Nokea
The colonic mucosal cells are very efficient in:
- A. Converting primary bile acids into secondary bile acids
- B. Converting bilirubin into stercobilinogen
- C. Absorption of aromatic amino acids
- D. Absorption of sodium
Correct Answer: D
Rationale: The correct answer is D: Absorption of sodium. Colonic mucosal cells are efficient in absorbing sodium through active transport processes. Sodium absorption helps in maintaining fluid and electrolyte balance. Choices A, B, and C are incorrect because primary bile acids are converted into secondary bile acids in the liver, bilirubin is converted into stercobilinogen in the intestines, and aromatic amino acids are mostly absorbed in the small intestine, not the colon.
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Bile pigments:
- A. Are derived from globin portion of hemoglobin.
- B. Help in fat digestion and absorption.
- C. Are conjugated in the liver mainly with sulphate.
- D. Their level increases in blood in liver disease.
Correct Answer: D
Rationale: The correct answer is D because bile pigments, such as bilirubin, increase in the blood in liver disease due to impaired liver function. Bilirubin is a waste product from the breakdown of red blood cells and is normally processed by the liver. Elevated levels of bile pigments in the blood are a common indicator of liver dysfunction.
Choice A is incorrect because bile pigments are derived from heme, not the globin portion of hemoglobin.
Choice B is incorrect because bile pigments aid in the emulsification of fats but do not directly help in fat digestion and absorption.
Choice C is incorrect as bile pigments are conjugated with glucuronic acid, not sulphate, in the liver.
Which organ has the most metabolically active cells?
- A. pancreas
- B. liver
- C. stomach
- D. small intestine
Correct Answer: B
Rationale: The correct answer is B: liver. The liver has the most metabolically active cells due to its crucial role in various metabolic processes, such as detoxification, protein synthesis, and glucose metabolism. It is responsible for producing enzymes and metabolizing nutrients. The pancreas, stomach, and small intestine are important organs, but they are not as metabolically active as the liver. The pancreas primarily produces digestive enzymes and regulates blood sugar levels. The stomach digests food, and the small intestine absorbs nutrients. However, in terms of overall metabolic activity, the liver surpasses these organs.
The nurse is teaching a patient with hypertension about lifestyle modifications. Which statement by the patient indicates that further teaching is needed?
- A. "I will reduce my intake of processed foods and sodium."
- B. "I will engage in regular physical activity, such as walking."
- C. "I will limit my alcohol intake to no more than two drinks per day."
- D. "I can stop taking my blood pressure medication when I feel better."
Correct Answer: D
Rationale: The correct answer is D because stopping blood pressure medication without medical guidance can be dangerous and worsen hypertension. A is correct as reducing sodium intake helps lower blood pressure. B is correct as physical activity is beneficial. C is incorrect, as limiting alcohol intake is also important in managing hypertension.
Which of the following is the most plausible explanation for the protective effect of dietary fibre against cancer of the colon?
- A. Propionic acid, formed during colonic fibre fermentation inhibits liver fatty acid synthesis
- B. Butyric acid, formed during colonic fibre fermentation stimulates 'silencing' of the SLC5A8 tumour suppressor gene
- C. None of these options are correct
- D. Butyric acid, formed during colonic fibre fermentation stimulates anti-oxidant defences in the colon
Correct Answer: D
Rationale: The correct answer is D because butyric acid, a short-chain fatty acid formed during colonic fiber fermentation, has been shown to stimulate antioxidant defenses in the colon. This helps protect against oxidative damage, a key factor in the development of cancer. Choice A is incorrect because propionic acid does not inhibit liver fatty acid synthesis in relation to colon cancer. Choice B is incorrect because butyric acid does not silence the SLC5A8 tumor suppressor gene; in fact, it has been shown to have anti-tumor effects. Choice C is incorrect as there is evidence supporting the protective effect of dietary fiber through butyric acid's stimulation of antioxidant defenses.
You're caring for Beth who underwent a Billroth II procedure (surgical removal of the pylorus and duodenum) for treatment of a peptic ulcer. Which findings suggest that the patient is developing dumping syndrome, a complication associated with this procedure?
- A. Flushed, dry skin
- B. Headache and bradycardia.
- C. Dizziness and sweating.
- D. Dyspnea and chest pain.
Correct Answer: C
Rationale: Rationale: Dumping syndrome is a common complication post-Billroth II procedure due to rapid emptying of gastric contents into the small intestine. Choice C (dizziness and sweating) align with early dumping syndrome symptoms like vasomotor symptoms and hypoglycemia. Flushed, dry skin (A) is not typical, headache and bradycardia (B) are more indicative of vagal reaction, and dyspnea and chest pain (D) are not usually associated with dumping syndrome.