Nokea
Probably the main reason why elderly people have antacids, Hâ‚‚ antagonists and proton pump inhibitors is because of the increase in ______ with age.
- A. Crohn's disease
- B. irritable bowel syndrome
- C. gastroesophageal reflux disorder
- D. colitis
Correct Answer: C
Rationale: The correct answer is C: gastroesophageal reflux disorder (GERD). As people age, they are more likely to experience GERD due to changes in the muscles of the esophagus and stomach, leading to acid reflux. Antacids, H2 antagonists, and proton pump inhibitors are commonly used to alleviate symptoms of GERD by reducing stomach acid production. Crohn's disease (A), irritable bowel syndrome (B), and colitis (D) are not typically associated with aging and are not directly related to the need for these medications in elderly people.
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Bile contains all of the following except:
- A. Alkaline phosphatase +
- B. K
- C. Cholesterol
- D. CCK
Correct Answer: B
Rationale: Bile does not contain potassium (K) as it is not a component of bile. The correct answer is B. Alkaline phosphatase is present in bile and aids in digestion. Cholesterol is also found in bile. CCK (Cholecystokinin) is a hormone released by the small intestine to stimulate bile release. Potassium is not a part of the composition of bile.
Carboxypeptidase requires _______ for its activity
- A. copper
- B. niacin
- C. iron
- D. Zn
Correct Answer: D
Rationale: Carboxypeptidase is a metalloenzyme that requires zinc (Zn) for its activity as a cofactor. Zinc plays a crucial role in stabilizing the enzyme's structure and facilitating the catalytic reaction. Copper (A), niacin (B), and iron (C) are not directly involved in the enzymatic activity of carboxypeptidase. Copper is more commonly associated with other enzymes like cytochrome c oxidase, niacin is a vitamin, and iron is typically involved in heme-containing proteins like hemoglobin. Zinc is the correct choice as it directly supports carboxypeptidase function.
How should the nurse explain esomeprazole (Nexium) to a patient with recurring heartburn?
- A. It reduces gastroesophageal reflux by increasing the rate of gastric emptying.
- B. It neutralizes stomach acid and provides relief of symptoms in a few minutes.
- C. It coats and protects the lining of the stomach and esophagus from gastric acid.
- D. It treats gastroesophageal reflux disease by decreasing stomach acid production.
Correct Answer: D
Rationale: The correct answer is D because esomeprazole (Nexium) is a proton pump inhibitor that works by decreasing stomach acid production, thereby treating gastroesophageal reflux disease. This explanation is important for the patient to understand the mechanism of action of the medication.
Choice A is incorrect because esomeprazole does not increase the rate of gastric emptying; instead, it reduces acid production. Choice B is incorrect because esomeprazole does not neutralize stomach acid immediately; it takes a few days to reach its full effect. Choice C is incorrect because esomeprazole does not coat and protect the stomach and esophagus; it works by reducing acid production.
In summary, the correct answer is D because it accurately describes how esomeprazole works to manage recurring heartburn by decreasing stomach acid production, which is essential for treating gastroesophageal reflux disease.
Which of the following is the transporter for fructose in the small intestine?
- A. SGLT1
- B. SGLT2
- C. GLUT4
- D. GLUT5
Correct Answer: D
Rationale: The correct answer is D: GLUT5. GLUT5 is the specific transporter responsible for transporting fructose across the apical membrane of enterocytes in the small intestine. It is a uniporter that facilitates the movement of fructose down its concentration gradient via facilitated diffusion. SGLT1 (Choice A) and SGLT2 (Choice B) are sodium-glucose transporters involved in the absorption of glucose and galactose, not fructose. GLUT4 (Choice C) is primarily found in muscle and adipose tissue and is responsible for insulin-mediated glucose uptake, not fructose transport in the small intestine.
A patient with chronic cholecystitis asks the nurse whether she will need to continue a low-fat diet after she has a cholecystectomy. What is the best response by the nurse?
- A. A low-fat diet will prevent the development of further gallstones and should be continued.'
- B. Yes; because you will not have a gallbladder to store bile, you will not be able to digest fats adequately.'
- C. A low-fat diet is recommended for a few weeks after surgery until the intestine adjusts to receiving a continuous flow of bile.'
- D. Removal of the gallbladder will eliminate the source of your pain associated with fat intake, so you may eat whatever you like.'
Correct Answer: C
Rationale: The correct answer is C because after a cholecystectomy, the gallbladder is removed, and bile flows continuously from the liver into the intestine. Initially, the intestine may struggle to adjust to this continuous flow of bile, leading to difficulty in digesting fats. Therefore, a low-fat diet is recommended for a few weeks post-surgery to aid in this adjustment period. This answer acknowledges the temporary need for a low-fat diet until the body adapts.
Choice A is incorrect because the primary purpose of a low-fat diet post-cholecystectomy is not to prevent further gallstones but to aid in fat digestion. Choice B is incorrect as the body can still digest fats adequately even without a gallbladder, though it may take some time to adjust. Choice D is incorrect because while the pain associated with fat intake may be eliminated, it is still important to follow dietary recommendations post-surgery for optimal recovery.