Nokea
Concerning deglutition (swallowing):
- A. Pharyngeal phase of swallowing is voluntary.
- B. Normally the lower esophageal sphincter (LES) is open.
- C. Dysphagia is caused by a lesion in the swallowing reflex.
- D. In the esophageal stage of swallowing, if the bolus is liquid it travels by peristalsis.
Correct Answer: C
Rationale: The correct answer is C because dysphagia, which is difficulty swallowing, can be caused by various factors such as neurological disorders affecting the swallowing reflex or physical obstructions in the esophagus. This is a key point in understanding the causes of swallowing difficulties.
Choice A is incorrect because the pharyngeal phase of swallowing is actually involuntary, not voluntary. Choice B is incorrect as the lower esophageal sphincter (LES) is normally closed to prevent acid reflux and only opens during swallowing. Choice D is incorrect because in the esophageal stage of swallowing, both liquid and solid boluses travel through the esophagus by peristalsis, not just liquid boluses.
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Which esophageal disorder is described as a precancerous lesion associated with GERD?
- A. Achalasia
- B. Barrett's esophagus
- C. Esophageal strictures
- D. Esophageal diverticula
Correct Answer: B
Rationale: Barrett's esophagus is the correct answer because it is a precancerous condition resulting from long-term GERD. The constant exposure to stomach acid causes changes in the esophageal lining, increasing the risk of esophageal cancer.
Achalasia (A) is a motility disorder characterized by difficulty swallowing due to impaired esophageal muscle movement. Esophageal strictures (C) are narrowing of the esophagus, commonly caused by chronic inflammation or scarring, but not directly associated with GERD. Esophageal diverticula (D) are outpouchings in the esophageal wall, not specifically linked to GERD or cancer risk.
While a female client is being prepared for discharge, the nasogastric (NG) feeding tube becomes clogged. To remedy this problem and teach the client's family how to deal with it at home, what should the nurse do?
- A. Irrigate the tube with warm water.
- B. Advance the tube into the intestine.
- C. Apply intermittent suction to the tube.
- D. Withdraw the obstruction with a 30-ml syringe.
Correct Answer: A
Rationale: The correct answer is A: Irrigate the tube with warm water. This is the correct action because irrigating the NG tube with warm water can help dislodge the clog and clear the obstruction. Here is a step-by-step rationale:
1. Gather necessary supplies: warm water, syringe, and towel.
2. Disconnect the tube from the feeding pump.
3. Draw up warm water into the syringe.
4. Gently insert the syringe into the tube and slowly push the warm water to flush out the clog.
5. Repeat the process as needed until the tube is clear.
Other choices are incorrect:
B: Advancing the tube into the intestine can be dangerous and should not be done without proper medical supervision.
C: Applying intermittent suction may not effectively clear the clog and could potentially worsen the situation.
D: Using a 30-ml syringe to withdraw the obstruction may not be as effective as irrigating with warm water.
Mumps is inflammation of the ______ salivary gland caused by a virus.
- A. buccal
- B. sublingual
- C. submandibular
- D. parotid
Correct Answer: D
Rationale: The correct answer is D: parotid. Mumps is inflammation of the parotid salivary gland. The parotid gland is the largest salivary gland located near the ear. It is commonly affected by the mumps virus, causing swelling and pain.
Rationale:
1. The parotid gland is the main salivary gland affected by the mumps virus.
2. The other choices, buccal, sublingual, and submandibular glands, are not typically associated with mumps.
3. Understanding the anatomical location and function of the salivary glands helps in identifying the correct answer.
The role of parietal cells is to:
- A. Secretes hydrogen ions and chloride ions into lumen and are responsible for maintaining the acidic pH
- B. alkaline mucous for shielding the epithelium from hydrochloric acid
- C. Secretes histamine which stimulates gastric acid secretion
- D. Secretes gastric lipase
Correct Answer: A
Rationale: The correct answer is A because parietal cells secrete hydrogen ions and chloride ions into the lumen, which combine to form hydrochloric acid, maintaining the acidic pH of the stomach essential for digestion. Option B is incorrect as alkaline mucous is produced by goblet cells, not parietal cells. Option C is incorrect as histamine is secreted by enterochromaffin-like cells, not parietal cells. Option D is incorrect as gastric lipase is primarily secreted by chief cells in the stomach.
What does the term 'peristalsis' refer to?
- A. the mixing of digestive juices
- B. the voluntary contraction of muscles
- C. the rhythmic contractions that move food along the digestive tract
- D. the absorption of nutrients
Correct Answer: C
Rationale: Peristalsis refers to the rhythmic contractions that move food along the digestive tract. This process helps propel food from the esophagus to the stomach and through the intestines for digestion and absorption. It is an involuntary movement controlled by the autonomic nervous system. Choice A is incorrect as it refers to digestion, not movement. Choice B is incorrect as peristalsis is involuntary, not voluntary. Choice D is incorrect as peristalsis does not involve absorption but rather transportation of food.