Nokea
Following a Billroth II procedure
- A. a patient develops dumping syndrome. The nurse should explain that the symptoms associated with this problem are caused by
- B. distention of the smaller stomach by too much food and fluid intake.
- C. hyperglycemia caused by uncontrolled gastric emptying into the small intestine.
- D. irritation of the stomach lining by reflux of bile salts because the pylorus has been removed.
Correct Answer: D
Rationale: Dumping syndrome occurs when food moves too rapidly into the small intestine, causing fluid to shift into the bowel and leading to symptoms like nausea, diarrhea, and abdominal cramping.
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How will an obstruction at the ampulla of Vater affect the digestion of all nutrients?
- A. Bile is responsible for emulsification of all nutrients and vitamins.
- B. Intestinal digestive enzymes are released through the ampulla of Vater.
- C. Both bile and pancreatic enzymes enter the duodenum at the ampulla of Vater.
- D. Gastric contents can only pass to the duodenum when the ampulla of Vater is open.
Correct Answer: C
Rationale: The ampulla of Vater is the entry point for both bile and pancreatic enzymes essential for digesting all nutrients.
The processes of chewing are referred to as _____.
- A. churning
- B. mastication
- C. peristalsis
- D. deglutition
Correct Answer: B
Rationale: The correct answer is B: mastication. Mastication refers to the mechanical process of chewing food in the mouth using the teeth and jaws. This process breaks down food into smaller pieces, making it easier to swallow and digest. Churning (A) is the mixing of food with digestive enzymes in the stomach. Peristalsis (C) is the involuntary muscle contractions that move food through the digestive tract. Deglutition (D) is the process of swallowing food. Mastication is the most appropriate term for the process of chewing specifically.
A patient diagnosed with chronic hepatitis B asks about drug therapy to treat the disease. What is the most appropriate response by the nurse?
- A. Only chronic hepatitis C is treatable and primarily with antiviral agents and interferon.'
- B. There are no specific drug therapies that are effective for treating acute viral hepatitis.'
- C. Interferon combined with lamivudine (Epivir) will decrease viral load and prevent complications.'
- D. There are no drugs used for the treatment of viral hepatitis because of the risk of additional liver damage.'
Correct Answer: C
Rationale: For chronic hepatitis B, antiviral therapy such as interferon and lamivudine (Epivir) is used to reduce the viral load and prevent complications like cirrhosis.
Ondansetron (Zofran) is prescribed for a patient with cancer chemotherapy'“induced vomiting. What should the nurse understand about this drug?
- A. It is a derivative of cannabis and has a potential for abuse.
- B. It has a strong antihistamine effect that provides sedation and induces sleep.
- C. It is used only when other therapies are ineffective because of side effects of anxiety and hallucinations.
- D. It relieves vomiting centrally by action in the vomiting center and peripherally by promoting gastric emptying.
Correct Answer: D
Rationale: Ondansetron works centrally to block serotonin receptors in the vomiting center and peripherally by improving gastric motility.
Relating to carbohydrate digestion:
- A. Cellulose can be digested by human amylases
- B. It occurs only if bile salts are present
- C. third of starch digestion occurs in the mouth and two-thirds occurs in the small gut
- D. It can only occur in the complete absence of protein digestion
Correct Answer: B
Rationale: The correct answer is B because bile salts are essential for the digestion and absorption of fats, not carbohydrates. Cellulose cannot be digested by human amylases, making choice A incorrect. Starch digestion starts in the mouth with salivary amylase, not one-third in the mouth and two-thirds in the small gut, so choice C is incorrect. Carbohydrate digestion can occur simultaneously with protein digestion, so choice D is also incorrect. Bile salts aid in emulsifying fats, facilitating their digestion and absorption in the small intestine.