Nokea
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.
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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.
The _____ duct directly receives the fluids from the gallbladder.
- A. cystic
- B. common bile
- C. hepatic
- D. common hepatic
Correct Answer: A
Rationale: The correct answer is A: cystic duct. The cystic duct directly receives the fluids from the gallbladder and connects it to the common bile duct. The cystic duct is responsible for carrying bile from the gallbladder to the digestive system. Choices B, C, and D are incorrect because the common bile duct carries a mixture of bile from the liver and gallbladder, the hepatic duct connects the liver to the common bile duct, and the common hepatic duct connects the liver to the gallbladder, respectively. Therefore, the cystic duct is the only duct directly receiving fluids from the gallbladder.
Which female patient is most likely to have metabolic syndrome?
- A. BP 128/78 mm Hg, triglycerides 160 mg/dL, fasting blood glucose 102 mg/dL
- B. BP 142/90 mm Hg, high-density lipoproteins 45 mg/dL, fasting blood glucose 130 mg/dL
- C. Waist circumference 36 in, triglycerides 162 mg/dL, high-density lipoproteins 55 mg/dL
- D. Waist circumference 32 in, high-density lipoproteins 38 mg/dL, fasting blood glucose 122 mg/dL
Correct Answer: B
Rationale: The correct answer is B because the patient's blood pressure, HDL levels, and fasting blood glucose levels all indicate a higher likelihood of metabolic syndrome. High blood pressure, low HDL levels, and elevated blood glucose are key components of metabolic syndrome.
Option A has normal blood pressure and slightly elevated triglycerides and blood glucose, but not as concerning as choice B.
Option C has a normal blood pressure, slightly elevated triglycerides, and good HDL levels, which lowers the likelihood of metabolic syndrome.
Option D has a normal blood pressure, very low HDL levels, and slightly elevated blood glucose, but the blood pressure is not in the hypertensive range as in choice B.
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.
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.