Nokea
After several days of antibiotic therapy for pneumonia, an older hospitalized patient develops watery
- A. Which action should the nurse take first?
- B. Notify the health care provider.
- C. Obtain a stool specimen for analysis.
- D. Teach the patient about hand washing.
Correct Answer: A
Rationale: The correct answer is A because the nurse should prioritize assessing the patient's condition to ensure immediate safety and appropriate intervention. This includes evaluating for signs of dehydration, electrolyte imbalance, and potential complications like Clostridium difficile infection. Option B is not the first action as immediate assessment is crucial. Option C is important but not the priority at this moment. Option D is important but should not be the first action in this scenario.
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The pharyngeal phase of swallowing is ______ , which is controlled by ______ muscle.
- A. involuntary; smooth
- B. voluntary; smooth
- C. involuntary; skeletal
- D. voluntary; skeletal
Correct Answer: C
Rationale: The pharyngeal phase of swallowing is an involuntary process, meaning it occurs automatically without conscious control. This phase involves the contraction of skeletal muscles in the pharynx to propel the food bolus towards the esophagus. Skeletal muscles are under voluntary control, but in the context of swallowing, the pharyngeal phase is involuntary. Thus, the correct answer is C: involuntary; skeletal.
Choice A (involuntary; smooth) is incorrect because smooth muscles are not typically involved in the pharyngeal phase of swallowing. Choice B (voluntary; smooth) is incorrect because the pharyngeal phase is not under voluntary control, and smooth muscles are not the primary muscles involved. Choice D (voluntary; skeletal) is incorrect because the pharyngeal phase is involuntary and skeletal muscles, not smooth muscles, are responsible for the muscle contractions during this phase.
Which of the following nutrients is absorbed in the stomach?
- A. vitamins
- B. water
- C. proteins
- D. carbohydrates
Correct Answer: B
Rationale: The correct answer is B: water. Water is the only nutrient that is absorbed in the stomach. The stomach mainly digests food using stomach acid and enzymes, but absorption of nutrients primarily occurs in the small intestine. Vitamins are absorbed in the small intestine, proteins are broken down in the stomach and further digested in the small intestine, and carbohydrates are primarily broken down and absorbed in the small intestine. Water, on the other hand, can be absorbed in the stomach through osmosis due to its small molecular size and the presence of aquaporins in the stomach lining.
The tunica muscularis in the superior esophagus is made up of ______ muscle.
- A. skeletal
- B. cardiac
- C. smooth
- D. smooth and skeletal
Correct Answer: A
Rationale: The correct answer is A: skeletal muscle. The superior esophagus contains skeletal muscle in its tunica muscularis, allowing for voluntary control over swallowing. Cardiac muscle is found in the heart, not in the esophagus. Smooth muscle is present in the lower esophagus for involuntary movements. Choice D is incorrect as the superior esophagus does not contain a mix of smooth and skeletal muscle.
A male infant, who was normal for the first three weeks of life, develops projectile vomiting after feeding. The likely diagnosis is:
- A. Meckel's diverticulum
- B. esophageal atresia
- C. congenital diaphragmatic hernia
- D. congenital pyloric stenosis
Correct Answer: D
Rationale: The correct answer is D, congenital pyloric stenosis. This condition typically presents in male infants around 3-6 weeks of age with projectile vomiting due to hypertrophy of the pyloric muscle, leading to obstruction at the pylorus. This causes the infant to forcefully vomit shortly after feeding. Meckel's diverticulum (A) presents with painless rectal bleeding. Esophageal atresia (B) presents with drooling and choking with feeding. Congenital diaphragmatic hernia (C) presents with respiratory distress and scaphoid abdomen due to herniation of abdominal organs into the chest cavity.
A nurse is interviewing a client who has acute pancreatitis. Which of the following factors should the nurse anticipate finding in the client's history?
- A. Gallstones
- B. Hypolipidemia
- C. COPD
- D. Diabetes mellitus
Correct Answer: A
Rationale: The correct answer is A: Gallstones. Acute pancreatitis is commonly caused by gallstones or alcohol consumption. Gallstones can block the pancreatic duct, leading to inflammation. Hypolipidemia, COPD, and diabetes mellitus are not directly associated with pancreatitis. This history finding helps the nurse identify the potential cause and plan appropriate care.