Nokea
A patient with ulcerative colitis undergoes the first phase of a total proctocolectomy with ileal pouch and anal anastomosis. On postoperative assessment of the patient, what should the nurse expect to find?
- A. A rectal tube set to low continuous suction
- B. A loop ileostomy with a plastic rod to hold it in place
- C. A colostomy stoma with an NG tube in place to provide pouch irrigations
- D. A permanent ileostomy stoma in the right lower quadrant of the abdomen
Correct Answer: B
Rationale: In the first phase of a total proctocolectomy with ileal pouch and anal anastomosis, a loop ileostomy is created to divert stool while the pouch heals.
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A nurse is planning care for a client who has diverticulitis. Which of the following menu selections should the nurse include in the plan?
- A. Turkey sandwich with celery sticks
- B. Sliced ham with green salad
- C. Pork tenderloin with green peas
- D. Grilled chicken breast with white rice
Correct Answer: D
Rationale: The correct answer is D because grilled chicken breast with white rice is a low-fiber, easily digestible option suitable for a client with diverticulitis. High-fiber foods like celery (choice A), green salad (choice B), and green peas (choice C) can worsen symptoms by irritating the inflamed diverticula. Pork tenderloin (choice C) is high in fat, which can be difficult to digest. Grilled chicken breast with white rice provides protein and carbohydrates without aggravating the condition.
The nurse recognizes that teaching a patient following a laparoscopic cholecystectomy has been effective when the patient makes which statement?
- A. "I can take a shower and walk around the house tomorrow."
- B. "I need to limit my activities and not return to work for 4 weeks."
- C. "I can expect yellowish drainage from the incision for a few days."
- D. "I will follow a low-fat diet for life because I do not have a gallbladder."
Correct Answer: A
Rationale: Rationale for Correct Answer (A): The statement "I can take a shower and walk around the house tomorrow" indicates an understanding of post-operative activity expectations. After a laparoscopic cholecystectomy, early ambulation is encouraged to prevent complications like blood clots. Additionally, showering promotes wound healing and hygiene.
Incorrect Choices:
B: "I need to limit my activities and not return to work for 4 weeks" - This choice is incorrect as it overestimates the recovery time for a laparoscopic cholecystectomy, which typically allows for a quicker return to normal activities.
C: "I can expect yellowish drainage from the incision for a few days" - While drainage is common after surgery, the color and duration mentioned are not typical for this procedure.
D: "I will follow a low-fat diet for life because I do not have a gallbladder" - Following a low-fat diet is recommended after surgery, but the statement is too extreme as dietary
Where does the chemical digestion of starch begin?
- A. mouth
- B. esophagus
- C. stomach
- D. small intestine
Correct Answer: A
Rationale: The correct answer is A: mouth. Chemical digestion of starch begins in the mouth with the enzyme amylase present in saliva. Amylase breaks down starch into maltose. This process initiates the breakdown of complex carbohydrates into simple sugars for absorption. In contrast, the esophagus is not involved in digestion, the stomach primarily performs mechanical and protein digestion, and the small intestine is where most of the digestion and absorption of nutrients occur, but not where the initial digestion of starch begins.
The major part of the aqueous component (other than water) of pancreatic juice is
- A. mucus.
- B. trypsinogen, chymotrypsinogen, and procarboxypeptidase.
- C. bicarbonate ions.
- D. secretin.
Correct Answer: C
Rationale: The correct answer is C: bicarbonate ions. Pancreatic juice is alkaline to neutralize the acidic chyme entering the small intestine from the stomach. Bicarbonate ions are secreted by pancreatic duct cells and play a major role in maintaining the pH balance. Mucus (choice A) is produced by goblet cells and helps protect the lining of the digestive tract but is not a major component of pancreatic juice. Trypsinogen, chymotrypsinogen, and procarboxypeptidase (choice B) are pancreatic enzymes, not the major component of the aqueous component. Secretin (choice D) is a hormone that stimulates the pancreas to release bicarbonate ions but is not a component of pancreatic juice itself.
Vomitting is not usually caused by:
- A. Irritation if the duodenal mucosa
- B. Diseases of the inner ear
- C. Microbial toxins in the blood
- D. Severe exercise
Correct Answer: B
Rationale: The correct answer is B: Diseases of the inner ear. Vomiting is primarily controlled by the vomiting center in the brainstem, which responds to various stimuli such as irritation of the duodenal mucosa (Choice A), microbial toxins in the blood (Choice C), and severe exercise (Choice D). Diseases of the inner ear do not directly trigger the vomiting reflex, making Choice B the correct answer.