The colonic microflora can be considered as 'an organ within an organ'. Which of the following statements best describes the functions of the microbiota?
- A. Measurement of daily dietary fibre intake underestimates the amount of fermentable material entering the colon each day
- B. All of the options given are correct
- C. Acetate, propionate and butyrate are the chief organic acids produced by anaerobic colic fermentation
- D. The establishment of an 'acetate buffer' in the colonic lumen suppresses the growth of some pathogenic bacteria.
Correct Answer: B
Rationale: The correct answer is B because the colonic microbiota performs multiple essential functions such as aiding in digestion, producing vitamins, regulating immune function, and maintaining gut barrier integrity. Option A is incorrect as it focuses on dietary fiber intake rather than the microbiota's functions. Option C is incorrect because while acetate, propionate, and butyrate are important organic acids produced, they are not the only ones. Option D is incorrect as the microbiota's establishment of an 'acetate buffer' does not necessarily suppress the growth of all pathogenic bacteria.
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What is the role of the large intestine?
- A. digestion of proteins
- B. absorption of nutrients
- C. absorption of water
- D. production of bile
Correct Answer: C
Rationale: The large intestine's main role is to absorb water from the indigestible food residue, forming feces. This process helps maintain proper hydration levels in the body. It does not digest proteins (choice A) or absorb nutrients (choice B), as these processes primarily occur in the small intestine. The production of bile (choice D) is carried out by the liver and stored in the gallbladder, not by the large intestine. Thus, choice C is correct as it aligns with the primary function of the large intestine.
A nurse is preparing to administer a medication via intramuscular (IM) injection. Which of the following sites is considered the safest for administering an IM injection?
- A. The dorsogluteal site
- B. The deltoid muscle
- C. The ventrogluteal site
- D. The vastus lateralis
Correct Answer: C
Rationale: The ventrogluteal site is considered the safest for IM injections due to the presence of fewer major blood vessels and nerves, reducing the risk of injury. The site is easily accessible and has a thick muscle mass suitable for medication absorption. To locate the ventrogluteal site, the nurse can ask the patient to lie on their side with the knee slightly flexed. The nurse should locate the greater trochanter and iliac crest, forming a V-shaped area where the injection is administered. The other choices are not as safe as the ventrogluteal site. The dorsogluteal site is not recommended due to proximity to the sciatic nerve and major blood vessels. The deltoid muscle is a smaller muscle and may not be suitable for all types of medications. The vastus lateralis site is more commonly used for pediatric patients or adults with limited muscle mass in other areas.
Which type of cells produce insulin in the pancreas?
- A. acinar cells
- B. duct cells
- C. alpha cells
- D. beta cells
Correct Answer: D
Rationale: The correct answer is D: beta cells. Beta cells are the specific type of cells in the pancreas responsible for producing insulin. They are located in the islets of Langerhans and play a crucial role in regulating blood sugar levels. Acinar cells (A) are responsible for producing digestive enzymes, duct cells (B) are involved in transporting pancreatic enzymes, and alpha cells (C) produce glucagon, which has the opposite effect of insulin in regulating blood sugar. Therefore, the correct choice is beta cells as they are the primary insulin-producing cells in the pancreas.
A patient with ulcerative colitis undergoes the first phase of a total proctocolectomy with ileal pouch and anal anastomosis. On postoperative assessment of the patient, what should the nurse expect to find?
- A. A rectal tube set to low continuous suction
- B. A loop ileostomy with a plastic rod to hold it in place
- C. A colostomy stoma with an NG tube in place to provide pouch irrigations
- D. A permanent ileostomy stoma in the right lower quadrant of the abdomen
Correct Answer: B
Rationale: In the first phase of a total proctocolectomy with ileal pouch and anal anastomosis, a loop ileostomy is created to divert stool while the pouch heals.
The nurse recognizes that teaching a patient following a laparoscopic cholecystectomy has been effective when the patient makes which statement?
- A. "I can take a shower and walk around the house tomorrow."
- B. "I need to limit my activities and not return to work for 4 weeks."
- C. "I can expect yellowish drainage from the incision for a few days."
- D. "I will follow a low-fat diet for life because I do not have a gallbladder."
Correct Answer: A
Rationale: Rationale for Correct Answer (A): The statement "I can take a shower and walk around the house tomorrow" indicates an understanding of post-operative activity expectations. After a laparoscopic cholecystectomy, early ambulation is encouraged to prevent complications like blood clots. Additionally, showering promotes wound healing and hygiene.
Incorrect Choices:
B: "I need to limit my activities and not return to work for 4 weeks" - This choice is incorrect as it overestimates the recovery time for a laparoscopic cholecystectomy, which typically allows for a quicker return to normal activities.
C: "I can expect yellowish drainage from the incision for a few days" - While drainage is common after surgery, the color and duration mentioned are not typical for this procedure.
D: "I will follow a low-fat diet for life because I do not have a gallbladder" - Following a low-fat diet is recommended after surgery, but the statement is too extreme as dietary