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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,
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In discussing long-term management with the patient with alcoholic cirrhosis, what should the nurse advise the patient?
- A. A daily exercise regimen is important to increase the blood flow through the liver.
- B. Cirrhosis can be reversed if the patient follows a regimen of proper rest and nutrition.
- C. Abstinence from alcohol is the most important factor in improvement of the patient's condition.
- D. The only over-the-counter analgesic that should be used for minor aches and pains is acetaminophen.
Correct Answer: C
Rationale: The correct answer is C: Abstinence from alcohol is the most important factor in improvement of the patient's condition. This is because alcohol is the primary cause of alcoholic cirrhosis, and continued consumption can worsen liver damage. Abstinence allows the liver to heal and potentially improve function.
Explanation of why the other choices are incorrect:
A: A daily exercise regimen is important for overall health but may not specifically increase blood flow through the liver in alcoholic cirrhosis.
B: Cirrhosis is irreversible, although proper rest and nutrition can help manage symptoms and prevent further damage.
D: Acetaminophen can be harmful to the liver in high doses and should be used cautiously in patients with cirrhosis.
After several days of antibiotic therapy for pneumonia, an older hospitalized patient develops watery diarrheWhich action should the nurse take first?
- A. Notify the health care provider.
- B. Obtain a stool specimen for analysis.
- C. Teach the patient about hand washing.
- D. Place the patient on contact precautions.
Correct Answer: D
Rationale: The correct answer is D, placing the patient on contact precautions. This is important because the patient has developed watery diarrhea after antibiotic therapy, which could indicate a Clostridium difficile infection. Placing the patient on contact precautions helps prevent the spread of this highly contagious infection to other patients and healthcare workers. It is the first priority to ensure the safety of others in the healthcare setting.
A: Notifying the health care provider can be done after placing the patient on contact precautions.
B: Obtaining a stool specimen for analysis is important but should be done after initiating contact precautions.
C: Teaching the patient about hand washing is important for infection control but is not the first priority when dealing with a potential infectious disease outbreak.
The nurse is educating a patient who is starting treatment with warfarin. Which instruction is most important to include in the teaching plan?
- A. "You can continue taking your aspirin as prescribed."
- B. "Be sure to have regular blood tests to monitor your INR."
- C. "You should increase your intake of vitamin K-rich foods."
- D. "If you miss a dose, double the dose the next day."
Correct Answer: B
Rationale: The correct answer is B: "Be sure to have regular blood tests to monitor your INR." Warfarin is a medication that requires close monitoring of the International Normalized Ratio (INR) to ensure it is within the therapeutic range. Regular blood tests are crucial to prevent complications such as bleeding or blood clots.
Choice A is incorrect because aspirin increases the risk of bleeding when taken with warfarin. Choice C is incorrect because increasing vitamin K-rich foods can interfere with the effectiveness of warfarin. Choice D is incorrect because doubling the dose can lead to an increased risk of bleeding. Regular monitoring of INR levels is essential for safe and effective warfarin therapy.
In report, the nurse learns that the patient has a transverse colostomy. What should the nurse expect when providing care for this patient?
- A. Semiliquid stools with increased fluid requirements
- B. Liquid stools in a pouch and increased fluid requirements
- C. Formed stools with a pouch, needing irrigation, but no fluid needs
- D. Semiformed stools in a pouch with the need to monitor fluid balance
Correct Answer: A
Rationale: The correct answer is A: Semiliquid stools with increased fluid requirements. A transverse colostomy is located in the upper part of the colon, where stool consistency is more liquid. This type of colostomy typically produces semiliquid stools due to the shorter transit time in the colon, leading to increased fluid requirements to prevent dehydration.
Summary of other choices:
B: Liquid stools in a pouch and increased fluid requirements - Incorrect because transverse colostomies produce semiliquid stools, not entirely liquid.
C: Formed stools with a pouch, needing irrigation, but no fluid needs - Incorrect as transverse colostomies do not produce formed stools, and fluid intake is necessary.
D: Semiformed stools in a pouch with the need to monitor fluid balance - Incorrect because transverse colostomies produce semiliquid stools, not semiformed, and increased fluid intake is needed.
Metabolic rate is high in the following Except:
- A. Pregnancy.
- B. Sleep.
- C. Male than female of the same body surface area.
- D. Walking than resting state.
Correct Answer: B
Rationale: The correct answer is B: Sleep. During sleep, the body's metabolic rate decreases as it enters a state of rest and recovery. Pregnancy (A) requires increased energy expenditure for fetal development. Males generally have higher metabolic rates than females (C) due to higher muscle mass. Walking (D) requires more energy than resting, leading to a higher metabolic rate. In summary, sleep is the exception as it lowers metabolic rate compared to the other activities listed.