Nokea
Priority Decision: During the treatment of the patient with bleeding esophageal varices, what is the most important thing the nurse should do?
- A. Prepare the patient for immediate portal shunting surgery.
- B. Perform guaiac testing on all stools to detect occult blood.
- C. Maintain the patient's airway and prevent aspiration of blood.
- D. Monitor for the cardiac effects of IV vasopressin and nitroglycerin.
Correct Answer: C
Rationale: Rationale: The correct answer is C because maintaining the patient's airway and preventing aspiration of blood is the top priority in a patient with bleeding esophageal varices. This is crucial to prevent respiratory compromise and potential life-threatening complications. Immediate portal shunting surgery (A) is not the priority as stabilizing the patient comes first. Guaiac testing (B) is not the priority as it does not address the immediate risk of airway obstruction. Monitoring cardiac effects (D) is important but not as critical as ensuring the patient's airway is secure.
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Which of the following is likely to fail to reduce secretion of hydrochloric acid in the stomach:
- A. A H receptor blocker
- B. A nicotinic cholinergic receptor blocker
- C. A muscarinic cholinergic receptor blocker
- D. An inhibitor of the hydrogen-potassium pump
Correct Answer: D
Rationale: The correct answer is D because an inhibitor of the hydrogen-potassium pump directly targets the mechanism responsible for the secretion of hydrochloric acid in the stomach. By inhibiting this pump, the production of acid is reduced.
A H receptor blocker (choice A) and a muscarinic cholinergic receptor blocker (choice C) work by blocking specific receptors involved in stimulating acid secretion. A nicotinic cholinergic receptor blocker (choice B) blocks a different type of receptor that is not directly involved in regulating acid secretion.
In summary, the inhibitor of the hydrogen-potassium pump (choice D) is the most direct and effective way to reduce the secretion of hydrochloric acid in the stomach compared to the other choices.
A nurse is teaching a client about strategies to manage gastroesophageal reflux disease (GERD). Which of the following statements should the nurse include?
- A. Elevate the head of your bed by 18 inches.'
- B. Avoid snacking between meals.'
- C. Limit foods that are high in fiber.'
- D. Avoid eating 2 to 3 hours before bedtime.'
Correct Answer: D
Rationale: The correct answer is D: Avoid eating 2 to 3 hours before bedtime. This is because lying down after eating can worsen GERD symptoms by allowing stomach acid to flow back up into the esophagus. By avoiding eating close to bedtime, the client can reduce the risk of acid reflux.
A: Elevating the head of the bed helps reduce nighttime symptoms, but it is not the most essential strategy.
B: Avoiding snacking between meals can help, but the timing of meals is more crucial for managing GERD.
C: Limiting foods high in fiber is not directly related to managing GERD; it is more about avoiding trigger foods like citrus, caffeine, and fatty foods.
The nervous system or systems that can control peristalsis in the inferior esophagus, stomach, small intestine and large intestine is (are) the
- A. somatic motor nervous system.
- B. sympathetic nervous system.
- C. sympathetic and parasympathetic nervous systems.
- D. autonomic and somatic motor nervous systems.
Correct Answer: C
Rationale: The correct answer is C because peristalsis, the involuntary movement of the digestive tract, is controlled by both sympathetic and parasympathetic nervous systems. The parasympathetic nervous system stimulates peristalsis, while the sympathetic nervous system inhibits it. Choice A is incorrect because the somatic motor nervous system controls voluntary movements, not peristalsis. Choice B is incorrect because the sympathetic nervous system inhibits peristalsis. Choice D is incorrect because the somatic motor nervous system does not control peristalsis in the digestive tract; it controls skeletal muscle movements.
The nurse is caring for a patient with chronic obstructive pulmonary disease (COPD). The patient asks about the best way to prevent respiratory infections. What is the nurse's best response?
- A. "Take a yearly flu shot and avoid crowds during flu season."
- B. "Increase your use of nebulizer treatments to keep your lungs clear."
- C. "Take vitamin C to boost your immune system."
- D. "Use an antibiotic regularly to prevent infections."
Correct Answer: A
Rationale: Step 1: The nurse's response should focus on preventing respiratory infections in a patient with COPD.
Step 2: Yearly flu shots are recommended to prevent influenza, a common trigger for respiratory infections in COPD.
Step 3: Avoiding crowds during flu season reduces exposure to pathogens, further preventing infections.
Step 4: Increasing nebulizer treatments does not directly prevent infections but may help manage COPD symptoms.
Step 5: Vitamin C may have some benefits but is not a primary preventive measure for respiratory infections in COPD.
Step 6: Regular antibiotic use is not recommended to prevent infections due to the risk of antibiotic resistance and potential side effects.
Conclusion: Option A is the best response as it includes evidence-based strategies to prevent respiratory infections in a patient with COPD.
If the submandibular salivary gland stops functioning:
- A. The volume of salivary secretion will be reduced by 20%
- B. There would be severe deficiency of
- C. amylase
- D. There would be no mucins in saliva
Correct Answer: B
Rationale: The correct answer is B because the submandibular salivary gland is responsible for producing around 70-75% of total saliva, including amylase. If it stops functioning, there would be a severe deficiency of amylase, leading to impaired digestion of starches. Choice A is incorrect because the reduction in salivary secretion would be more significant than 20%. Choice D is incorrect as mucins are produced by other salivary glands and not solely by the submandibular gland.