Nokea
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.
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Which finding by the nurse during abdominal auscultation indicates a need for a focused abdominal assessment?
- A. Loud gurgles
- B. High-pitched gurgles
- C. Absent bowel sounds
- D. Frequent clicking sounds
Correct Answer: C
Rationale: The correct answer is C, absent bowel sounds. Absence of bowel sounds may indicate a serious issue requiring further assessment. Normal bowel sounds include soft gurgles and clicks, so choices A, B, and D are variations of normal findings and do not necessarily indicate a need for further assessment. Absent bowel sounds could indicate bowel obstruction, peritonitis, or ischemia, warranting a focused abdominal assessment to determine the underlying cause.
Bile salts combine with fatty acids to form complexes called _____ that facilitate absorption.
- A. chylomicrons
- B. micelles
- C. globules
- D. lipoproteins
Correct Answer: B
Rationale: The correct answer is B: micelles. Bile salts emulsify fats in the small intestine, forming micelles that enhance the absorption of fatty acids. Chylomicrons (A) are large lipoprotein particles that transport dietary lipids, not complexes with bile salts. Globules (C) are not specifically related to bile salts and fatty acids. Lipoproteins (D) are also involved in lipid transport but are not the complexes formed by bile salts and fatty acids. Thus, choice B is the correct answer as it directly relates to the process of fat absorption facilitated by bile salts.
During a morning assessment, the nurse observes that a patient displays bulging flanks when supine with the knees flexeWhich action should the nurse take next?
- A. Measure the patient's abdominal girth.
- B. Auscultate each quadrant of the abdomen for 5 minutes.
- C. Document the finding.
- D. Notify the charge nurse.
Correct Answer: A
Rationale: The correct answer is A: Measure the patient's abdominal girth. Bulging flanks could indicate ascites, which is an abnormal accumulation of fluid in the abdominal cavity. Measuring the abdominal girth can help assess for the presence and severity of ascites. This step is important for further evaluation and monitoring of the patient's condition. Auscultating the abdomen for 5 minutes (choice B) would not address the potential underlying issue of ascites. Simply documenting the finding (choice C) without further assessment could delay necessary interventions. Notifying the charge nurse (choice D) is premature without completing a thorough assessment first.
Relating to carbohydrate digestion:
- A. Cellulose can be digested by human amylases
- B. It occurs only if bile salts are present
- C. third of starch digestion occurs in the mouth and two-thirds occurs in the small gut
- D. It can only occur in the complete absence of protein digestion
Correct Answer: B
Rationale: The correct answer is B because bile salts are essential for the digestion and absorption of fats, not carbohydrates. Cellulose cannot be digested by human amylases, making choice A incorrect. Starch digestion starts in the mouth with salivary amylase, not one-third in the mouth and two-thirds in the small gut, so choice C is incorrect. Carbohydrate digestion can occur simultaneously with protein digestion, so choice D is also incorrect. Bile salts aid in emulsifying fats, facilitating their digestion and absorption in the small intestine.
Which of these is most associated with villi?
- A. haustra
- B. lacteals
- C. bacterial flora
- D. intestinal glands
Correct Answer: B
Rationale: The correct answer is B: lacteals. Villi are small finger-like projections in the small intestine that increase surface area for nutrient absorption. Lacteals are lymphatic vessels found in villi responsible for absorbing dietary fats. Haustra are pouches in the colon, not associated with villi. Bacterial flora is mainly found in the large intestine, not specifically associated with villi. Intestinal glands are responsible for producing digestive enzymes, but they are not directly associated with villi.