Nokea
These contractions occur 3 to 4 times a day and involve large parts of the transverse and descending colon. These contractions are called
- A. mass movements.
- B. haustral churning.
- C. the defecation reflex.
- D. teniae coli waves.
Correct Answer: A
Rationale: The correct answer is A: mass movements. Mass movements are strong contractions that occur 3 to 4 times a day, moving large amounts of fecal material through the colon. This process involves the transverse and descending colon, which aligns with the description provided in the question. Mass movements help propel waste towards the rectum for elimination.
Choice B, haustral churning, refers to the mixing and propelling actions that occur in the haustra of the colon, not involving large parts of the transverse and descending colon. Choice C, the defecation reflex, is the process that triggers the urge to defecate, not specific contractions involving the colon. Choice D, teniae coli waves, are contractions of the longitudinal muscles of the colon that create the haustra, not the strong propulsive contractions described in the question.
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Which of the following hormones stimulates the release of gastric acid?
- A. gastrin
- B. secretin
- C. insulin
- D. cholecystokinin
Correct Answer: A
Rationale: The correct answer is A: gastrin. Gastrin is a hormone produced by G cells in the stomach lining that stimulates the release of gastric acid. It acts directly on parietal cells to increase acid secretion. Secretin (B) stimulates pancreatic bicarbonate secretion, not gastric acid. Insulin (C) regulates blood sugar levels, not gastric acid secretion. Cholecystokinin (D) stimulates the release of bile from the gallbladder and pancreatic enzymes, not gastric acid.
What type of pain does the nurse expect a patient with an ulcer of the posterior portion of the duodenum to experience?
- A. Pain that occurs after not eating all day
- B. Back pain that occurs 2 to 4 hours following meals
- C. Midepigastric pain that is unrelieved with antacids
- D. High epigastric burning that is relieved with food intake
Correct Answer: B
Rationale: The correct answer is B: Back pain that occurs 2 to 4 hours following meals. This type of pain is characteristic of duodenal ulcers due to increased acid secretion post-meals. Pain occurs when acidic stomach contents enter the duodenum, stimulating pain receptors. Back pain is common as the ulcer is located in the posterior portion of the duodenum. Choices A, C, and D are incorrect as they do not correspond to the typical pain pattern of a duodenal ulcer. Choice A is more indicative of gastritis, Choice C is suggestive of peptic ulcer disease, and Choice D is more characteristic of gastric ulcers.
After several days of antibiotic therapy for pneumonia, an older hospitalized patient develops watery diarrheWhich action should the nurse take first?
- A. Notify the health care provider.
- B. Obtain a stool specimen for analysis.
- C. Teach the patient about hand washing.
- D. Place the patient on contact precautions.
Correct Answer: D
Rationale: The correct answer is D, placing the patient on contact precautions. This is important because the patient has developed watery diarrhea after antibiotic therapy, which could indicate a Clostridium difficile infection. Placing the patient on contact precautions helps prevent the spread of this highly contagious infection to other patients and healthcare workers. It is the first priority to ensure the safety of others in the healthcare setting.
A: Notifying the health care provider can be done after placing the patient on contact precautions.
B: Obtaining a stool specimen for analysis is important but should be done after initiating contact precautions.
C: Teaching the patient about hand washing is important for infection control but is not the first priority when dealing with a potential infectious disease outbreak.
In report, the nurse learns that the patient has a transverse colostomy. What should the nurse expect when providing care for this patient?
- A. Semiliquid stools with increased fluid requirements
- B. Liquid stools in a pouch and increased fluid requirements
- C. Formed stools with a pouch, needing irrigation, but no fluid needs
- D. Semiformed stools in a pouch with the need to monitor fluid balance
Correct Answer: A
Rationale: The correct answer is A: Semiliquid stools with increased fluid requirements. A transverse colostomy is located in the upper part of the colon, where stool consistency is more liquid. This type of colostomy typically produces semiliquid stools due to the shorter transit time in the colon, leading to increased fluid requirements to prevent dehydration.
Summary of other choices:
B: Liquid stools in a pouch and increased fluid requirements - Incorrect because transverse colostomies produce semiliquid stools, not entirely liquid.
C: Formed stools with a pouch, needing irrigation, but no fluid needs - Incorrect as transverse colostomies do not produce formed stools, and fluid intake is necessary.
D: Semiformed stools in a pouch with the need to monitor fluid balance - Incorrect because transverse colostomies produce semiliquid stools, not semiformed, and increased fluid intake is needed.
Bilateral ovarian metastases presenting as tumor masses are most characteristically associated with carcinoma of the:
- A. esophagus
- B. stomach
- C. small intestine
- D. appendix
Correct Answer: B
Rationale: The correct answer is B, stomach. Ovarian metastases from gastric carcinoma are commonly bilateral due to the close anatomical relationship between the stomach and ovaries. Stomach cancer frequently spreads to the ovaries through direct extension or lymphatic dissemination. In contrast, esophageal, small intestine, and appendix carcinomas less commonly metastasize to the ovaries, making choices A, C, and D less likely. Thus, the characteristic bilateral ovarian metastases are most commonly associated with carcinoma of the stomach.