Nokea
Most of the enzymes produced in the large intestine and the formation of Vitamin K occurs in
- A. Goblet cells.
- B. simple columnar cells.
- C. teniae coli.
- D. bacteria.
Correct Answer: D
Rationale: The correct answer is D: bacteria. Enzymes in the large intestine are primarily produced by the gut microbiota, which are bacteria residing in the colon. These bacteria play a crucial role in the breakdown of complex carbohydrates and the production of certain vitamins, including Vitamin K. Goblet cells (A) produce mucus, simple columnar cells (B) are involved in absorption, and teniae coli (C) are muscle bands in the colon - none of which are directly responsible for enzyme production or Vitamin K synthesis in the large intestine.
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Which of the following pretest evaluation measures should the nurse ensure before a client undergoes the gallbladder series test?
- A. Determining the work environment of the client
- B. Determining whether the client has a family history of GI disorders
- C. Determining whether the client is pregnant
- D. Determining whether the client is allergic to seafood or iodine
Correct Answer: C
Rationale: Step-by-step rationale for the correct answer (C): Determining whether the client is pregnant is crucial before a gallbladder series test because the test involves radiation exposure, which can be harmful to a developing fetus. It is essential to ensure the safety of both the client and the unborn child.
Summary:
- A: Determining the work environment of the client is not directly related to the safety or appropriateness of a gallbladder series test.
- B: Determining whether the client has a family history of GI disorders is important for overall health assessment but not specifically necessary for the pretest evaluation of a gallbladder series test.
- D: Determining whether the client is allergic to seafood or iodine is relevant for contrast materials used in some imaging tests but not specifically for a gallbladder series test.
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.
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.
Which structure is located where the esophagus penetrates the diaphragm?
- A. esophageal hiatus
- B. cardiac orifice
- C. upper esophageal sphincter
- D. lower esophageal sphincter
Correct Answer: A
Rationale: The correct answer is A: esophageal hiatus. This is the opening in the diaphragm through which the esophagus passes, connecting the thoracic and abdominal cavities. The esophageal hiatus is specifically located at the level of the tenth thoracic vertebra. The other choices are incorrect because:
B: Cardiac orifice refers to the opening of the stomach into the esophagus, not where the esophagus penetrates the diaphragm.
C: Upper esophageal sphincter is a muscular valve at the upper end of the esophagus, not related to its passage through the diaphragm.
D: Lower esophageal sphincter is located at the junction of the esophagus and stomach, not at the point where the esophagus penetrates the diaphragm.
A male patient who has undergone an anterior-posterior repair is worried about his sexuality. What is an appropriate nursing intervention for this patient?
- A. Have the patient's sexual partner reassure the patient that he is still desirable.
- B. Reassure the patient that sexual function will return when healing is complete.
- C. Remind the patient that affection can be expressed in ways other than through sexual intercourse.
- D. Explain that physical and emotional factors can affect sexual function but not necessarily the patient's sexuality.
Correct Answer: C
Rationale: Rationale:
1. Choice C is correct because it acknowledges the patient's concerns about sexuality post-surgery.
2. Reminding the patient that affection can be expressed in non-sexual ways validates his feelings.
3. It promotes open communication and offers alternative ways to maintain intimacy during the healing process.
Summary of Incorrect Choices:
A. Involving the sexual partner may add pressure and may not address the patient's personal insecurities.
B. Promising a return to normal sexual function may create false expectations and overlook emotional aspects.
D. Focusing on physical and emotional factors may downplay the patient's specific concerns about his sexuality.