Nokea
The nurse caring for an 80-year-old woman who is undergoing extensive bowel preparation for a colonoscopy. The nurse should most closely monitor the patient for which potential complication?
- A. Diarrhea
- B. Metabolic acidosis
- C. Fatigue
- D. Dyspnea
Correct Answer: B
Rationale: The correct answer is B: Metabolic acidosis. During bowel preparation for a colonoscopy, the patient may experience fluid and electrolyte imbalances, leading to metabolic acidosis. The nurse should closely monitor for signs such as confusion, weakness, and increased respiratory rate. Diarrhea (choice A) is expected during bowel preparation but does not directly lead to metabolic acidosis. Fatigue (choice C) and dyspnea (choice D) are less likely complications of bowel preparation and do not directly relate to metabolic acidosis.
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Regardless of the precipitating factor
- A. what causes the injury to mucosal cells in peptic ulcers?
- B. Acid back diffusion into the mucosa
- C. The release of histamine from GI cells
- D. Ammonia formation in the mucosal wall
Correct Answer: D
Rationale: Step 1: Peptic ulcers are mainly caused by H. pylori infection or NSAIDs use, not directly related to acid injury.
Step 2: Ammonia formation in the mucosal wall neutralizes acid, protecting mucosal cells.
Step 3: Ammonia is produced by H. pylori urease enzyme, contributing to ulcer formation.
Step 4: Acid back diffusion (B) and histamine release (C) are consequences, not direct causes of ulcers.
Summary: Ammonia formation (D) is the correct answer as it directly contributes to mucosal injury in peptic ulcers. Acid back diffusion (B) and histamine release (C) are secondary effects of ulcer formation, not the primary cause.
The nurse monitors the laboratory results of the patient with protein-calorie malnutrition during treatment. Which result is an indication of improvement in the patient's condition?
- A. Decreased lymphocytes
- B. Increased serum transferrin
- C. Increased serum potassium
- D. Decreased serum prealbumin
Correct Answer: B
Rationale: The correct answer is B because an increase in serum transferrin levels indicates improvement in protein-calorie malnutrition as transferrin is a protein that binds and transports iron, which is essential for various body functions. When protein intake increases, transferrin levels also increase to support iron transport.
A: Decreased lymphocytes do not directly reflect improvement in protein-calorie malnutrition.
C: Increased serum potassium is not specific to improvement in protein-calorie malnutrition.
D: Decreased serum prealbumin levels indicate ongoing malnutrition, not improvement.
Which of the following is a common risk factor for gallstones?
- A. High-fat diet
- B. Advanced age
- C. Gender (female)
- D. Family history of gallbladder disease
Correct Answer: C
Rationale: The correct answer is C: Gender (female). Women have a higher risk of developing gallstones due to hormonal factors, such as estrogen increasing cholesterol levels in bile. This imbalance can lead to gallstone formation. Advanced age (B) is a risk factor but not as common as gender. While a high-fat diet (A) can contribute to gallstone formation, it is not a primary risk factor. Family history (D) can increase the likelihood of gallstones, but it is not as common as being female.
Gastrin secretion will stop when the stomach pH reaches _____.
- A. 7
- B. 4.5
- C. 1.5
- D. 3
Correct Answer: D
Rationale: The correct answer is D: 3. Gastrin secretion is stimulated by low pH levels in the stomach. When the stomach pH drops below 3, gastrin secretion is triggered to increase stomach acid production. Once the stomach pH reaches around 3, a negative feedback mechanism is activated to stop gastrin secretion and prevent excessive acid production. Choices A (7), B (4.5), and C (1.5) are incorrect because gastrin secretion is actually inhibited by higher pH levels, not when the pH reaches neutral (7), slightly acidic (4.5), or extremely acidic (1.5) levels. The key here is to understand the physiological response of gastrin secretion to pH levels in the stomach.
Which of the following are liver waste products?
- A. bilirubin
- B. bile salts
- C. cholesterol
- D. electrolytes
Correct Answer: A
Rationale: The correct answer is A: bilirubin. Bilirubin is a waste product produced during the breakdown of red blood cells in the liver. It is excreted in bile and gives feces its brown color. Bile salts aid in digestion, cholesterol is a lipid used for various functions, and electrolytes are essential for bodily functions but are not liver waste products. Therefore, bilirubin is the only true liver waste product in this list.