Nokea
An endoscopic biopsy of gastric mucosa reveals small intestinal type epithelium. This finding is most likely due to:
- A. chronic gastritis
- B. congenital heterotopia
- C. precancerous dysplasia
- D. metastatic carcinoma
Correct Answer: B
Rationale: The correct answer is B: congenital heterotopia. This is because the presence of small intestinal type epithelium in the gastric mucosa indicates ectopic tissue that is not normally found in the stomach. This condition is known as congenital heterotopia, where tissues from one organ are found in another due to developmental abnormalities.
A: Chronic gastritis would not lead to the presence of small intestinal type epithelium in the gastric mucosa.
C: Precancerous dysplasia refers to abnormal cellular changes that can progress to cancer but does not explain the presence of small intestinal type epithelium.
D: Metastatic carcinoma would involve the spread of cancer cells from another primary site, not the presence of ectopic tissue.
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A nurse is preparing an intervention plan for a client who is receiving tube feedings after an oral surgery. Which of the following measures can prevent improper infusion and assist in preventing vomiting?
- A. Consulting the physician and dietitian
- B. Administering the feedings at room temperature
- C. Changing the tube feeding container and tubing
- D. Checking the tube placement and gastric residual prior to feedings
Correct Answer: D
Rationale: The correct answer is D: Checking the tube placement and gastric residual prior to feedings. This is crucial to ensure proper placement of the tube and to assess if there is any undigested food in the stomach, which can lead to vomiting if fed through the tube. By checking these factors before administering feedings, the nurse can prevent complications.
A: Consulting the physician and dietitian is important but does not directly prevent improper infusion or vomiting.
B: Administering feedings at room temperature is a good practice but does not directly prevent vomiting.
C: Changing the tube feeding container and tubing may be necessary for hygiene but does not directly prevent improper infusion or vomiting.
In summary, checking the tube placement and gastric residual is essential in preventing vomiting and ensuring proper feeding, making it the correct choice.
Bile facilitates digestion by causing the _____ of fats.
- A. hydrolysis
- B. digestion
- C. catalysis
- D. emulsification
Correct Answer: D
Rationale: Bile facilitates digestion by emulsifying fats, breaking them down into smaller droplets for better absorption. Emulsification increases the surface area of fats for enzymes to work on. Hydrolysis (A) is the breakdown of molecules by adding water, not specific to fats. Digestion (B) is a general term encompassing all processes, not specific to fats. Catalysis (C) refers to the process of speeding up chemical reactions but doesn't specifically relate to fats like emulsification does.
In which part of the alimentary canal does most digestion occur?
- A. stomach
- B. proximal small intestine
- C. distal small intestine
- D. ascending colon
Correct Answer: B
Rationale: The correct answer is B: proximal small intestine. Most digestion occurs in the proximal small intestine because it is where the majority of enzymes are secreted to break down food. This section also has a large surface area for absorption of nutrients. The stomach primarily breaks down food with acids, while the distal small intestine and ascending colon focus on absorption of nutrients and water, respectively.
A male client with a recent history of rectal bleeding is being prepared for a colonoscopy. How should the nurse position the client for this test initially?
- A. Lying on the right side with legs straight
- B. Lying on the left side with knees bent
- C. Prone with the torso elevated
- D. Bent over with hands touching the floor
Correct Answer: B
Rationale: The correct answer is B: Lying on the left side with knees bent. This position allows for better visualization and access to the colon during the colonoscopy procedure. By lying on the left side, the client's colon is in a more optimal position for the scope to navigate through the colon. Additionally, bending the knees helps to relax the abdominal muscles and make the procedure more comfortable for the client.
Incorrect choices:
A: Lying on the right side with legs straight - This position does not provide optimal access to the colon and may make the procedure more difficult.
C: Prone with the torso elevated - This position is not suitable for a colonoscopy as it does not allow for proper access to the colon.
D: Bent over with hands touching the floor - This position is not recommended for a colonoscopy as it is not conducive to the procedure and may cause discomfort for the client.
A nurse is providing instructions for a 52-year-old client who is scheduled for a colonoscopy. The client reports that he has not had the procedure before and is very anxious about feeling pain during the procedure. Which of the following responses by the nurse is appropriate?
- A. Don't worry; most clients dislike the prep more than the procedure itself.'
- B. Before the examination, your provider will give you a sedative that will make you sleepy.'
- C. I know you're anxious, but this procedure is recommended for people your age.'
- D. After you have signed the consent form, we can talk more about this.'
Correct Answer: B
Rationale: Step 1: Providing a sedative before the colonoscopy is appropriate as it helps reduce anxiety and discomfort during the procedure.
Step 2: Sedatives induce relaxation and drowsiness, making the client feel sleepy and less likely to experience pain.
Step 3: Addressing the client's anxiety by mentioning the sedative shows empathy and reassurance.
Step 4: This option focuses on addressing the client's concern about pain during the procedure effectively.
Summary:
- Option A dismisses the client's concerns and does not provide a solution.
- Option C acknowledges the anxiety but does not offer a specific solution.
- Option D delays addressing the client's anxiety without providing immediate reassurance or information.