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What condition should the nurse anticipate when caring for a patient with a history of a total gastrectomy?
- A. Constipation
- B. Dehydration
- C. Elevated total serum cholesterol
- D. Cobalamin (vitamin B ) deficiency
Correct Answer: D
Rationale: The correct answer is D: Cobalamin (vitamin B12) deficiency. After a total gastrectomy, the patient lacks the intrinsic factor needed for vitamin B12 absorption in the ileum, leading to deficiency. This can result in megaloblastic anemia, neurological symptoms, and fatigue.
A: Constipation is not typically associated with total gastrectomy.
B: Dehydration may occur postoperatively but is not a specific consequence of total gastrectomy.
C: Elevated total serum cholesterol is not a direct effect of total gastrectomy.
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What problem should the nurse assess the patient for if the patient was on prolonged antibiotic therapy?
- A. Coagulation problems
- B. Impaired absorption of amino acids
- C. Elevated serum ammonia levels
- D. Increased mucus and bicarbonate secretion
Correct Answer: C
Rationale: The correct answer is C: Elevated serum ammonia levels. Prolonged antibiotic therapy can lead to disruption of normal gut flora, causing overgrowth of ammonia-producing bacteria. Elevated serum ammonia levels can indicate hepatic encephalopathy, a serious condition that requires immediate intervention. Coagulation problems (A) are more commonly associated with liver disease or vitamin deficiencies. Impaired absorption of amino acids (B) is typically seen in conditions like celiac disease or gastrointestinal disorders, not specifically related to prolonged antibiotic use. Increased mucus and bicarbonate secretion (D) are not directly related to prolonged antibiotic therapy, but rather to respiratory or gastrointestinal conditions.
A 25-yr-old male patient calls the clinic reporting diarrhea for 24 hours. Which action should the nurse take first?
- A. Inform the patient that testing of blood and stools will be neede
- C. Suggest that the patient drink clear liquid fluids with electrolytes.
- D. Ask the patient to describe the stools and any associated symptoms.
Correct Answer: D
Rationale: The correct answer is D because asking the patient to describe the stools and associated symptoms helps the nurse gather important information for assessment. Understanding the frequency, consistency, color, and presence of blood in the stools can help determine the severity and potential causes of diarrhea. This information guides the nurse in deciding the appropriate next steps for care. Option A is incorrect as testing should be based on assessment findings. Option C is premature without assessing the patient first. Option B lacks relevance to the assessment process.
Treatment of the patient with appendicitis includes:
- A. Transfusion to replace blood loss.
- B. Bowel prep for cleansing.
- C. Surgical removal of appendix.
- D. Medications to lower pH within the stomach.
Correct Answer: C
Rationale: The correct answer is C: Surgical removal of appendix. Appendicitis is inflammation of the appendix, which requires surgical intervention (appendectomy) to prevent rupture and potential life-threatening complications. Transfusion (A) is not a standard treatment for appendicitis unless severe bleeding occurs post-surgery. Bowel prep (B) is unnecessary for appendicitis treatment as it is not related to colon cleansing. Medications to lower stomach pH (D) are used to treat conditions like acid reflux, not appendicitis. In summary, surgical removal of the inflamed appendix is the definitive treatment for appendicitis to prevent complications.
When assessing a client for acute pancreatitis, which of the following symptoms will the nurse observe?
- A. Increased thirst and urination
- B. Hypertension and nausea
- C. Rapid breathing and pulse rate
- D. Frothy, foul-smelling stools
Correct Answer: C
Rationale: The correct answer is C: Rapid breathing and pulse rate. In acute pancreatitis, inflammation of the pancreas can lead to systemic complications, including respiratory distress and tachycardia. This occurs due to the release of inflammatory mediators affecting the respiratory and cardiovascular systems. Increased thirst and urination (Choice A) are more indicative of diabetes or renal issues. Hypertension and nausea (Choice B) are not typical symptoms of acute pancreatitis. Frothy, foul-smelling stools (Choice D) are more likely linked to malabsorption disorders rather than acute pancreatitis. Rapid breathing and pulse rate are key signs that indicate the severity of the condition and the need for prompt intervention.
Concerning saliva:
- A. its secretion is under neural control only.
- B. its secretion is under hormonal control only.
- C. it is alkaline.
- D. Contains enzymes that digest proteins.
Correct Answer: C
Rationale: Step-by-step rationale:
1. Saliva is slightly acidic, not alkaline.
2. The secretion of saliva is under both neural and hormonal control.
3. Saliva contains enzymes that digest carbohydrates, not proteins.
4. Therefore, choice C is correct as it provides accurate information about the alkalinity of saliva.