Nokea
Gastric secretion composed of all of the following Except:
- A. HCL.
- B. IF.
- C. Mucous.
- D. Amylase.
Correct Answer: D
Rationale: The correct answer is D: Amylase. Gastric secretion does not contain amylase. Amylase is an enzyme produced by the pancreas and salivary glands to break down carbohydrates. In the stomach, gastric secretions mainly consist of hydrochloric acid (HCl) for digestion, intrinsic factor (IF) for vitamin B12 absorption, and mucous to protect the stomach lining. Therefore, amylase is not a component of gastric secretion.
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Which statement about intestinal 'brakes' and 'accelerators' is FALSE?
- A. Dietary starch is a potent stimulator of small intestinal motility because it causes insulin release from the pancreas
- B. Food in the stomach causes gastrin release, which stimulates acid secretion
- C. Short-chain fatty acids which move from colon to caecum (reflux) promote ileo-caecal motility
- D. The arrival of lipid in the duodenum causes an immediate reduction in motility and a switch from the 'fasting' to the 'feeding' pattern.
Correct Answer: A
Rationale: The correct answer is A because dietary starch does not cause insulin release from the pancreas, but rather stimulates the release of incretin hormones like glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). These incretins help regulate blood sugar levels postprandially and do not directly affect intestinal motility.
Incorrect choices:
B: Food in the stomach causing gastrin release is true and stimulates acid secretion.
C: Short-chain fatty acids moving from colon to caecum promoting ileo-caecal motility is true.
D: The arrival of lipid in the duodenum causing a reduction in motility is true.
A patient with cirrhosis that is refractory to other treatments for esophageal varices undergoes a portacaval shunt. As a result of this procedure, what should the nurse expect the patient to experience?
- A. An improved survival rate
- B. Decreased serum ammonia levels
- C. Improved metabolism of nutrients
- D. Improved hemodynamic function and renal perfusion
Correct Answer: D
Rationale: The correct answer is D: Improved hemodynamic function and renal perfusion. A portacaval shunt is a surgical procedure that diverts blood flow from the portal vein directly into the vena cava, reducing portal hypertension. This leads to improved hemodynamic function by decreasing pressure in the portal system, which can improve renal perfusion. Choices A, B, and C are incorrect because a portacaval shunt may not necessarily improve survival rate, decrease serum ammonia levels, or improve metabolism of nutrients.
One of the major functions of bile salts is to
- A. break down fat to fatty acids and glycerol.
- B. emulsify fat to fatty droplets.
- C. break down fat to cholesterol and lecithin.
- D. emulsify fats to bilirubin.
Correct Answer: B
Rationale: The correct answer is B because bile salts emulsify fat into smaller droplets, increasing the surface area for enzymes to break down fats into fatty acids and glycerol. This aids in fat digestion and absorption in the small intestine. Choice A is incorrect as bile salts do not directly break down fats into fatty acids and glycerol. Choice C is incorrect as bile salts do not break down fats into cholesterol and lecithin. Choice D is incorrect as bile salts do not emulsify fats to bilirubin, but rather help in the digestion of fats.
What information should be included in the dietary teaching for the patient following a Roux-en-Y gastric bypass?
- A. Avoid sugary foods and limit fluids to prevent dumping syndrome.
- B. Gradually increase the amount of food ingested to preoperative levels.
- C. Maintain a long-term liquid diet to prevent damage to the surgical site.
- D. Consume foods high in complex carbohydrates, protein, and fiber to add bulk to contents.
Correct Answer: A
Rationale: The correct answer is A: Avoid sugary foods and limit fluids to prevent dumping syndrome. After a Roux-en-Y gastric bypass, the patient's stomach size is reduced, making it important to avoid sugary foods that can cause rapid spikes in blood sugar and lead to dumping syndrome. Dumping syndrome occurs when food moves too quickly from the stomach to the small intestine, causing symptoms like nausea, vomiting, diarrhea, and weakness. Limiting fluids can also help prevent this by slowing down digestion. Choices B and C are incorrect as increasing food intake rapidly or maintaining a liquid diet long-term can be harmful post-surgery. Choice D is incorrect because consuming foods high in complex carbohydrates, protein, and fiber can be difficult for the patient to digest due to the altered anatomy.
A patient receives atropine, an anticholinergic drug, in preparation for surgery. The nurse expects this drug to affect the GI tract by doing what?
- A. Increasing gastric emptying
- B. Relaxing pyloric and ileocecal sphincters
- C. Decreasing secretions and peristaltic action
- D. Stimulating the nervous system of the GI tract
Correct Answer: C
Rationale: The correct answer is C: Decreasing secretions and peristaltic action. Atropine, as an anticholinergic drug, inhibits the action of acetylcholine, leading to decreased secretions and peristaltic movement in the GI tract. This results in reduced motility and secretion production.
A: Increasing gastric emptying - This is incorrect because atropine actually slows down gastric emptying by reducing peristaltic action.
B: Relaxing pyloric and ileocecal sphincters - This is incorrect because atropine does not directly relax these sphincters.
D: Stimulating the nervous system of the GI tract - This is incorrect because atropine inhibits the parasympathetic nervous system, leading to decreased GI tract activity.