Nokea
Corticosteroid medications are associated with the development of peptic ulcers because of which probable pathophysiologic mechanism?
- A. The enzyme urease is produced.
- B. Secretion of hydrochloric acid is increased.
- C. The rate of mucous cell renewal is decreased.
- D. The synthesis of mucus and prostaglandins is inhibited.
Correct Answer: D
Rationale: The correct answer is D because corticosteroids inhibit the synthesis of mucus and prostaglandins, which are important for protecting the stomach lining. Without enough mucus and prostaglandins, the stomach lining becomes more susceptible to damage from stomach acid, leading to the development of peptic ulcers.
Choice A is incorrect because the enzyme urease is associated with the development of Helicobacter pylori infection, not peptic ulcers directly. Choice B is incorrect because corticosteroids actually decrease hydrochloric acid secretion. Choice C is incorrect because a decreased rate of mucous cell renewal would lead to decreased mucus production, which could contribute to peptic ulcers, but it is not the primary mechanism associated with corticosteroids.
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The nurse is preparing to administer liquid laxative to a patient in preparation for a colonoscopy. Which action should the nurse take?
- A. Offer a small snack.
- B. Take the patient's temperature.
- C. Mix the laxative with orange juice.
- D. Chill the laxative and pour it over ice.
Correct Answer: D
Rationale: The correct answer is D because chilling the laxative and pouring it over ice can help improve its taste and make it more palatable for the patient. This can encourage the patient to consume the laxative as needed for the colonoscopy preparation. Offering a small snack (choice A) may interfere with the effectiveness of the laxative. Taking the patient's temperature (choice B) is not relevant to administering a laxative. Mixing the laxative with orange juice (choice C) may alter its effectiveness and is not recommended.
Saliva decreases gingivitis and caries because it contains immunoglobulin A and
- A. lysozymes.
- B. mucus.
- C. salivary amylase.
- D. water.
Correct Answer: A
Rationale: The correct answer is A: lysozymes. Lysozymes in saliva help to break down bacterial cell walls, reducing the risk of gingivitis and caries. Immunoglobulin A helps to fight off harmful bacteria. Salivary amylase aids in digestion, not in preventing gingivitis or caries. Mucus and water in saliva do not directly contribute to the reduction of gingivitis or caries.
The nurse is teaching a client about sexual modifications for clients with an ostomy. Which of the following strategies would the nurse suggest when anticipating sexual activity?
- A. Leave the stoma open to air and cover with a towel.
- B. Instruct the client to limit foods that activate the bowel.
- C. Bathe and apply a fresh pouch after having sex.
- D. Consult with members of a local ostomy support group.
Correct Answer: B
Rationale: The correct answer is B because limiting foods that activate the bowel can help reduce the chances of embarrassing situations during sexual activity. Certain foods can cause gas or increase stool output, which may affect the client's confidence and comfort. Leaving the stoma open to air and covering with a towel (choice A) is not recommended during sexual activity as it may lead to odor and potential leakage. Bathing and applying a fresh pouch after sex (choice C) is important for hygiene but does not directly address preparation for sexual activity. Consulting with an ostomy support group (choice D) is beneficial for emotional support but does not specifically address strategies for anticipating sexual activity.
The ileocecal valve prevents chyme from entering the _____.
- A. large intestine
- B. small intestine
- C. stomach
- D. duodenum
Correct Answer: A
Rationale: The correct answer is A: large intestine. The ileocecal valve is located between the ileum (part of the small intestine) and the cecum (part of the large intestine). Its primary function is to prevent the backflow of contents from the large intestine into the small intestine, specifically preventing chyme from entering the large intestine prematurely. This allows for proper digestion and absorption of nutrients in the small intestine before the remaining waste material enters the large intestine for further processing. Choices B, C, and D are incorrect as the ileocecal valve specifically regulates the flow of material between the small and large intestines, not other parts of the digestive system such as the stomach or duodenum.
Priority Decision: A patient returns to the surgical unit with a nasogastric (NG) tube to low intermittent suction, IV fluids, and a Jackson-Pratt drain at the surgical site following an exploratory laparotomy and repair of a bowel perforation. Four hours after admission, the patient experiences nausea and vomiting. What is a priority nursing intervention for the patient?
- A. Assess the abdomen for distention and bowel sounds.
- B. Inspect the surgical site and drainage in the Jackson-Pratt.
- C. Check the amount and character of gastric drainage and the patency of the NG tube.
- D. Administer prescribed prochlorperazine (Compazine) to control the nausea and vomiting.
Correct Answer: C
Rationale: The correct answer is C: Check the amount and character of gastric drainage and the patency of the NG tube. This is the priority nursing intervention because the patient is experiencing nausea and vomiting, which could indicate potential complications related to the NG tube, such as blockage or displacement. By checking the gastric drainage and NG tube patency, the nurse can assess if the patient's symptoms are related to these issues and take appropriate actions to address them.
Choice A is incorrect because assessing the abdomen for distention and bowel sounds is important but not the priority in this situation where the patient is experiencing nausea and vomiting. Choice B is incorrect as inspecting the surgical site and drainage in the Jackson-Pratt drain is also important but not as urgent as checking the NG tube patency in this case. Choice D is incorrect as administering medication should not be the first action taken without first assessing the underlying cause of the symptoms.