The nurse is caring for multiple patients. The nurse determines that which patient has the highest risk for developing gallstones?
- A. A 37-year-old white man of normal weight on long-term corticosteroids for asthm
- B. A 42-year-old African American man of normal weight who has smoked for 25 years.
- C. A 46-year-old Indonesian woman who is under normal weight and has recently had radiation treatments.
- D. A 50-year-old obese Mexican American woman who has type 1 diabetes.
Correct Answer: D
Rationale: The correct answer is D because obesity and type 1 diabetes are known risk factors for developing gallstones. Obesity leads to increased cholesterol production in the liver, which can contribute to gallstone formation. Type 1 diabetes can also increase the risk of gallstones due to impaired gallbladder function. Both factors combined in the 50-year-old obese Mexican American woman put her at the highest risk for developing gallstones.
Choice A is less likely as long-term corticosteroid use for asthma is not a major risk factor for gallstones. Choice B, smoking, is a risk factor but not as significant as obesity and diabetes in this context. Choice C, recent radiation treatment and being underweight, are not as strongly associated with gallstone formation compared to obesity and diabetes.
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What is the function of the enteric nervous system?
- A. controlling voluntary movements
- B. regulating hormone secretion
- C. controlling digestion independently of the brain
- D. controlling respiratory functions
Correct Answer: C
Rationale: The correct answer is C because the enteric nervous system is a complex network of neurons that controls digestion independently of the brain. It regulates gastrointestinal functions such as peristalsis, secretion of digestive enzymes, and blood flow. This system can operate autonomously but is also influenced by the central nervous system. Choices A, B, and D are incorrect because the enteric nervous system is not responsible for controlling voluntary movements, regulating hormone secretion, or controlling respiratory functions.
A nurse is caring for a client who is receiving total parenteral nutrition (TPN). The nurse notices that the solution bag is almost empty and there is not another bag of TPN to administer. Which of the following IV solutions should the nurse administer until the next bag of TPN solution is available?
- A. 10% dextrose in water (D10W)
- B. 0.45% sodium chloride (0.45% NaCl)
- C. Lactated Ringer's solution
- D. 5% dextrose in lactated Ringer's solution (D5LR)
Correct Answer: A
Rationale: The correct answer is A: 10% dextrose in water (D10W). When a TPN bag is almost empty, abruptly stopping it can lead to hypoglycemia. Administering D10W provides a temporary source of glucose to prevent this. D10W is a hypertonic solution that delivers a high concentration of dextrose for energy. Option B (0.45% NaCl) is hypotonic and lacks the necessary glucose content. Option C (Lactated Ringer's solution) does not contain glucose, and option D (D5LR) contains lactate, which may not be suitable for all patients. Administering D10W is the most appropriate choice to prevent hypoglycemia until the next bag of TPN is available.
Which one of the connective tissue sheets listed below consists of two layers of serous membranes with a thin layer of connective tissue between them and attaches to the small intestine?
- A. lesser omentum
- B. mesentery proper
- C. greater omentum
- D. falciform ligament
Correct Answer: B
Rationale: The correct answer is B: mesentery proper. The mesentery proper consists of two layers of serous membranes with a thin layer of connective tissue between them, and it attaches to the small intestine. This structure provides support and allows for movement of the small intestine.
A: The lesser omentum attaches the stomach to the liver, not the small intestine.
C: The greater omentum is a large apron-like structure that hangs down from the stomach and covers the intestines, but it does not specifically attach to the small intestine.
D: The falciform ligament attaches the liver to the diaphragm and anterior abdominal wall, not the small intestine.
Which enzyme is primarily responsible for the digestion of carbohydrates in the small intestine?
- A. Pepsin
- B. Lipase
- C. Amylase
- D. Trypsin
Correct Answer: C
Rationale: The correct answer is C: Amylase. Amylase is primarily responsible for digesting carbohydrates in the small intestine. It breaks down complex carbohydrates into simpler sugars like maltose and glucose. Pepsin (A) is a stomach enzyme that breaks down proteins, not carbohydrates. Lipase (B) digests fats, not carbohydrates. Trypsin (D) is a pancreatic enzyme that digests proteins, not carbohydrates. Amylase is the only enzyme among the choices that specifically targets carbohydrates for digestion in the small intestine.
The enzymes present in pancreatic juice are
- A. Amylase, Trypsinogen, Peptidase, Rennin
- B. Trypsinogen, Lipase, Amylase, Procarbo xypeptidase
- C. Peptidase, Pepsin, Amylase, Rennin
- D. Maltase, Amylase, Trypsinogen, Pepsin
Correct Answer: B
Rationale: The correct answer is B because pancreatic juice contains enzymes such as Trypsinogen, Lipase, Amylase, and Procarboxypeptidase. Trypsinogen helps in protein digestion, Lipase breaks down fats, Amylase digests carbohydrates, and Procarboxypeptidase aids in protein digestion.
Choice A is incorrect because it includes Rennin, which is not typically found in pancreatic juice. Choice C is incorrect because Pepsin is a stomach enzyme, not found in pancreatic juice. Choice D is incorrect because Maltase is an enzyme found in the small intestine, not in pancreatic juice.