Nokea
The ileocecal valve prevents chyme from entering the _____.
- A. large intestine
- B. small intestine
- C. stomach
- D. duodenum
Correct Answer: A
Rationale: The correct answer is A: large intestine. The ileocecal valve is located between the ileum (part of the small intestine) and the cecum (part of the large intestine). Its primary function is to prevent the backflow of contents from the large intestine into the small intestine, specifically preventing chyme from entering the large intestine prematurely. This allows for proper digestion and absorption of nutrients in the small intestine before the remaining waste material enters the large intestine for further processing. Choices B, C, and D are incorrect as the ileocecal valve specifically regulates the flow of material between the small and large intestines, not other parts of the digestive system such as the stomach or duodenum.
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Although HAV antigens are not tested in the blood, they stimulate specific immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies. Which antibody indicates there is acute HAV infection?
- A. Anti-HBc IgG
- B. Anti-HBc IgM
- C. Anti-HAV IgG
- D. Anti-HAV IgM
Correct Answer: D
Rationale: The correct answer is D: Anti-HAV IgM. IgM antibodies indicate acute infection as they are the first antibodies produced in response to a new infection. In the case of HAV, the presence of Anti-HAV IgM suggests recent exposure to the virus.
A: Anti-HBc IgG is not relevant to HAV infection. It indicates past or chronic hepatitis B infection.
B: Anti-HBc IgM is specific to hepatitis B infection, not HAV.
C: Anti-HAV IgG indicates past exposure or immunity to HAV, not acute infection.
What does the liver secrete to aid in digestion?
- A. insulin
- B. bile
- C. gastrin
- D. pepsin
Correct Answer: B
Rationale: The correct answer is B: bile. The liver secretes bile to aid in digestion by emulsifying fats, helping in their breakdown and absorption. Insulin (choice A) is secreted by the pancreas to regulate blood sugar levels, not aid in digestion. Gastrin (choice C) is a hormone produced by the stomach to stimulate the secretion of gastric acid, not by the liver. Pepsin (choice D) is an enzyme produced in the stomach to break down proteins, not secreted by the liver.
If the submandibular salivary gland stops functioning:
- A. The volume of salivary secretion will be reduced by 20%
- B. There would be severe deficiency of
- C. amylase
- D. There would be no mucins in saliva
Correct Answer: B
Rationale: The correct answer is B because the submandibular salivary gland is responsible for producing around 70-75% of total saliva, including amylase. If it stops functioning, there would be a severe deficiency of amylase, leading to impaired digestion of starches. Choice A is incorrect because the reduction in salivary secretion would be more significant than 20%. Choice D is incorrect as mucins are produced by other salivary glands and not solely by the submandibular gland.
On examining a patient 8 hours after having surgery to create a colostomy, what should the nurse expect to find?
- A. Hyperactive, high-pitched bowel sounds
- B. A brick-red, puffy stoma that oozes blood
- C. A purplish stoma, shiny and moist with mucus
- D. A small amount of liquid fecal drainage from the stoma
Correct Answer: C
Rationale: The correct answer is C because 8 hours post colostomy surgery, a purplish stoma that is shiny and moist with mucus indicates adequate blood supply and tissue perfusion, which are signs of a healthy stoma. A is incorrect as hyperactive, high-pitched bowel sounds are not expected immediately post-surgery. B is incorrect as a brick-red, puffy stoma oozing blood could indicate poor perfusion. D is incorrect as liquid fecal drainage is not expected immediately post-surgery; it usually starts a few days later.
Priority Decision: A patient returns to the surgical unit with a nasogastric (NG) tube to low intermittent suction, IV fluids, and a Jackson-Pratt drain at the surgical site following an exploratory laparotomy and repair of a bowel perforation. Four hours after admission, the patient experiences nausea and vomiting. What is a priority nursing intervention for the patient?
- A. Assess the abdomen for distention and bowel sounds.
- B. Inspect the surgical site and drainage in the Jackson-Pratt.
- C. Check the amount and character of gastric drainage and the patency of the NG tube.
- D. Administer prescribed prochlorperazine (Compazine) to control the nausea and vomiting.
Correct Answer: C
Rationale: The correct answer is C: Check the amount and character of gastric drainage and the patency of the NG tube. This is the priority nursing intervention because the patient is experiencing nausea and vomiting, which could indicate potential complications related to the NG tube, such as blockage or displacement. By checking the gastric drainage and NG tube patency, the nurse can assess if the patient's symptoms are related to these issues and take appropriate actions to address them.
Choice A is incorrect because assessing the abdomen for distention and bowel sounds is important but not the priority in this situation where the patient is experiencing nausea and vomiting. Choice B is incorrect as inspecting the surgical site and drainage in the Jackson-Pratt drain is also important but not as urgent as checking the NG tube patency in this case. Choice D is incorrect as administering medication should not be the first action taken without first assessing the underlying cause of the symptoms.