Nokea
The nurse is percussing a patient's abdomen and hears a dull thud in the right upper quadrant. This sound indicates that the nurse is percussing over which location?
- A. The liver
- B. The small intestine
- C. The stomach
- D. The lungs
Correct Answer: A
Rationale: The correct answer is A: The liver. When percussing the abdomen, a dull thud in the right upper quadrant indicates the presence of a solid organ like the liver. The liver is located in the right upper quadrant of the abdomen, making it the most likely source of the dull sound. The other choices are incorrect because the small intestine and stomach are hollow organs, which would produce a tympanic sound when percussed. The lungs are located in the thoracic cavity, not the abdominal cavity, so percussing over the lungs would not produce a sound in the right upper quadrant of the abdomen.
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An 82-year-old man is admitted with an acute attack of diverticulitis. What should the nurse include in his care?
- A. Monitor for signs of peritonitis.
- B. Treat with daily medicated enemas.
- C. Prepare for surgery to resect the involved colon.
- D. Provide a heating pad to apply to the left lower quadrant.
Correct Answer: A
Rationale: The correct answer is A: Monitor for signs of peritonitis. Peritonitis is a serious complication of diverticulitis that can result from a rupture of inflamed diverticula leading to abdominal infection. Monitoring for signs such as severe abdominal pain, rigidity, and fever is crucial for early detection and prompt intervention. Option B is incorrect as daily medicated enemas are not the standard treatment for diverticulitis. Option C is also incorrect as surgery is usually reserved for complicated cases or recurrent attacks. Option D is incorrect because applying a heating pad may exacerbate inflammation and is not recommended in diverticulitis management.
The liver combines a toxic by-product of amino acid metabolism, ammonia, with another waste product, carbon dioxide, to form the water-soluble ______, which is excreted in the kidneys.
- A. cholesterol
- B. bilirubin
- C. urea
- D. uric acid
Correct Answer: C
Rationale: Rationale: The correct answer is C: urea. Ammonia is toxic and needs to be converted into a less toxic form for excretion. The liver combines ammonia with carbon dioxide to form urea through the urea cycle. Urea is water-soluble and is excreted by the kidneys in urine. Cholesterol (A) is a lipid molecule, bilirubin (B) is a by-product of heme metabolism, and uric acid (D) is a by-product of purine metabolism. These molecules are not formed from the combination of ammonia and carbon dioxide and are not excreted in the kidneys.
The _____ nervous system division usually stimulates and promotes digestion.
- A. somatic
- B. sympathetic
- C. central
- D. parasympathetic
Correct Answer: D
Rationale: The correct answer is D: parasympathetic. The parasympathetic nervous system is responsible for rest and digest functions, including stimulating digestion. It slows heart rate, increases intestinal activity, and promotes the secretion of digestive enzymes. The somatic nervous system (A) controls voluntary movements, the sympathetic nervous system (B) is responsible for the fight or flight response, and the central nervous system (C) consists of the brain and spinal cord, serving as the main control center of the body.
In which part of the alimentary canal does most digestion occur?
- A. stomach
- B. proximal small intestine
- C. distal small intestine
- D. ascending colon
Correct Answer: B
Rationale: The correct answer is B: proximal small intestine. Most digestion occurs in the proximal small intestine because it is where the majority of enzymes are secreted to break down food. This section also has a large surface area for absorption of nutrients. The stomach primarily breaks down food with acids, while the distal small intestine and ascending colon focus on absorption of nutrients and water, respectively.
The patient has peritonitis, which is a major complication of appendicitis. What treatment will the nurse plan to include?
- A. Peritoneal lavage
- B. Peritoneal dialysis
- C. IV fluid replacement
- D. Increased oral fluid intake
Correct Answer: C
Rationale: The correct answer is C: IV fluid replacement. IV fluids are essential in managing peritonitis to maintain hydration and electrolyte balance. It helps to support the patient's circulation and prevent shock. Peritoneal lavage (choice A) is not typically used in the treatment of peritonitis. Peritoneal dialysis (choice B) is used for kidney failure, not peritonitis. Increased oral fluid intake (choice D) may not be sufficient in cases of peritonitis where IV fluids are needed for rapid rehydration and support.