Nokea
A tumor producing large amounts of gastrin DOES NOT include:
- A. Hyperplasia of gastric epithelium
- B. Hyperplasia of gastric mucosal lymphocytes
- C. Excessive gastric acid secretion
- D. Histamine secretion in the gastric mucosa
Correct Answer: B
Rationale: The correct answer is B: Hyperplasia of gastric mucosal lymphocytes. In a tumor producing large amounts of gastrin, hyperplasia of gastric epithelium (choice A) is expected due to increased gastrin stimulation. Excessive gastric acid secretion (choice C) is also expected as gastrin stimulates acid production. Histamine secretion in the gastric mucosa (choice D) can occur as histamine is released in response to gastrin. However, hyperplasia of gastric mucosal lymphocytes (choice B) is not a direct consequence of increased gastrin levels. Lymphocyte hyperplasia is more commonly associated with chronic inflammation or infection rather than gastrin overproduction.
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A nurse is doing discharge teaching on a client with a colostomy. What would the nurse convey to the client regarding when is the best time to perform irrigation?
- A. After a meal.
- B. After a bowel movement.
- C. During a meal.
- D. Two hours before a meal.
Correct Answer: D
Rationale: The correct answer is D: Two hours before a meal. This timing allows for the colon to be relatively empty, making irrigation more effective. Irrigating two hours before a meal helps to prevent interference with digestion and absorption processes. Irrigating after a meal (choice A) or during a meal (choice C) may lead to discomfort, bloating, or potential leakage. Irrigating after a bowel movement (choice B) may not provide enough time for the colon to be adequately empty for effective irrigation.
Which patient is at highest risk for having a gastric ulcer?
- A. 55-year-old female, smoker, with nausea and vomiting
- B. 45-year-old female admitted for illicit drug detoxification
- C. 37-year-old male, smoker, who fell while looking for a job
- D. 27-year old male who is being divorced and has back pain
Correct Answer: A
Rationale: The correct answer is A because a 55-year-old female who is a smoker and experiencing symptoms of nausea and vomiting has multiple risk factors for developing a gastric ulcer. Smoking and older age are established risk factors for gastric ulcers. Nausea and vomiting can be indicative of underlying gastrointestinal issues.
Choice B is less likely as illicit drug use typically does not directly increase the risk of gastric ulcers.
Choice C is less likely as the male falling while looking for a job does not directly relate to gastric ulcer development.
Choice D is less likely as divorce and back pain are not direct risk factors for gastric ulcers.
What contributes to increased protein-calorie needs?
- A. Surgery
- B. Vegan diet
- C. Lowered temperature
- D. Cultural or religious beliefs
Correct Answer: A
Rationale: The correct answer is A: Surgery. Surgery increases protein-calorie needs due to the body's increased demand for nutrients to support healing and recovery. The body requires more protein and calories to repair tissues and maintain immune function post-surgery.
Choice B: A vegan diet does not necessarily contribute to increased protein-calorie needs as it is possible to meet nutritional requirements with proper planning.
Choice C: Lowered temperature does not directly affect protein-calorie needs.
Choice D: Cultural or religious beliefs do not inherently increase protein-calorie needs, as dietary choices can still meet nutritional requirements.
The patient with a new ileostomy needs discharge teaching. What should the nurse plan to include in this teaching?
- A. The pouch can be worn for up to 2 weeks before changing it.
- B. Decrease the amount of fluid intake to decrease the amount of drainage.
- C. The pouch can be removed when bowel movements have been regulated.
- D. If leakage occurs, promptly remove the pouch, clean the skin, and apply a new pouch.
Correct Answer: D
Rationale: The correct answer is D because in the event of leakage from the pouch, it is important to promptly remove it, clean the skin, and apply a new pouch to prevent skin irritation and infection. This step is crucial for maintaining skin integrity and preventing complications.
Choice A is incorrect as ileostomy pouches typically need to be changed more frequently, usually every 3-7 days, to prevent skin breakdown and odor.
Choice B is incorrect because decreasing fluid intake can lead to dehydration and electrolyte imbalances, which are especially risky for ileostomy patients who have increased fluid losses.
Choice C is incorrect because the pouch should not be removed until the stoma and bowel movements have been evaluated and regulated to ensure proper functioning.
Which of the following cells in the stomach secrete pepsinogen?
- A. parietal cells
- B. chief cells
- C. mucous neck cells
- D. enteroendocrine cells
Correct Answer: B
Rationale: The correct answer is B: chief cells. Chief cells are responsible for secreting pepsinogen in the stomach. Pepsinogen is an inactive form of pepsin, which is an enzyme that helps in protein digestion. Parietal cells secrete hydrochloric acid, not pepsinogen. Mucous neck cells secrete mucus to protect the stomach lining. Enteroendocrine cells secrete hormones like gastrin, but not pepsinogen. Therefore, the correct answer is B as chief cells are the specific cells that secrete pepsinogen in the stomach.