Nokea
A two-week-old boy develops persistent projectile vomiting. The most likely diagnosis is:
- A. pyloric stenosis
- B. esophageal atresia
- C. annular pancreas
- D. incomplete rotation of the gut
Correct Answer: A
Rationale: The correct answer is A: pyloric stenosis. In pyloric stenosis, there is hypertrophy of the pyloric sphincter muscle, leading to gastric outlet obstruction and projectile vomiting. This typically presents in infants around 2-6 weeks of age. Other choices (B) esophageal atresia presents with difficulty feeding and choking, (C) annular pancreas with duodenal obstruction, and (D) incomplete rotation of the gut with volvulus or obstruction due to malrotation. Pyloric stenosis is the most likely diagnosis in this scenario based on the age of the infant and the symptom of projectile vomiting.
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After eating, a patient with an inflamed gallbladder experiences pain caused by contraction of the gallbladder. What is the mechanism responsible for this action?
- A. Production of bile by the liver
- B. Production of secretin by the duodenum
- C. Release of gastrin from the stomach antrum
- D. Production of cholecystokinin by the duodenum
Correct Answer: D
Rationale: The correct answer is D: Production of cholecystokinin by the duodenum. Cholecystokinin (CCK) is released by the duodenum in response to the presence of fatty acids and amino acids. It stimulates the gallbladder to contract, causing the release of bile into the small intestine to aid in digestion. This is directly related to the patient's symptoms of gallbladder pain after eating, as the contraction of the gallbladder is triggered by CCK.
A: Production of bile by the liver is not the mechanism responsible for the gallbladder contraction.
B: Production of secretin by the duodenum is involved in regulating the pH of the duodenum, not gallbladder contraction.
C: Release of gastrin from the stomach antrum is related to stomach acid secretion, not gallbladder contraction.
In summary, the correct answer, D, is directly related to the mechanism responsible for gallbladder pain after eating,
What is the fate of any excess glucose that goes to the liver that is not required for energy and not stored as glycogen?
- A. it is converted into fat
- B. it is converted into protein
- C. it is immediately released back into the bloodstream
- D. it is degraded
Correct Answer: A
Rationale: The correct answer is A: it is converted into fat. Excess glucose not needed for immediate energy or stored as glycogen is converted into fat through a process called de novo lipogenesis in the liver. This occurs when glucose levels are high and glycogen stores are full. The liver converts the excess glucose into fatty acids and then into triglycerides for storage in adipose tissue. This process helps regulate blood glucose levels and prevents hyperglycemia.
Other choices are incorrect:
B: Glucose is not directly converted into protein. Proteins are synthesized from amino acids, not glucose.
C: Releasing excess glucose back into the bloodstream would lead to high blood sugar levels, which is not a typical physiological response.
D: Glucose is not simply degraded; it is either used for energy, stored as glycogen, or converted into fat when in excess.
Which of the following teaching strategies would the nurse plan for a client with an anal fissure?
- A. Teach the client strategies to relieve diarrhea
- B. Instruct the client to not eat any fiber
- C. Teach the client how to insert a suppository
- D. Teach the client how to apply ice
Correct Answer: D
Rationale: The correct answer is D: Teach the client how to apply ice. Applying ice helps reduce inflammation and pain associated with anal fissures. It constricts blood vessels, decreases blood flow, and numbs the area, promoting healing.
A: Teaching strategies to relieve diarrhea is not directly related to managing anal fissures.
B: Instructing the client to not eat any fiber is incorrect because fiber helps soften stools and prevent constipation, which can worsen anal fissures.
C: Teaching the client how to insert a suppository may not be necessary for managing anal fissures unless prescribed by a healthcare provider for specific reasons.
Bilateral ovarian metastases presenting as tumor masses are most characteristically associated with carcinoma of the:
- A. esophagus
- B. stomach
- C. small intestine
- D. appendix
Correct Answer: B
Rationale: The correct answer is B, stomach. Ovarian metastases from gastric carcinoma are commonly bilateral due to the close anatomical relationship between the stomach and ovaries. Stomach cancer frequently spreads to the ovaries through direct extension or lymphatic dissemination. In contrast, esophageal, small intestine, and appendix carcinomas less commonly metastasize to the ovaries, making choices A, C, and D less likely. Thus, the characteristic bilateral ovarian metastases are most commonly associated with carcinoma of the stomach.
Contractions that mix material in the small intestine are called
- A. peristalsis.
- B. deglutition.
- C. mass movements
- D. segmental contractions.
Correct Answer: D
Rationale: The correct answer is D: segmental contractions. Segmental contractions mix material in the small intestine by contracting and relaxing specific segments of the intestine to mix and move the contents. This process helps with digestion and nutrient absorption.
A: Peristalsis refers to the wave-like muscle contractions that propel food through the digestive system, not mixing.
B: Deglutition is the process of swallowing food, not mixing it in the small intestine.
C: Mass movements are large contractions that move material through the large intestine, not the small intestine where mixing occurs.