligament attaches the liver to the gallbladder and the lesser curvature of the stomach.
D: The caudate ligament attaches the liver to the diaphragm and is not directly related to the abdominal wall attachment.
What is the role of the villi in the small intestine?
- A. secreting digestive enzymes
- B. absorbing nutrients
- C. producing bile
- D. producing mucus
Correct Answer: B
Rationale: The correct answer is B: absorbing nutrients. Villi are finger-like projections in the small intestine that increase surface area for absorption of nutrients. They contain blood vessels and lacteals that absorb nutrients like glucose and amino acids. Villi do not secrete digestive enzymes (choice A), produce bile (choice C), or produce mucus (choice D). Digestive enzymes are produced by the pancreas and bile is produced by the liver. Mucus is produced by goblet cells in the intestine.