Nokea
In which of the following segments of the gastrointestinal tract is primary carcinoma least common?
- A. esophagus
- B. stomach
- C. small intestine
- D. colon
Correct Answer: C
Rationale: The correct answer is C: small intestine. Primary carcinoma is least common in the small intestine due to its relatively lower exposure to carcinogens and slower cellular turnover compared to other segments like the colon. The esophagus is prone to carcinoma due to chronic irritation from acid reflux. The stomach is susceptible due to factors like Helicobacter pylori infection and dietary habits. The colon is at higher risk due to frequent exposure to fecal carcinogens. In summary, the small intestine has the least incidence of primary carcinoma due to lower exposure to risk factors.
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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.
By the time food leaves the stomach it is:
- A. a creamy paste called chyme.
- B. rolled into a bolus.
- C. ready to be mixed with pepsin for protein digestion.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: a creamy paste called chyme. After food enters the stomach, it gets mixed with gastric juices and enzymes, forming a semi-liquid substance known as chyme. This chyme is then slowly released into the small intestine for further digestion and absorption of nutrients. Option B is incorrect as food is not rolled into a bolus in the stomach but rather churned into chyme. Option C is incorrect as pepsin, an enzyme for protein digestion, is already present in the stomach and starts working on digesting proteins before the food leaves the stomach. Option D is incorrect as chyme is the accurate description of the partially digested food leaving the stomach.
A client is admitted to the hospital for a hemorrhoidectomy. Postoperatively, which of the following would a client's nurse be most concerned about?
- A. Pain at the incision site
- B. White blood count of 6.5
- C. Client's refusal of a stool softener
- D. Excessive bloody drainage on the external gauze dressing
Correct Answer: D
Rationale: The correct answer is D because excessive bloody drainage on the external gauze dressing could indicate hemorrhage, a serious complication post-hemorrhoidectomy. This requires immediate medical attention to prevent further complications.
A: Pain at the incision site is expected postoperatively and can be managed with pain medication.
B: A white blood count of 6.5 is within the normal range and not a cause for concern.
C: Client's refusal of a stool softener is important for bowel movement management but is not the most immediate concern compared to excessive bloody drainage.
A patient calls the clinic to report a new onset of severe diarrheWhat should the nurse anticipate that the patient will need to do?
- A. Collect a stool specimen.
- B. Prepare for colonoscopy.
- C. Schedule a barium enema.
- D. Have blood cultures drawn.
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Stool specimen collection helps identify the cause of diarrhea (e.g., infection).
2. It assists in determining appropriate treatment.
3. It helps rule out serious conditions.
4. Colonoscopy (B) and barium enema (C) are invasive procedures not typically indicated for acute diarrhea.
5. Blood cultures (D) are not the first-line investigation for diarrhea without systemic signs of infection.
Salivary secretion is stimulated by
- A. the salivary nucleus only.
- B. the salivary nucleus and gastrin.
- C. gastrin only.
- D. the salivary nucleus and local reflexes in the tunica mucosa and submucosa.
Correct Answer: D
Rationale: The correct answer is D. Salivary secretion is stimulated by the salivary nucleus in the brainstem and local reflexes in the tunica mucosa and submucosa of the oral cavity. The salivary nucleus receives input from higher brain centers and initiates the salivary reflex. Local reflexes in the oral cavity, such as mechanical stimulation of the mucosa, also trigger salivary secretion. Gastrin, as mentioned in option B and C, is not directly involved in the stimulation of salivary secretion. Option A is incorrect as salivary secretion is not solely stimulated by the salivary nucleus. Option D encompasses the comprehensive stimulation pathways involved in salivary secretion.