Nokea
Pancreatic exocrine secretion is stimulated by the following except:
- A. CCK
- B. Entropeptidase
- C. Vagal stimulation
- D. Presence of food in stomach
Correct Answer: B
Rationale: The correct answer is B: Entropeptidase. Pancreatic exocrine secretion is primarily stimulated by hormones like CCK and the presence of food in the stomach. Vagal stimulation can also trigger pancreatic secretion. However, enteropeptidase is an enzyme that activates trypsinogen to trypsin in the small intestine, not a direct stimulator of pancreatic exocrine secretion. Therefore, choice B is the exception among the given options.
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Patients with a paralytic ileus typically have:
- A. Intravenous fluid replacement and a nasogastric tube connected to suction.
- B. Surgical correction of the problem.
- C. Endoscopic injection of botulinum toxin or esophageal dilation.
- D. Endoscopy to allow biopsy followed with broad-spectrum antibiotics.
Correct Answer: A
Rationale: Paralytic ileus is typically managed with intravenous fluids to correct electrolyte imbalances and a nasogastric tube to decompress the bowel.
Which of the following dietary interventions should a nurse consider after the removal of the nasogastric tube in a client who has undergone surgery for a liver disorder?
- A. Provide small sips of clear liquids
- B. Provide small sips of fruit juice or soup
- C. Provide small meal of soft foods
- D. Provide meal of protein-rich foods
Correct Answer: A
Rationale: After NG tube removal, clear liquids are introduced first to assess tolerance and prevent nausea or complications.
A patient diagnosed with chronic hepatitis B asks about drug therapy to treat the disease. What is the most appropriate response by the nurse?
- A. Only chronic hepatitis C is treatable and primarily with antiviral agents and interferon.'
- B. There are no specific drug therapies that are effective for treating acute viral hepatitis.'
- C. Interferon combined with lamivudine (Epivir) will decrease viral load and prevent complications.'
- D. There are no drugs used for the treatment of viral hepatitis because of the risk of additional liver damage.'
Correct Answer: C
Rationale: For chronic hepatitis B, antiviral therapy such as interferon and lamivudine (Epivir) is used to reduce the viral load and prevent complications like cirrhosis.
Ondansetron (Zofran) is prescribed for a patient with cancer chemotherapy'“induced vomiting. What should the nurse understand about this drug?
- A. It is a derivative of cannabis and has a potential for abuse.
- B. It has a strong antihistamine effect that provides sedation and induces sleep.
- C. It is used only when other therapies are ineffective because of side effects of anxiety and hallucinations.
- D. It relieves vomiting centrally by action in the vomiting center and peripherally by promoting gastric emptying.
Correct Answer: D
Rationale: Ondansetron works centrally to block serotonin receptors in the vomiting center and peripherally by improving gastric motility.
The nurse is caring for a patient receiving a blood transfusion. Which of the following should the nurse do first if the patient develops chills and fever?
- A. Stop the transfusion and notify the healthcare provider.
- B. Administer acetaminophen as prescribed.
- C. Check the blood bag for any abnormalities.
- D. Increase the rate of the transfusion to flush the system.
Correct Answer: A
Rationale: The correct answer is A: Stop the transfusion and notify the healthcare provider. This is the first step because chills and fever during a blood transfusion could indicate a transfusion reaction, which can be serious. Stopping the transfusion is crucial to prevent further complications. Notifying the healthcare provider promptly ensures appropriate assessment and management. Administering acetaminophen (choice B) may help with fever but does not address the underlying issue. Checking the blood bag (choice C) can be done after stopping the transfusion. Increasing the rate of the transfusion (choice D) can exacerbate the reaction and should be avoided.