Nokea
Peritonitis can occur as a complication of:
- A. Septicemia
- B. Multiple organ failure
- C. Hypovolemic shock
- D. Peptic ulcer disease
Correct Answer: A
Rationale: Peritonitis can occur as a complication of septicemia because the infection can spread to the peritoneum, causing inflammation and infection. Septicemia is the presence of pathogenic organisms in the bloodstream, which can lead to systemic inflammation and infection throughout the body, including the peritoneum. In contrast, multiple organ failure, hypovolemic shock, and peptic ulcer disease are not direct causes of peritonitis. Multiple organ failure involves dysfunction of various organs, hypovolemic shock is caused by severe blood loss leading to inadequate perfusion, and peptic ulcer disease is related to the erosion of the stomach lining. Hence, the correct answer is A, as septicemia is a direct cause of peritonitis.
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The nurse recognizes that teaching a patient following a laparoscopic cholecystectomy has been effective when the patient makes which statement?
- A. "I can take a shower and walk around the house tomorrow."
- B. "I need to limit my activities and not return to work for 4 weeks."
- C. "I can expect yellowish drainage from the incision for a few days."
- D. "I will follow a low-fat diet for life because I do not have a gallbladder."
Correct Answer: A
Rationale: Rationale for Correct Answer (A): The statement "I can take a shower and walk around the house tomorrow" indicates an understanding of post-operative activity expectations. After a laparoscopic cholecystectomy, early ambulation is encouraged to prevent complications like blood clots. Additionally, showering promotes wound healing and hygiene.
Incorrect Choices:
B: "I need to limit my activities and not return to work for 4 weeks" - This choice is incorrect as it overestimates the recovery time for a laparoscopic cholecystectomy, which typically allows for a quicker return to normal activities.
C: "I can expect yellowish drainage from the incision for a few days" - While drainage is common after surgery, the color and duration mentioned are not typical for this procedure.
D: "I will follow a low-fat diet for life because I do not have a gallbladder" - Following a low-fat diet is recommended after surgery, but the statement is too extreme as dietary
Melena is an indication of:
- A. upper gastrointestinal bleeding
- B. lower gastrointestinal bleeding
- C. both
- D. neither
Correct Answer: A
Rationale: The correct answer is A: upper gastrointestinal bleeding. Melena is black, tarry stool resulting from the digestion of blood in the gastrointestinal tract. This typically occurs in the upper GI tract due to the longer transit time, allowing the blood to be digested. Lower GI bleeding usually presents as bright red blood in the stool or maroon-colored stool. Therefore, melena is a specific indicator of upper GI bleeding. Choices B, C, and D are incorrect because melena specifically points to upper GI bleeding, not lower GI bleeding or both.
Concerning cholecystokinin (CCK):
- A. Secreted from the jejunum
- B. Stimulates the contraction of gallbladder.
- C. inhibits the stomach mobility.
- D. All of the above are correct.
Correct Answer: B
Rationale: Certainly! The correct answer is B: Cholecystokinin (CCK) stimulates the contraction of the gallbladder. This hormone is released from the duodenum in response to the presence of fats and proteins in the small intestine. Its main function is to signal the gallbladder to contract and release bile into the duodenum to aid in the digestion and absorption of fats.
A: CCK is not secreted from the jejunum but from the duodenum.
C: CCK does not inhibit stomach motility; instead, it enhances the release of digestive enzymes and bile.
In summary, choice B is correct as it accurately reflects the role of CCK in stimulating gallbladder contraction, while choices A and C are incorrect based on the functions of CCK in the digestive system.
The patient has been newly diagnosed with Wilson's disease and D-penicillamine, a chelating agent, has been prescribe What assessment finding should the nurse expect?
- A. Pruritus
- B. Acute kidney injury
- C. Corneal Fleischer rings
- D. Elevated serum iron levels
Correct Answer: C
Rationale: Corneal Fleischer rings are a characteristic finding in Wilson's disease, caused by copper deposits in the cornea.
The nurse needs to administer feedings to a client who has diarrhea due to gastroenteritis. Which of the following factors should the nurse consider?
- A. Administer feedings at room temperature
- B. Administer cold feedings
- C. Administer bolus feedings
- D. Administer intermittent feedings
Correct Answer: A
Rationale: Room temperature feedings reduce gastric irritation, which can help prevent worsening diarrhea.