Nokea
The stomach:
- A. Secretes pepsinogen, intrinsic factor and pepsin.
- B. Secretion increase following total vagus nerve cut.
- C. PH is always 7.2.
- D. Secretes intrinsic factor which is essential for vitamin B12 absorption.
Correct Answer: D
Rationale: The correct answer is D because the stomach secretes intrinsic factor, which is essential for vitamin B12 absorption in the small intestine. This is crucial for preventing vitamin B12 deficiency and maintaining neurological health. The other choices are incorrect because A is partially true but not the main function of the stomach, B is false as total vagus nerve cut decreases stomach secretion, and C is false as the stomach pH varies from acidic (around 1.5-3.5) depending on food intake.
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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.
An important nursing intervention for a patient with a small intestinal obstruction who has an NG tube is to
- A. offer ice chips to suck PRN.
- B. provide mouth care every 1 to 2 hours.
- C. irrigate the tube with normal saline every 8 hours.
- D. keep the patient supine with the head of the bed elevated 30 degrees.
Correct Answer: B
Rationale: The correct answer is B: provide mouth care every 1 to 2 hours. This is crucial to maintain oral hygiene and comfort for the patient with an NG tube to prevent complications like dry mouth and infection. Offering ice chips (choice A) may worsen the obstruction. Irrigating the tube with normal saline (choice C) can disrupt the bowel and is not recommended. Keeping the patient supine with the head of the bed elevated (choice D) is a general measure but not specific to NG tube care.
Mucosal necrosis is an essential part of:
- A. blind loop syndrome
- B. pseudomembranous enterocolitis
- C. both
- D. neither
Correct Answer: B
Rationale: The correct answer is B: pseudomembranous enterocolitis. Mucosal necrosis is a key characteristic of pseudomembranous enterocolitis, a condition caused by Clostridium difficile infection. The bacteria release toxins that lead to inflammation and damage to the mucosal lining of the intestines, resulting in mucosal necrosis. Blind loop syndrome (choice A) does not specifically involve mucosal necrosis, while pseudomembranous enterocolitis (choice B) does. Choice C is incorrect because only pseudomembranous enterocolitis involves mucosal necrosis. Choice D is incorrect as pseudomembranous enterocolitis does involve mucosal necrosis.
Infants' gastric juice contains
- A. nuclease, pepsinogen, lipase
- B. maltase, pepsinogen, rennin
- C. amylase, rennin, pepsinogen
- D. pepsinogen, lipase, rennin
Correct Answer: A
Rationale: The correct answer is A because infants' gastric juice contains nuclease, pepsinogen, and lipase. Nuclease helps in breaking down nucleic acids, pepsinogen is the precursor of pepsin which digests proteins, and lipase digests fats. This combination of enzymes is essential for the digestion of various macromolecules in infants.
Choice B is incorrect because maltase is an enzyme that breaks down maltose (a sugar), which is not typically found in gastric juice. Rennin is an enzyme that helps in digesting milk protein, which is more common in the stomach of newborn mammals, but not in human infants.
Choice C is incorrect because amylase is an enzyme that breaks down carbohydrates and is usually found in saliva, not gastric juice. Rennin and pepsinogen are not typically present in infants' gastric juice.
Choice D is incorrect because while pepsinogen and rennin are enzymes found in gastric juice, lip
Concerning deglutition (swallowing):
- A. Pharyngeal phase of swallowing is voluntary.
- B. Normally the lower esophageal sphincter (LES) is open.
- C. Dysphagia is caused by a lesion in the swallowing reflex.
- D. In the esophageal stage of swallowing, if the bolus is liquid it travels by peristalsis.
Correct Answer: C
Rationale: The correct answer is C because dysphagia, which is difficulty swallowing, can be caused by various factors such as neurological disorders affecting the swallowing reflex or physical obstructions in the esophagus. This is a key point in understanding the causes of swallowing difficulties.
Choice A is incorrect because the pharyngeal phase of swallowing is actually involuntary, not voluntary. Choice B is incorrect as the lower esophageal sphincter (LES) is normally closed to prevent acid reflux and only opens during swallowing. Choice D is incorrect because in the esophageal stage of swallowing, both liquid and solid boluses travel through the esophagus by peristalsis, not just liquid boluses.