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During a routine screening colonoscopy on a 56-year-old patient, a rectosigmoidal polyp was identified and remove The patient asks the nurse if his risk for colon cancer is increased because of the polyp. What is the best response by the nurse?
- A. It is very rare for polyps to become malignant but you should continue to have routine colonoscopies.'
- B. Individuals with polyps have a 100% lifetime risk of developing colorectal cancer and at an earlier age than those without polyps.'
- C. All polyps are abnormal and should be removed but the risk for cancer depends on the type and if malignant changes are present.'
- D. All polyps are premalignant and a source of most colon cancer. You will need to have a colonoscopy every 6 months to check for new polyps.'
Correct Answer: C
Rationale: Rationale:
1. Choice C is correct because it acknowledges that all polyps are abnormal and should be removed, but the risk for cancer depends on the type and presence of malignant changes.
2. This response is accurate as not all polyps become cancerous, and the risk varies depending on the specific characteristics of the polyp.
3. It also emphasizes the importance of removing polyps and monitoring for any signs of malignancy, aligning with best practice guidelines for colon cancer prevention.
4. In contrast, choices A, B, and D provide misleading information by either downplaying or exaggerating the risk associated with polyps, which can lead to unnecessary anxiety or complacency in the patient.
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The lymphatic capillaries in the villi of the small intestine are called
- A. lacteals.
- B. Peyer's patches.
- C. Crypts of Lieberkuhn.
- D. microvilli.
Correct Answer: A
Rationale: The correct answer is A: lacteals. Lacteals are specialized lymphatic capillaries found in the villi of the small intestine that absorb dietary fats and fat-soluble vitamins. They play a crucial role in the transport of these nutrients to the bloodstream. Peyer's patches (B) are lymphoid nodules in the small intestine involved in immune responses. Crypts of Lieberkuhn (C) are intestinal glands that secrete digestive enzymes. Microvilli (D) are small projections on the surface of intestinal cells that increase surface area for nutrient absorption but are not lymphatic capillaries.
Which of the following is FALSE about the enteric nervous system?
- A. It works through local control.
- B. It consists of enteric sensory and motor neurons.
- C. Enteric interneurons connect sensory and motor neurons together.
- D. The enteric neurons are incapable of controlling digestive tract functions without the central nervous system (CNS).
Correct Answer: D
Rationale: Correct Answer: D
Rationale:
1. The enteric nervous system can autonomously regulate digestive functions locally without input from the central nervous system.
2. Enteric sensory and motor neurons are key components of the enteric nervous system, responsible for detecting stimuli and coordinating gut movements.
3. Enteric interneurons play a crucial role in connecting sensory and motor neurons within the enteric nervous system.
4. Choice D is false because the enteric neurons are capable of controlling digestive tract functions independently from the central nervous system.
Calcium is actively absorbed by the small intestine and this is accelerated by
- A. sodium.
- B. the intrinsic factor.
- C. Vitamin D.
- D. Vitamin K.
Correct Answer: C
Rationale: The correct answer is C: Vitamin D. Vitamin D plays a crucial role in enhancing the absorption of calcium in the small intestine by promoting the synthesis of calcium-binding proteins. This process ensures adequate levels of calcium are absorbed efficiently. In contrast, choice A (sodium) does not directly impact calcium absorption, choice B (intrinsic factor) is involved in the absorption of vitamin B12, not calcium, and choice D (Vitamin K) is essential for blood clotting but not directly related to calcium absorption. Therefore, Vitamin D is the correct choice as it directly influences the active absorption of calcium in the small intestine.
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).
Why should a nurse instruct a client with an ileostomy to avoid enteric-coated products?
- A. The coating prevents the absorption of the product.
- B. The coating adversely affects ileostomy.
- C. The coating affects the absorption of vitamins.
- D. The coating causes particularly strong odors.
Correct Answer: A
Rationale: The correct answer is A because enteric-coated products are designed to bypass the stomach and dissolve in the small intestine, where absorption of medications occurs. Since an ileostomy bypasses the large intestine, the medication in enteric-coated products may not be fully absorbed, leading to reduced effectiveness. Choices B, C, and D are incorrect because they do not directly relate to the specific issue of absorption in the context of an ileostomy.