Nokea
The physiology instructor is discussing the GI system with the pre-nursing class. What should the instructor describe as a major function of the GI tract?
- A. The breakdown of food particles into cell form for digestion
- B. The maintenance of fluid and acid-base balance
- C. The absorption into the bloodstream of nutrient molecules produced by digestion
- D. The control of absorption and elimination of electrolytes
Correct Answer: C
Rationale: Primary functions of the GI tract include the breakdown of food particles into molecular form for digestion; the absorption into the bloodstream of small nutrient molecules produced by digestion; and the elimination of undigested unabsorbed food stuffs and other waste products. Nutrients must be broken down into molecular form, not cell form. Fluid, electrolyte, and acid-base balance are primarily under the control of the kidneys.
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A patient presents at the walk-in clinic complaining of recurrent sharp stomach pain that is relieved by eating. The nurse suspects that the patient may have an ulcer. How would the nurse explain the formation and role of acid in the stomach to the patient?
- A. Hydrochloric acid is secreted by glands in the stomach in response to the actual or anticipated presence of food.
- B. As digestion occurs in the stomach, the stomach combines free hydrogen ions from the food to form acid.
- C. The body requires an acidic environment in order to synthesize pancreatic digestive enzymes; the stomach provides this environment.
- D. The acidic environment in the stomach exists to buffer the highly alkaline environment in the esophagus.
Correct Answer: A
Rationale: The stomach, which stores and mixes food with secretions, secretes a highly acidic fluid in response to the presence or anticipated ingestion of food. The stomach does not turn food directly into acid and the esophagus is not highly alkaline. Pancreatic enzymes are not synthesized in a highly acidic environment.
A medical patient's CA 19-9 levels have become available and they are significantly elevated. How should the nurse best interpret this diagnostic finding?
- A. The patient may have cancer, but other GI disease must be ruled out.
- B. The patient most likely has early-stage colorectal cancer.
- C. The patient has a genetic predisposition to gastric cancer.
- D. The patient has cancer, but the site is unknown.
Correct Answer: A
Rationale: CA 19-9 levels are elevated in most patients with advanced pancreatic cancer, but they may also be elevated in other conditions such as colorectal, lung, and gallbladder cancers; gallstones; pancreatitis; cystic fibrosis; and liver disease. A cancer diagnosis cannot be made solely on CA 19-9 results.
A nurse is caring for a newly admitted patient with a suspected GI bleed. The nurse assesses the patient's stool after a bowel movement and notes it to be a tarry-black color. This finding is suggestive of bleeding from what location?
- A. Sigmoid colon
- B. Upper GI tract
- C. Large intestine
- D. Anus or rectum
Correct Answer: B
Rationale: Blood shed in sufficient quantities in the upper GI tract will produce a tarry-black color (melena). Blood entering the lower portion of the GI tract or passing rapidly through it will appear bright or dark red. Lower rectal or anal bleeding is suspected if there is streaking of blood on the surface of the stool or if blood is noted on toilet tissue.
The nurse is providing health education to a patient scheduled for a colonoscopy. The nurse should explain that she will be placed in what position during this diagnostic test?
- A. In a knee-chest position (lithotomy position)
- B. Lying prone with legs drawn toward the chest
- C. Lying on the left side with legs drawn toward the chest
- D. In a prone position with two pillows elevating the buttocks
Correct Answer: C
Rationale: For best visualization, colonoscopy is performed while the patient is lying on the left side with the legs drawn up toward the chest. A knee-chest position, lying on the stomach with legs drawn to the chest, and a prone position with two pillows elevating the legs do not allow for the best visualization.
A nurse in a stroke rehabilitation facility recognizes that the brain regulates swallowing. Damage to what area of the brain will most affect the patient's ability to swallow?
- A. Temporal lobe
- B. Medulla oblongata
- C. Cerebellum
- D. Pons
Correct Answer: B
Rationale: Swallowing is a voluntary act that is regulated by a swallowing center in the medulla oblongata of the central nervous system. Swallowing is not regulated by the temporal lobe, cerebellum, or pons.