Nokea
The nurse cautions that constant stress can cause which alteration to the gastrointestinal (GI) system?
- A. Slowed GI mobility resulting in constipation
- B. Reversed peristalsis resulting in projectile vomiting
- C. Increased digestive juices resulting in a gastric ulcer
- D. Decreased digestive juices resulting in ineffective metabolism
Correct Answer: C
Rationale: The correct answer is C because constant stress triggers the release of excess digestive juices, leading to increased acid production and potentially causing a gastric ulcer. Stress activates the sympathetic nervous system, which in turn stimulates the release of stress hormones that can disrupt the balance of digestive juices. Slowed GI mobility (choice A) typically causes constipation, not directly related to stress. Reversed peristalsis (choice B) leading to projectile vomiting is more commonly associated with conditions such as food poisoning or intestinal blockages. Decreased digestive juices (choice D) would likely result in poor digestion and nutrient absorption, but it is not a common consequence of stress-induced alterations to the GI system.
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A nurse is planning care for a client who is postoperative and at risk for paralytic ileus. Which of the following interventions should the nurse plan to take to promote peristalsis?
- A. Increase ambulation.
- B. Decrease fluid intake.
- C. Increase protein intake.
- D. Offer the client the bedpan every 2 hr.
Correct Answer: A
Rationale: The correct answer is A: Increase ambulation. Ambulation helps stimulate peristalsis by promoting movement in the gastrointestinal tract. This movement aids in preventing or alleviating paralytic ileus, a common postoperative complication. Increasing ambulation helps to increase muscle tone and activity in the intestines, promoting bowel motility.
Summary of other choices:
B: Decrease fluid intake - This is incorrect because adequate hydration is essential for promoting peristalsis and preventing constipation.
C: Increase protein intake - Protein intake is important for wound healing and overall nutrition but does not directly impact peristalsis.
D: Offer the client the bedpan every 2 hr - While providing opportunities for toileting is important, it does not directly promote peristalsis like ambulation does.
While a female client is being prepared for discharge, the nasogastric (NG) feeding tube becomes clogged. To remedy this problem and teach the client's family how to deal with it at home, what should the nurse do?
- A. Irrigate the tube with warm water.
- B. Advance the tube into the intestine.
- C. Apply intermittent suction to the tube.
- D. Withdraw the obstruction with a 30-ml syringe.
Correct Answer: A
Rationale: The correct answer is A: Irrigate the tube with warm water. This is the correct action because irrigating the NG tube with warm water can help dislodge the clog and clear the obstruction. Here is a step-by-step rationale:
1. Gather necessary supplies: warm water, syringe, and towel.
2. Disconnect the tube from the feeding pump.
3. Draw up warm water into the syringe.
4. Gently insert the syringe into the tube and slowly push the warm water to flush out the clog.
5. Repeat the process as needed until the tube is clear.
Other choices are incorrect:
B: Advancing the tube into the intestine can be dangerous and should not be done without proper medical supervision.
C: Applying intermittent suction may not effectively clear the clog and could potentially worsen the situation.
D: Using a 30-ml syringe to withdraw the obstruction may not be as effective as irrigating with warm water.
A hiatal hernia is a weakness in the _____ muscle, which allows a portion of the digestive tract to enter the thoracic cavity.
- A. diaphragm
- B. stomach
- C. intestinal
- D. thoracic wall
Correct Answer: A
Rationale: The correct answer is A: diaphragm. The diaphragm is a dome-shaped muscle that separates the thoracic and abdominal cavities. A hiatal hernia occurs when the stomach pushes through the opening in the diaphragm known as the esophageal hiatus, allowing a portion of the stomach to enter the thoracic cavity. The other choices, B: stomach, C: intestinal, and D: thoracic wall, are incorrect because a hiatal hernia specifically involves a weakness in the diaphragm muscle, not in these other structures. The stomach is the organ affected by the hernia, but the primary issue lies in the diaphragm's weakness. The intestinal and thoracic wall choices are not directly related to the development of a hiatal hernia.
This region of the large intestine has a simple columnar epithelium in its tunica mucosa, smooth muscle in its tunica muscularis, and epiploic appendages attach to its outer surface. This region is called the
- A. cecum.
- B. colon.
- C. rectum.
- D. anal canal.
Correct Answer: B
Rationale: The correct answer is B: colon. The colon is characterized by having a simple columnar epithelium in its tunica mucosa, smooth muscle in its tunica muscularis, and epiploic appendages attached to its outer surface. The cecum (A) is a pouch-like structure at the beginning of the large intestine. The rectum (C) is the final segment of the large intestine before the anal canal (D). The anal canal is lined by stratified squamous epithelium, not simple columnar epithelium like the colon.
Organs that lie outside the abdominal cavity such as the duodenum, pancreas, urinary bladder and rectum are
- A. covered with parietal peritoneum.
- B. covered with visceral peritoneum.
- C. retroperitoneal.
- D. covered with serous membranes
Correct Answer: C
Rationale: The correct answer is C: retroperitoneal. Organs like the duodenum, pancreas, urinary bladder, and rectum are considered retroperitoneal because they lie behind the parietal peritoneum, which lines the abdominal cavity. They are not completely covered by visceral peritoneum (B) as they are not suspended in the abdominal cavity. They are not covered by parietal peritoneum (A) as this layer lines the abdominal wall. While these organs are covered with serous membranes (D), the defining characteristic is their location behind the peritoneum, making option C the most accurate choice.