Nokea
The following statements are true about bile except:
- A. 25% is produced by bile duct cells
- B. The bile stored in the gall bladder contains secondary bile acids
- C. Its secretion is increased by secretin
- D. Bile pigments are needed for micelle formation
Correct Answer: D
Rationale: The correct answer is D because bile pigments are not needed for micelle formation. Micelles are formed by bile salts, which aid in the emulsification of fats. Choice A is incorrect as bile is primarily produced by the liver, not bile duct cells. Choice B is incorrect as primary bile acids are stored in the gall bladder, not secondary bile acids. Choice C is incorrect as secretin stimulates the release of pancreatic enzymes, not bile secretion.
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Which enzyme is responsible for breaking down proteins in the stomach?
- A. Amylase
- B. Protease
- C. Lipase
- D. Pepsin
Correct Answer: D
Rationale: Pepsin is the correct answer as it is the enzyme specifically produced by gastric chief cells in the stomach to break down proteins into peptides. It works optimally in the acidic environment of the stomach. Amylase (choice A) breaks down carbohydrates, protease (choice B) refers to a general term for enzymes that break down proteins, and lipase (choice C) breaks down fats, making them incorrect for this question.
In report, the nurse learns that the patient has a transverse colostomy. What should the nurse expect when providing care for this patient?
- A. Semiliquid stools with increased fluid requirements
- B. Liquid stools in a pouch and increased fluid requirements
- C. Formed stools with a pouch, needing irrigation, but no fluid needs
- D. Semiformed stools in a pouch with the need to monitor fluid balance
Correct Answer: A
Rationale: The correct answer is A: Semiliquid stools with increased fluid requirements. A transverse colostomy is located in the upper part of the colon, where stool consistency is more liquid. This type of colostomy typically produces semiliquid stools due to the shorter transit time in the colon, leading to increased fluid requirements to prevent dehydration.
Summary of other choices:
B: Liquid stools in a pouch and increased fluid requirements - Incorrect because transverse colostomies produce semiliquid stools, not entirely liquid.
C: Formed stools with a pouch, needing irrigation, but no fluid needs - Incorrect as transverse colostomies do not produce formed stools, and fluid intake is necessary.
D: Semiformed stools in a pouch with the need to monitor fluid balance - Incorrect because transverse colostomies produce semiliquid stools, not semiformed, and increased fluid intake is needed.
The nurse is caring for a patient who returns to the floor at lunchtime after undergoing an upper GI (UGI) series. Which action is most important for the nurse to perform first?
- A. Administer a laxative.
- B. Educate the patient about the possibility of white stools.
- C. Offer the patient a small snack.
- D. Provide oral care.
Correct Answer: A
Rationale: The correct answer is A: Administer a laxative. After an upper GI series, it is important to help the patient eliminate the contrast dye used during the procedure. Administering a laxative will facilitate the removal of the dye from the gastrointestinal tract. This is crucial to prevent any potential complications or adverse effects from the contrast dye.
Explanation for incorrect choices:
B: Educating the patient about the possibility of white stools is not the most immediate concern after an upper GI series. While this information is important for the patient to know, it is not the most urgent action to take.
C: Offering the patient a small snack may be appropriate after the procedure, but ensuring the elimination of the contrast dye through a laxative is more critical.
D: Providing oral care is important for overall patient comfort and hygiene, but it is not the priority immediately following an upper GI series.
Where does chemical digestion of carbohydrates begin?
- A. Mouth
- B. Stomach
- C. Small intestine
- D. Large intestine
Correct Answer: A
Rationale: The correct answer is A: Mouth. In the mouth, salivary amylase is secreted, which starts breaking down carbohydrates into simpler sugars like maltose. This initial breakdown of carbohydrates through the enzyme amylase marks the beginning of chemical digestion. The stomach primarily digests proteins, not carbohydrates (eliminating option B). The small intestine is where most of the carbohydrate digestion and absorption occurs, but the process begins in the mouth (eliminating option C). The large intestine is responsible for absorbing water and electrolytes, not carbohydrate digestion (eliminating option D).
In discussing long-term management with the patient with alcoholic cirrhosis, what should the nurse advise the patient?
- A. A daily exercise regimen is important to increase the blood flow through the liver.
- B. Cirrhosis can be reversed if the patient follows a regimen of proper rest and nutrition.
- C. Abstinence from alcohol is the most important factor in improvement of the patient's condition.
- D. The only over-the-counter analgesic that should be used for minor aches and pains is acetaminophen.
Correct Answer: C
Rationale: The correct answer is C: Abstinence from alcohol is the most important factor in improvement of the patient's condition. This is because alcohol is the primary cause of alcoholic cirrhosis, and continued consumption can worsen liver damage. Abstinence allows the liver to heal and potentially improve function.
Explanation of why the other choices are incorrect:
A: A daily exercise regimen is important for overall health but may not specifically increase blood flow through the liver in alcoholic cirrhosis.
B: Cirrhosis is irreversible, although proper rest and nutrition can help manage symptoms and prevent further damage.
D: Acetaminophen can be harmful to the liver in high doses and should be used cautiously in patients with cirrhosis.