Nokea
The nurse is teaching a client about sexual modifications for clients with an ostomy. Which of the following strategies would the nurse suggest when anticipating sexual activity?
- A. Leave the stoma open to air and cover with a towel.
- B. Instruct the client to limit foods that activate the bowel.
- C. Bathe and apply a fresh pouch after having sex.
- D. Consult with members of a local ostomy support group.
Correct Answer: B
Rationale: The correct answer is B because limiting foods that activate the bowel can help reduce the chances of embarrassing situations during sexual activity. Certain foods can cause gas or increase stool output, which may affect the client's confidence and comfort. Leaving the stoma open to air and covering with a towel (choice A) is not recommended during sexual activity as it may lead to odor and potential leakage. Bathing and applying a fresh pouch after sex (choice C) is important for hygiene but does not directly address preparation for sexual activity. Consulting with an ostomy support group (choice D) is beneficial for emotional support but does not specifically address strategies for anticipating sexual activity.
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Which tissue layer provides for primary digestive motility?
- A. Mucosa
- B. Submucosa
- C. Mesentery (a fold of tissue that attaches organs to the body wall)
- D. Muscularis Mucosa
Correct Answer: D
Rationale: The correct answer is D: Muscularis Mucosa. This layer is responsible for primary digestive motility due to its smooth muscle fibers that contract to move food along the digestive tract. The other choices do not directly contribute to motility. A: Mucosa is the innermost layer involved in absorption. B: Submucosa provides support and contains blood vessels. C: Mesentery is a connective tissue that supports and attaches organs, but does not directly regulate motility.
Which of the following is not a component of saliva?
- A. Water
- B. Amylase
- C. Mucus
- D. Hydrochloric acid
Correct Answer: D
Rationale: The correct answer is D: Hydrochloric acid. Saliva is composed mainly of water, amylase (an enzyme that breaks down starch), and mucus. Hydrochloric acid is not a component of saliva; instead, it is a component of gastric juice produced in the stomach. It plays a role in the digestion of food in the stomach by lowering the pH level. Therefore, choice D is the correct answer as it does not belong to the components of saliva. Choices A, B, and C are incorrect as they are all components found in saliva.
Care for which of these clients is most appropriate to assign to the LPN/LVN, under the supervision of an RN?
- A. A client with oral cancer who is scheduled in the morning for glossectomy
- B. An obese client returned from surgery following a vertical banded gastroplasty
- C. A client with anorexia nervosa with muscle weakness and decreased urine output
- D. A client with intractable nausea and vomiting related to chemotherapy
Correct Answer: D
Rationale: The correct answer is D because the LPN/LVN can provide care for a client with intractable nausea and vomiting related to chemotherapy under the supervision of an RN. The LPN/LVN can administer prescribed antiemetic medications, monitor the client's response, assess for dehydration, and provide comfort measures. This task falls within the scope of practice for an LPN/LVN and does not require the advanced assessment and intervention skills of an RN.
Choice A is incorrect because a client undergoing a glossectomy for oral cancer requires complex post-operative care that is beyond the scope of practice for an LPN/LVN.
Choice B is incorrect because post-operative care for an obese client following a vertical banded gastroplasty involves monitoring for complications such as leaks or infections, which require the expertise of an RN.
Choice C is incorrect because a client with anorexia nervosa with muscle weakness and decreased urine output may have underlying medical issues that require an RN's assessment and intervention skills
When the stomach is empty, it folds up into wrinkles called:
- A. shincters
- B. bolus
- C. rugae
- D. chyme
Correct Answer: C
Rationale: The correct answer is C: rugae. When the stomach is empty, it folds up into wrinkles called rugae. These folds allow the stomach to expand when food is consumed and contract when it is empty. Shincters (A) are muscular valves that control the flow of food in and out of the stomach, not the folds of the stomach itself. Bolus (B) refers to a small rounded mass of a substance, typically food that has been chewed and is ready to be swallowed, not the wrinkles of the stomach. Chyme (D) is the semi-fluid mass of partly digested food that is expelled by the stomach into the small intestine, not the folds of the stomach.
A nurse is teaching a client about strategies to manage gastroesophageal reflux disease (GERD). Which of the following statements should the nurse include?
- A. Elevate the head of your bed by 18 inches.'
- B. Avoid snacking between meals.'
- C. Limit foods that are high in fiber.'
- D. Avoid eating 2 to 3 hours before bedtime.'
Correct Answer: D
Rationale: The correct answer is D: Avoid eating 2 to 3 hours before bedtime. This is because lying down after eating can worsen GERD symptoms by allowing stomach acid to flow back up into the esophagus. By avoiding eating close to bedtime, the client can reduce the risk of acid reflux.
A: Elevating the head of the bed helps reduce nighttime symptoms, but it is not the most essential strategy.
B: Avoiding snacking between meals can help, but the timing of meals is more crucial for managing GERD.
C: Limiting foods high in fiber is not directly related to managing GERD; it is more about avoiding trigger foods like citrus, caffeine, and fatty foods.