Nokea
If the oesophageal muscles are not working:
- A. Swallowing in the upright position is not affected because of gravity
- B. Water swallowing is not affected
- C. There will be dysphagia to solids and liquids
- D. There will be frequent attacks of vomiting
Correct Answer: C
Rationale: The correct answer is C because if the oesophageal muscles are not working, dysphagia to solids and liquids would occur. This is because the muscles are responsible for peristalsis, which is the wave-like contractions that push food down the esophagus. Choice A is incorrect because gravity alone cannot compensate for muscle dysfunction. Choice B is incorrect as water swallowing also requires proper muscle function. Choice D is incorrect as vomiting is not directly related to oesophageal muscle dysfunction.
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Which of the following is synthesized and stored in the liver cells?
- A. Galactose
- B. Lactose
- C. Glycogen
- D. Arabinose
Correct Answer: C
Rationale: The correct answer is C: Glycogen. Glycogen is synthesized and stored in liver cells as a form of glucose storage for energy. The liver plays a key role in regulating blood glucose levels by converting excess glucose into glycogen for storage. Galactose (A) is a sugar found in milk and is metabolized in the liver, but it is not synthesized or stored there. Lactose (B) is a disaccharide found in dairy products and is broken down into glucose and galactose in the intestine, not synthesized or stored in the liver. Arabinose (D) is a sugar found in plants but is not synthesized or stored in the liver.
Priority Decision: A postoperative patient has a nursing diagnosis of pain related to effects of medication and decreased GI motility as evidenced by abdominal pain and distention and inability to pass flatus. Which nursing intervention is most appropriate for this patient?
- A. Ambulate the patient more frequently.
- B. Assess the abdomen for bowel sounds.
- C. Place the patient in high Fowler's position.
- D. Withhold opioids because they decrease bowel motility.
Correct Answer: A
Rationale: Rationale for Correct Answer (A): Ambulating the patient more frequently helps to stimulate GI motility, reduce abdominal distention, and promote passage of flatus. Movement aids in peristalsis, which can alleviate postoperative GI issues.
Summary of Incorrect Choices:
B: Assessing bowel sounds is important but does not directly address the issue of stimulating GI motility or addressing the patient's pain and distention.
C: Placing the patient in a high Fowler's position may improve respiratory function but does not specifically target GI motility or pain relief.
D: Withholding opioids may be necessary in some cases, but pain management is crucial for postoperative care. There are other ways to address decreased GI motility without completely withholding pain medications.
A nurse is providing discharge teaching to a client who has gastroesophageal reflux disease. Which of the following statements by the client indicates an understanding of the teaching?
- A. The type of foods I eat does not affect this condition.'
- B. I will sleep on my left side.'
- C. I will eat a snack just before going to bed.'
- D. I will sleep with the head of my bed elevated.'
Correct Answer: D
Rationale: The correct answer is D. Elevating the head of the bed helps prevent acid reflux by keeping the stomach acid from flowing back into the esophagus while sleeping. This position helps gravity keep the acid in the stomach. Choice A is incorrect because certain foods can indeed trigger or worsen GERD symptoms. Choice B is incorrect as sleeping on the left side may worsen symptoms due to the position of the stomach. Choice C is incorrect as eating right before bed can increase the risk of acid reflux.
What is the function of bile salts?
- A. emulsifying fats
- B. breaking down carbohydrates
- C. activating pepsin
- D. digesting proteins
Correct Answer: A
Rationale: The correct answer is A: emulsifying fats. Bile salts help emulsify fats by breaking them into smaller droplets, increasing the surface area for enzymes to act upon during digestion. This aids in the absorption of fats in the small intestine. Choices B, C, and D are incorrect because bile salts do not have a direct role in breaking down carbohydrates (choice B), activating pepsin (choice C), or digesting proteins (choice D). These functions are carried out by other digestive enzymes in the gastrointestinal tract.
Stimulation by the sympathetic nervous system will cause which one of the following effects in the inferior esophagus, stomach, small intestine and large intestine?
- A. nothing, because skeletal muscle is found in the walls of these areas
- B. increases peristalsis by stimulation of smooth muscle
- C. decreases peristalsis by inhibition of smooth muscle
- D. decreases peristalsis by stimulation of smooth muscle
Correct Answer: C
Rationale: The correct answer is C: decreases peristalsis by inhibition of smooth muscle. The sympathetic nervous system inhibits gastrointestinal motility by decreasing peristalsis. This is achieved through the release of norepinephrine, which binds to adrenergic receptors on smooth muscle cells, leading to reduced contraction and motility. Choices A and B are incorrect because the sympathetic nervous system can still affect smooth muscle, not just skeletal muscle. Choice D is incorrect because sympathetic stimulation does not directly increase peristalsis.