Nokea
The most common cause of upper gastrointestinal hemorrhage (hematemesis or melena) is:
- A. esophageal varices
- B. gastric carcinoma
- C. peptic ulcer
- D. gastritis
Correct Answer: C
Rationale: The correct answer is C: peptic ulcer. Peptic ulcers are a common cause of upper gastrointestinal hemorrhage due to erosion of the stomach lining. The acidic environment in the stomach can lead to ulcer formation. Esophageal varices are associated with liver cirrhosis, not a common cause of hemorrhage. Gastric carcinoma may cause bleeding but is less common than peptic ulcers. Gastritis is inflammation of the stomach lining and can cause bleeding but is not as common as peptic ulcers.
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How should the nurse teach the patient with a hiatal hernia or GERD to control symptoms?
- A. Drink 10 to 12 oz of water with each meal.
- B. Space six small meals a day between breakfast and bedtime.
- C. Sleep with the head of the bed elevated on 4- to 6-inch blocks
- D. Perform daily exercises of toe-touching, sit-ups, and weight lifting.
Correct Answer: C
Rationale: Sleeping with the head of the bed elevated helps prevent gastric contents from refluxing into the esophagus, reducing GERD symptoms.
Which one of the following enzymes is not part of the enzymatic component of the pancreatic juice?
- A. amylase
- B. lipase
- C. nucleases
- D. chymotrypsin
Correct Answer: D
Rationale: The correct answer is D: chymotrypsin. Chymotrypsin is not part of the enzymatic component of pancreatic juice. Pancreatic juice contains amylase for carbohydrate digestion, lipase for fat digestion, and nucleases for nucleic acid digestion. Chymotrypsin is produced in the pancreas but is not secreted directly into the pancreatic juice. It is released in an inactive form that is activated in the small intestine. Therefore, chymotrypsin is not directly involved in the initial breakdown of nutrients in the pancreatic juice.
The term wisdom tooth refers to the _____ tooth.
- A. incisor
- B. third molar
- C. second bicuspid
- D. first cuspid
Correct Answer: B
Rationale: The correct answer is B: third molar. Wisdom teeth are the third molars located at the back of the mouth. They typically erupt in late teens or early twenties. Incisors (A) are front teeth for cutting, second bicuspids (C) help with chewing, and first cuspids (D) are also known as canines for tearing food. The key is understanding dental anatomy and the specific location/function of each tooth type.
Which information in this male patient's electronic health record as shown in the accompanying figure will the nurse use to confirm that the patient has metabolic syndrome? (Select all that apply.)
- A. Weight
- B. Waist size
- C. Blood glucose
- D. Blood pressure
Correct Answer: B
Rationale: The correct answer is B: Waist size. The nurse can confirm metabolic syndrome by assessing waist size as it is a key component in diagnosing the condition. Metabolic syndrome is characterized by central obesity, which is reflected in an increased waist circumference. The other choices, weight (A), blood glucose (C), and blood pressure (D), may provide valuable information in assessing the patient's overall health but are not specific indicators of metabolic syndrome. Weight alone does not necessarily indicate central obesity, blood glucose may be elevated due to other reasons, and blood pressure can be affected by various factors unrelated to metabolic syndrome. Therefore, waist size is the most relevant measure to confirm the presence of metabolic syndrome in this case.
A patient's peripheral parenteral nutrition (PN) bag is nearly empty, and a new PN bag has not arrived yet from the pharmacy. Which intervention by the nurse is appropriate?
- A. Monitor the patient's capillary blood glucose every 6 hours.
- B. Infuse 5% dextrose in water until a new PN bag is delivere
- D. Decrease the PN infusion rate to 10 mL/hr until a new bag arrives.
Correct Answer: B
Rationale: Correct Answer: B
Rationale:
1. Infusing 5% dextrose in water will provide the patient with necessary calories and prevent hypoglycemia until the new PN bag arrives.
2. Dextrose infusion will help maintain glucose levels and prevent metabolic complications.
3. Monitoring capillary blood glucose every 6 hours (Choice A) may not provide immediate support to prevent hypoglycemia.
4. Decreasing the PN infusion rate (Choice D) may lead to inadequate nutrition and compromise patient's metabolic needs.