Nokea
Bile salts:
- A. Protein emulsifier.
- B. Are needed by pancreatic amylase for carbohydrate digestion.
- C. Are produced by the liver from cholesterol.
- D. Increase lipid surface tension.
Correct Answer: C
Rationale: The correct answer is C: Bile salts are produced by the liver from cholesterol.
Rationale:
1. Bile salts aid in the emulsification and digestion of fats, not proteins (A).
2. Pancreatic amylase is responsible for carbohydrate digestion, not bile salts (B).
3. The liver synthesizes bile salts from cholesterol to facilitate fat digestion and absorption (C).
4. Bile salts reduce lipid surface tension to form micelles, aiding in fat digestion, rather than increasing it (D).
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The nurse is caring for multiple patients. The nurse determines that which patient has the highest risk for developing gallstones?
- A. A 37-year-old white man of normal weight on long-term corticosteroids for asthm
- B. A 42-year-old African American man of normal weight who has smoked for 25 years.
- C. A 46-year-old Indonesian woman who is under normal weight and has recently had radiation treatments.
- D. A 50-year-old obese Mexican American woman who has type 1 diabetes.
Correct Answer: D
Rationale: The correct answer is D because obesity and type 1 diabetes are known risk factors for developing gallstones. Obesity leads to increased cholesterol production in the liver, which can contribute to gallstone formation. Type 1 diabetes can also increase the risk of gallstones due to impaired gallbladder function. Both factors combined in the 50-year-old obese Mexican American woman put her at the highest risk for developing gallstones.
Choice A is less likely as long-term corticosteroid use for asthma is not a major risk factor for gallstones. Choice B, smoking, is a risk factor but not as significant as obesity and diabetes in this context. Choice C, recent radiation treatment and being underweight, are not as strongly associated with gallstone formation compared to obesity and diabetes.
Bile production by the liver cells is increased by:
- A. Sympathetic activation
- B. Secretin
- C. CCK
- D. Bile salts
Correct Answer: C
Rationale: The correct answer is C: CCK. Cholecystokinin (CCK) is a hormone released by the small intestine in response to the presence of fatty acids and amino acids. It stimulates the release of bile from the gallbladder and increases bile production by the liver cells to aid in digestion. Sympathetic activation (choice A) typically inhibits digestive functions. Secretin (choice B) primarily stimulates pancreatic bicarbonate secretion, not bile production. Bile salts (choice D) are products of bile, not direct stimulators of bile production. Therefore, CCK is the correct choice as it directly influences the production of bile by the liver cells.
Where does the majority of chemical digestion in the stomach occur?
- A. fundus and body
- B. cardia and fundus
- C. body and pylorus
- D. body
Correct Answer: A
Rationale: The majority of chemical digestion in the stomach occurs in the fundus and body regions. These areas contain gastric glands that secrete hydrochloric acid and pepsinogen, which break down proteins. The fundus and body also mix and churn food to create chyme. The cardia and pylorus do not play a significant role in chemical digestion. The cardia is the entry point of the stomach and mainly responsible for food entry, while the pylorus regulates the release of chyme into the small intestine. The body region alone does not have as many gastric glands compared to the fundus and is mainly involved in mixing and storing food.
Surface area of the stomach is increased by
- A. gastric pits.
- B. plicae circulares.
- C. villi.
- D. microvilli.
Correct Answer: A
Rationale: The correct answer is A: gastric pits. Gastric pits are invaginations in the stomach lining that contain specialized cells for secretion of gastric juices. These pits increase the surface area of the stomach by providing a larger area for nutrient absorption and digestion. Plicae circulares are folds in the small intestine, not the stomach. Villi and microvilli are found in the small intestine and further increase surface area for absorption, not in the stomach.
A nurse is caring for a client who has ulcerative colitis and is teaching the client about the common link with Crohn's disease. Which of the following information should the nurse include?
- A. Both are inflammatory
- B. Both begin in the rectum
- C. Both manifest fistula formation
- D. Both require frequent surgery
Correct Answer: A
Rationale: The correct answer is A: Both are inflammatory. Ulcerative colitis and Crohn's disease are both inflammatory bowel diseases. Ulcerative colitis primarily affects the colon and rectum, while Crohn's disease can affect any part of the digestive tract. This common inflammatory nature is the link between the two conditions. Choices B and C are incorrect because Crohn's disease can start in any part of the digestive tract, not specifically in the rectum, and fistula formation is more common in Crohn's disease than in ulcerative colitis. Choice D is incorrect as not all cases of ulcerative colitis and Crohn's disease require frequent surgery; surgery is usually considered for complications or severe cases.