Nokea
Priority Decision: Before administering a bolus of intermittent tube feeding to a patient with a percutaneous endoscopic gastrostomy (PEG), the nurse aspirates 220 mL of gastric contents. How should the nurse respond?
- A. Return the aspirate to the stomach and recheck the volume of aspirate in an hour.
- B. Return the aspirate to the stomach and continue with the tube feeding as planned.
- C. Discard the aspirate to prevent overdistending the stomach when the new feeding is given.
- D. Notify the health care provider that the feedings have been scheduled too frequently to allow for stomach emptying
Correct Answer: B
Rationale: Returning the aspirate to the stomach and continuing the feeding is standard practice as long as the volume is within safe limits.
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A male infant, who was normal for the first three weeks of life, develops projectile vomiting after feeding. The likely diagnosis is:
- A. Meckel's diverticulum
- B. esophageal atresia
- C. congenital diaphragmatic hernia
- D. congenital pyloric stenosis
Correct Answer: D
Rationale: The correct answer is D, congenital pyloric stenosis. This condition typically presents in male infants around 3-6 weeks of age with projectile vomiting due to hypertrophy of the pyloric muscle, leading to obstruction at the pylorus. This causes the infant to forcefully vomit shortly after feeding. Meckel's diverticulum (A) presents with painless rectal bleeding. Esophageal atresia (B) presents with drooling and choking with feeding. Congenital diaphragmatic hernia (C) presents with respiratory distress and scaphoid abdomen due to herniation of abdominal organs into the chest cavity.
Which of the following statements is TRUE? The protein FOXO1:
- A. activates (increases the expression of) genes related to greater longevity
- B. is activated by caloric restriction
- C. is deactivated by increased insulin signalling
- D. all of the above are true
Correct Answer: D
Rationale: Step-by-step rationale:
1. FOXO1 activates genes related to greater longevity by regulating stress responses and promoting cell survival.
2. Caloric restriction activates FOXO1 to promote cellular stress resistance and increase lifespan.
3. Increased insulin signaling deactivates FOXO1, leading to decreased stress resistance and potentially shorter lifespan.
4. Therefore, all the statements (A, B, and C) are true regarding the protein FOXO1. It plays a crucial role in longevity through gene regulation, is activated by caloric restriction, and is deactivated by increased insulin signaling.
Which of the following nutrients is absorbed in the stomach?
- A. vitamins
- B. water
- C. proteins
- D. carbohydrates
Correct Answer: B
Rationale: The correct answer is B: water. Water is the only nutrient that is absorbed in the stomach. The stomach mainly digests food using stomach acid and enzymes, but absorption of nutrients primarily occurs in the small intestine. Vitamins are absorbed in the small intestine, proteins are broken down in the stomach and further digested in the small intestine, and carbohydrates are primarily broken down and absorbed in the small intestine. Water, on the other hand, can be absorbed in the stomach through osmosis due to its small molecular size and the presence of aquaporins in the stomach lining.
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.
After several days of antibiotic therapy for pneumonia, an older hospitalized patient develops watery
- A. Which action should the nurse take first?
- B. Notify the health care provider.
- C. Obtain a stool specimen for analysis.
- D. Teach the patient about hand washing.
Correct Answer: A
Rationale: The correct answer is A because the nurse should prioritize assessing the patient's condition to ensure immediate safety and appropriate intervention. This includes evaluating for signs of dehydration, electrolyte imbalance, and potential complications like Clostridium difficile infection. Option B is not the first action as immediate assessment is crucial. Option C is important but not the priority at this moment. Option D is important but should not be the first action in this scenario.