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During discharge instructions for a patient following a laparoscopic cholecystectomy, what should the nurse include in the teaching?
- A. Keep the incision areas clean and dry for at least a week.
- B. Report the need to take pain medication for shoulder pain.
- C. Report any bile-colored or purulent drainage from the incisions.
- D. Expect some postoperative nausea and vomiting for a few days.
Correct Answer: C
Rationale: The correct answer is C: Report any bile-colored or purulent drainage from the incisions. This is important because it could indicate infection or bile leak, which are complications that need immediate medical attention. A is incorrect because incision areas should be kept clean and dry, but typically for 48 hours, not a week. B is incorrect as shoulder pain is a common referred pain after laparoscopic cholecystectomy and not necessarily an immediate concern. D is incorrect because while some nausea and vomiting can be expected, it should not be considered normal for days postoperatively.
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In caring for a client with GERD, which task would be appropriate to assign to the nursing assistant?
- A. Share successful strategies for weight reduction.
- B. Encourage the client to express concerns about lifestyle modification.
- C. Remind the client not to lie down for 2-3 hours after eating.
- D. Explain the rationale for small frequent meals.
Correct Answer: C
Rationale: The correct answer is C because reminding the client not to lie down after eating helps prevent acid reflux in GERD. Nursing assistants can provide this basic instruction to promote client safety. Choice A involves sharing strategies that require more in-depth knowledge, not within a nursing assistant's scope. Choice B involves addressing emotional concerns, typically handled by nurses. Choice D involves explaining the rationale, which requires more understanding of the condition, beyond a nursing assistant's role.
Secretin and cholecystokinin are secreted in
- A. pyloric region
- B. Ileum
- C. duodenum
- D. Oesophagus
Correct Answer: C
Rationale: The correct answer is C, duodenum. Secretin and cholecystokinin are hormones secreted by the duodenal mucosa in response to the presence of acidic chyme from the stomach entering the duodenum. Secretin stimulates the pancreas to release bicarbonate to neutralize the acidic chyme, while cholecystokinin stimulates the gallbladder to release bile to aid in digestion. Choices A (pyloric region), B (Ileum), and D (Oesophagus) are incorrect because secretin and cholecystokinin are not secreted in these regions of the gastrointestinal tract.
The nurse is caring for a patient who has been prescribed digoxin. Which statement by the patient indicates the need for further teaching about the medication?
- A. "I will report any changes in my pulse rate."
- B. "I should take my medication at the same time every day."
- C. "I can stop taking the medication if I feel dizzy."
- D. "I will monitor my weight weekly."
Correct Answer: C
Rationale: The correct answer is C. This statement indicates a need for further teaching because stopping digoxin abruptly can be dangerous. Digoxin should not be discontinued without consulting a healthcare provider. A: Monitoring pulse rate is important as digoxin can affect heart rate. B: Consistency in timing helps maintain consistent drug levels. D: Monitoring weight is crucial as digoxin can cause fluid retention. Therefore, choice C is incorrect as it suggests a potentially harmful action.
Hepatocytes or hepatic cells produce bile, which is secreted into the
- A. hepatic portal vein.
- B. bile canaliculi.
- C. hepatic sinusoid.
- D. lacteal.
Correct Answer: B
Rationale: The correct answer is B: bile canaliculi. Hepatocytes produce bile, which is then secreted into bile canaliculi within the liver. From there, bile flows into bile ducts and eventually reaches the gallbladder or small intestine. The other options are incorrect because bile is not secreted directly into the hepatic portal vein (A), hepatic sinusoid (C), or lacteal (D). The hepatic portal vein carries blood from the digestive organs to the liver, the hepatic sinusoid is a type of blood vessel within the liver, and lacteals are lymphatic vessels in the small intestine.
The muscular contractions, which move material through the digestive tract, are called:
- A. peristalsis
- B. deglutition.
- C. mass movements.
- D. segmental contractions.
Correct Answer: A
Rationale: The correct answer is A: peristalsis. Peristalsis refers to the wave-like muscular contractions that propel food through the digestive tract. First, circular muscles contract behind the food bolus creating a narrowing, then longitudinal muscles contract ahead of the bolus, pushing it forward. This coordinated movement helps move food along the digestive tract efficiently. Deglutition (B) refers to the act of swallowing, not the movement of food through the digestive tract. Mass movements (C) refer to large, powerful contractions that occur in the colon to move feces. Segmental contractions (D) are localized contractions that mix and churn food in the intestines, not the primary mechanism for moving food along the digestive tract.