Nokea
Priority Decision: During care of the severely obese patient
- A. what is most important for the nurse to do?
- B. Avoid reference to the patient's weight to avoid embarrassing the patient.
- C. Emphasize to the patient how important it is to lose weight to maintain health.
- D. Plan for necessary modifications in equipment and nursing techniques before initiating care.
Correct Answer: C
Rationale: Planning for necessary equipment modifications is crucial to safely care for obese patients, ensuring comfort and effectiveness in care.
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A patient with advanced cirrhosis has a nursing diagnosis of imbalanced nutrition: less than body requirements related to anorexia and inadequate food intake. What would be an appropriate midday snack for the patient?
- A. Peanut butter and salt-free crackers
- B. A fresh tomato sandwich with salt-free butter
- C. Popcorn with salt-free butter and herbal seasoning
- D. Canned chicken noodle soup with low-protein bread
Correct Answer: A
Rationale: Peanut butter and salt-free crackers provide protein and energy, which can help address nutritional deficiencies in a patient with cirrhosis.
Gastric enzymes are secreted by the _____ cells.
- A. chief
- B. goblet
- C. parietal
- D. oxyntic
Correct Answer: A
Rationale: The correct answer is A: chief cells. Chief cells are responsible for secreting gastric enzymes, such as pepsinogen, in the stomach. These enzymes play a crucial role in breaking down proteins during digestion. Goblet cells (B) secrete mucus, parietal cells (C) secrete hydrochloric acid, and oxyntic cells (D) are another term for parietal cells. Therefore, the correct choice is A as chief cells specifically produce gastric enzymes.
Where does the absorption of most nutrients take place?
- A. stomach
- B. small intestine
- C. large intestine
- D. rectum
Correct Answer: B
Rationale: The correct answer is B: small intestine. The absorption of most nutrients occurs in the small intestine due to its large surface area, which is facilitated by villi and microvilli. Digestive enzymes and bile produced by the liver and pancreas help break down food into absorbable nutrients. Nutrients like carbohydrates, proteins, fats, vitamins, and minerals are absorbed through the walls of the small intestine and into the bloodstream for distribution to the body. The stomach primarily functions in digestion, while the large intestine absorbs water and salts and the rectum stores waste before elimination.
Regarding deglutition (swallowing):
- A. Pharyngeal phase is voluntary.
- B. Is controlled by a center in the medulla oblongata.
- C. Readily occurs with an open mouth.
- D. Buccal phase is accompanied by apnea.
Correct Answer: B
Rationale: The correct answer is B because swallowing is controlled by the swallowing center in the medulla oblongata. This center coordinates the complex sequence of muscle contractions involved in swallowing, ensuring food moves from the mouth to the esophagus without entering the airway. The pharyngeal phase is actually involuntary, not voluntary (Choice A). Swallowing usually occurs with a closed mouth, not an open one (Choice C). Additionally, the buccal phase is not accompanied by apnea; breathing typically continues during this phase (Choice D). Therefore, the correct answer is B due to the central control of swallowing in the medulla oblongata.
A nurse is providing teaching to a client who has a new colostomy. Which of the following information should the nurse include in the teaching?
- A. You can expect fecal output within 24 hours.'
- B. You will need to increase your dietary intake of raw vegetables.'
- C. You can expect the stoma to be purplish in color for the first week.'
- D. You may experience a small amount of bleeding around the stoma.'
Correct Answer: A
Rationale: The correct answer is A because it is important for the nurse to educate the client that fecal output should be expected within 24 hours after colostomy surgery. This information is crucial for the client to understand the functioning of the colostomy and to monitor for any potential issues.
Choice B is incorrect because increasing dietary intake of raw vegetables may not be suitable for all colostomy patients and can potentially lead to digestive issues.
Choice C is incorrect because a purplish color of the stoma is not a normal finding and could indicate inadequate blood supply or other complications that should be promptly addressed by a healthcare provider.
Choice D is incorrect because experiencing bleeding around the stoma is abnormal and should be reported to the healthcare provider immediately for further evaluation.