Nokea
The gallbladder contracts in response to
- A. vagal stimulation only.
- B. cholecystokinin and vagal stimulation.
- C. cholecystokinin and secretin.
- D. a low pH of chyme.
Correct Answer: B
Rationale: The gallbladder contracts in response to cholecystokinin and vagal stimulation. Cholecystokinin is released in response to the presence of fatty acids and amino acids in the duodenum, signaling the gallbladder to contract and release bile. Vagal stimulation also plays a role in gallbladder contraction by transmitting signals from the brain to the gallbladder. Secretin is primarily involved in stimulating pancreatic secretion, not gallbladder contraction. A low pH of chyme does not directly stimulate gallbladder contraction.
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The patient asks the nurse why she needs to have surgery for a femoral, strangulated herni What is the best explanation the nurse can give the patient?
- A. The surgery will relieve her constipation.
- B. The abnormal hernia must be replaced into the abdomen.
- C. The surgery is needed to allow intestinal flow and prevent necrosis.
- D. The hernia is because the umbilical opening did not close after birth as it should have.
Correct Answer: C
Rationale: Surgery for a strangulated hernia is needed to prevent the intestines from becoming necrotic due to impaired blood flow.
Priority Decision: Before administering a bolus of intermittent tube feeding to a patient with a percutaneous endoscopic gastrostomy (PEG), the nurse aspirates 220 mL of gastric contents. How should the nurse respond?
- A. Return the aspirate to the stomach and recheck the volume of aspirate in an hour.
- B. Return the aspirate to the stomach and continue with the tube feeding as planned.
- C. Discard the aspirate to prevent overdistending the stomach when the new feeding is given.
- D. Notify the health care provider that the feedings have been scheduled too frequently to allow for stomach emptying
Correct Answer: B
Rationale: Returning the aspirate to the stomach and continuing the feeding is standard practice as long as the volume is within safe limits.
Which of these is most associated with bile?
- A. liver
- B. pancreas
- C. gallbladder
- D. small intestine
Correct Answer: A
Rationale: The correct answer is A: liver. Bile is produced in the liver and stored in the gallbladder before being released into the small intestine to aid in digestion. The liver plays a crucial role in bile production, whereas the pancreas is primarily responsible for producing digestive enzymes. The gallbladder stores and concentrates bile but does not produce it. The small intestine is where bile acts to break down fats. Therefore, the liver is most associated with bile due to its production and regulation of bile.
The nurse is caring for a patient receiving a blood transfusion. Which of the following should the nurse do first if the patient develops chills and fever?
- A. Stop the transfusion and notify the healthcare provider.
- B. Administer acetaminophen as prescribed.
- C. Check the blood bag for any abnormalities.
- D. Increase the rate of the transfusion to flush the system.
Correct Answer: A
Rationale: The correct answer is A: Stop the transfusion and notify the healthcare provider. This is the first step because chills and fever during a blood transfusion could indicate a transfusion reaction, which can be serious. Stopping the transfusion is crucial to prevent further complications. Notifying the healthcare provider promptly ensures appropriate assessment and management. Administering acetaminophen (choice B) may help with fever but does not address the underlying issue. Checking the blood bag (choice C) can be done after stopping the transfusion. Increasing the rate of the transfusion (choice D) can exacerbate the reaction and should be avoided.
Patients with a paralytic ileus typically have:
- A. Intravenous fluid replacement and a nasogastric tube connected to suction.
- B. Surgical correction of the problem.
- C. Endoscopic injection of botulinum toxin or esophageal dilation.
- D. Endoscopy to allow biopsy followed with broad-spectrum antibiotics.
Correct Answer: A
Rationale: Paralytic ileus is typically managed with intravenous fluids to correct electrolyte imbalances and a nasogastric tube to decompress the bowel.