Nokea
GIT hormones with a major effect on the stomach include the following except:
- A. Gastrin
- B. Secretin
- C. GIP
- D. Neurotensin
Correct Answer: B
Rationale: Secretin is the correct answer because it is not a hormone that directly affects the stomach. Gastrin stimulates gastric acid secretion, GIP enhances insulin release, and neurotensin regulates gastric motility. Secretin primarily targets the pancreas and liver, stimulating the release of bicarbonate-rich pancreatic juice. This hormone does not have a direct major effect on the stomach like the other options. Therefore, Secretin is the exception among the listed GIT hormones affecting the stomach.
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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.
A tumor producing large amounts of gastrin DOES NOT include:
- A. Hyperplasia of gastric epithelium
- B. Hyperplasia of gastric mucosal lymphocytes
- C. Excessive gastric acid secretion
- D. Histamine secretion in the gastric mucosa
Correct Answer: B
Rationale: The correct answer is B: Hyperplasia of gastric mucosal lymphocytes. In a tumor producing large amounts of gastrin, hyperplasia of gastric epithelium (choice A) is expected due to increased gastrin stimulation. Excessive gastric acid secretion (choice C) is also expected as gastrin stimulates acid production. Histamine secretion in the gastric mucosa (choice D) can occur as histamine is released in response to gastrin. However, hyperplasia of gastric mucosal lymphocytes (choice B) is not a direct consequence of increased gastrin levels. Lymphocyte hyperplasia is more commonly associated with chronic inflammation or infection rather than gastrin overproduction.
Priority Decision: A patient is admitted to the emergency department with acute abdominal pain. What nursing intervention should the nurse implement first?
- A. Measurement of vital signs
- B. Administration of prescribed analgesics
- C. Assessment of the onset, location, intensity, duration, and character of the pain
- D. Physical assessment of the abdomen for distention, bowel sounds, and pigmentation changes
Correct Answer: C
Rationale: The correct answer is C. Assessing the onset, location, intensity, duration, and character of the pain is the priority because it helps determine the potential cause of the abdominal pain. This information guides further interventions and informs the healthcare team about the urgency of the situation.
Choice A (Measurement of vital signs) can be important but assessing the pain characteristics takes precedence as it directly informs the urgency of the situation.
Choice B (Administration of prescribed analgesics) should be delayed until the cause of the pain is identified to prevent masking symptoms that could aid in diagnosis.
Choice D (Physical assessment of the abdomen) is important but assessing the pain characteristics comes first to guide the physical assessment and subsequent interventions.
Which of the following routes is used to instill a dye for a radionuclide imaging test?
- A. Infusion through oral or IV route
- B. Infusion through a T-tube
- C. Infusion through a small nasogastric tube
- D. Infusion through an endoscope
Correct Answer: A
Rationale: The correct answer is A because instilling a dye for radionuclide imaging test involves injecting the dye intravenously or orally to allow it to circulate in the bloodstream and be absorbed by the body tissues. IV route ensures rapid and direct entry into the bloodstream for proper distribution. Choices B, C, and D are incorrect as they do not provide the necessary direct access to the bloodstream required for effective distribution of the dye for imaging purposes.
The patient with liver failure has had a liver transplant. What should the nurse teach the patient about care after the transplant?
- A. Alcohol intake is now okay.
- B. HBIG will be required to prevent rejection.
- C. Elevate the head 30 degrees to improve ventilation when sleeping.
- D. Monitor closely for infection because of the immunosuppressive medication.
Correct Answer: D
Rationale: The correct answer is D because patients who undergo liver transplant are put on immunosuppressive medication to prevent rejection. This medication weakens the immune system, making the patient more susceptible to infections. Monitoring closely for signs of infection is crucial to prevent complications.
Choice A is incorrect because alcohol intake is not recommended after a liver transplant as it can further damage the new liver. Choice B is incorrect because HBIG (Hepatitis B Immunoglobulin) is typically given to prevent hepatitis B recurrence, not rejection. Choice C is incorrect as elevating the head has no direct correlation with post-liver transplant care.