Nokea
Secretin and cholecystokinin are secreted in
- A. pyloric region
- B. Ileum
- C. duodenum
- D. Oesophagus
Correct Answer: C
Rationale: The correct answer is C, duodenum. Secretin and cholecystokinin are hormones secreted by the duodenal mucosa in response to the presence of acidic chyme from the stomach entering the duodenum. Secretin stimulates the pancreas to release bicarbonate to neutralize the acidic chyme, while cholecystokinin stimulates the gallbladder to release bile to aid in digestion. Choices A (pyloric region), B (Ileum), and D (Oesophagus) are incorrect because secretin and cholecystokinin are not secreted in these regions of the gastrointestinal tract.
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The patient with liver failure has had a liver transplant. What should the nurse teach the patient about care after the transplant?
- A. Alcohol intake is now okay.
- B. HBIG will be required to prevent rejection.
- C. Elevate the head 30 degrees to improve ventilation when sleeping.
- D. Monitor closely for infection because of the immunosuppressive medication.
Correct Answer: D
Rationale: The correct answer is D because patients who undergo liver transplant are put on immunosuppressive medication to prevent rejection. This medication weakens the immune system, making the patient more susceptible to infections. Monitoring closely for signs of infection is crucial to prevent complications.
Choice A is incorrect because alcohol intake is not recommended after a liver transplant as it can further damage the new liver. Choice B is incorrect because HBIG (Hepatitis B Immunoglobulin) is typically given to prevent hepatitis B recurrence, not rejection. Choice C is incorrect as elevating the head has no direct correlation with post-liver transplant care.
Priority Decision: The nurse admitting a patient for bariatric surgery obtains the following information from the patient. Which finding should be brought to the surgeon's attention before proceeding with further patient preparation?
- A. History of hypertension
- B. History of untreated depression
- C. History of multiple attempts at weight loss
- D. History of sleep apnea treated with continuous positive airway pressure (CPAP)
Correct Answer: B
Rationale: The correct answer is B: History of untreated depression. Before proceeding with further patient preparation for bariatric surgery, it is crucial to address untreated depression as it can significantly impact the patient's mental and emotional well-being post-operatively. Untreated depression can lead to poor compliance with post-operative instructions, medication management issues, and potentially increase the risk of complications. It is essential to involve the surgeon to assess the patient's psychological readiness for surgery and ensure appropriate support and resources are in place.
Incorrect choices:
A: History of hypertension - While hypertension should be managed pre-operatively, it is not a critical factor that would require immediate attention before further preparation.
C: History of multiple attempts at weight loss - This is a common issue in patients undergoing bariatric surgery and does not pose an immediate risk that needs urgent attention.
D: History of sleep apnea treated with CPAP - While sleep apnea is a relevant consideration for bariatric surgery, the fact that it is being treated with
CCK:
- A. increases gastric secretion.
- B. inhibits the stomach motility.
- C. inhibits pancreatic enzyme secretion.
- D. increases pancreatic secretions rich in bicarbonate.
Correct Answer: B
Rationale: Step 1: CCK (Cholecystokinin) is released in response to the presence of fats and proteins in the small intestine.
Step 2: CCK inhibits stomach motility to allow enough time for the gallbladder to release bile.
Step 3: This slowing down of stomach motility aids in the digestion and absorption of fats.
Step 4: Choices A, C, and D are incorrect as CCK does not directly affect gastric secretion, pancreatic enzyme secretion, or increase pancreatic secretions rich in bicarbonate.
In caring for a client with GERD, which task would be appropriate to assign to the nursing assistant?
- A. Share successful strategies for weight reduction.
- B. Encourage the client to express concerns about lifestyle modification.
- C. Remind the client not to lie down for 2-3 hours after eating.
- D. Explain the rationale for small frequent meals.
Correct Answer: C
Rationale: The correct answer is C because reminding the client not to lie down after eating helps prevent acid reflux in GERD. Nursing assistants can provide this basic instruction to promote client safety. Choice A involves sharing strategies that require more in-depth knowledge, not within a nursing assistant's scope. Choice B involves addressing emotional concerns, typically handled by nurses. Choice D involves explaining the rationale, which requires more understanding of the condition, beyond a nursing assistant's role.
The Kupffer cells are phagocytic cells found in the _____.
- A. gallbladder
- B. pancreas
- C. intestine
- D. liver
Correct Answer: D
Rationale: The correct answer is D: liver. Kupffer cells are specialized macrophages found in the liver, where they play a crucial role in phagocytosis and immune responses. They help remove debris, toxins, and pathogens from the blood. The other options (A: gallbladder, B: pancreas, C: intestine) are incorrect because Kupffer cells are not typically present in these organs. The liver is the main site for Kupffer cells due to its role in filtering and processing blood.