Nokea
What information should be included in the dietary teaching for the patient following a Roux-en-Y gastric bypass?
- A. Avoid sugary foods and limit fluids to prevent dumping syndrome.
- B. Gradually increase the amount of food ingested to preoperative levels.
- C. Maintain a long-term liquid diet to prevent damage to the surgical site.
- D. Consume foods high in complex carbohydrates, protein, and fiber to add bulk to contents.
Correct Answer: A
Rationale: The correct answer is A: Avoid sugary foods and limit fluids to prevent dumping syndrome. After a Roux-en-Y gastric bypass, the patient's stomach size is reduced, making it important to avoid sugary foods that can cause rapid spikes in blood sugar and lead to dumping syndrome. Dumping syndrome occurs when food moves too quickly from the stomach to the small intestine, causing symptoms like nausea, vomiting, diarrhea, and weakness. Limiting fluids can also help prevent this by slowing down digestion. Choices B and C are incorrect as increasing food intake rapidly or maintaining a liquid diet long-term can be harmful post-surgery. Choice D is incorrect because consuming foods high in complex carbohydrates, protein, and fiber can be difficult for the patient to digest due to the altered anatomy.
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Salivary secretion is stimulated by
- A. the salivary nucleus only.
- B. the salivary nucleus and gastrin.
- C. gastrin only.
- D. the salivary nucleus and local reflexes in the tunica mucosa and submucosa.
Correct Answer: D
Rationale: The correct answer is D. Salivary secretion is stimulated by the salivary nucleus in the brainstem and local reflexes in the tunica mucosa and submucosa of the oral cavity. The salivary nucleus receives input from higher brain centers and initiates the salivary reflex. Local reflexes in the oral cavity, such as mechanical stimulation of the mucosa, also trigger salivary secretion. Gastrin, as mentioned in option B and C, is not directly involved in the stimulation of salivary secretion. Option A is incorrect as salivary secretion is not solely stimulated by the salivary nucleus. Option D encompasses the comprehensive stimulation pathways involved in salivary secretion.
A client with proctitis needs a rectal suppository. A senior nursing student assigned to this client tells you that she is afraid to insert the suppository because she has never done it before. What is the most appropriate action in supervising this student?
- A. You give the medication and report the student to the instructor.
- B. Ask the student to leave the clinical area for being unprepared.
- C. Reassign the client to an LPN/LVN.
- D. Show the student how to insert the suppository and talk to the instructor.
Correct Answer: D
Rationale: Correct Answer: D
Rationale:
1. Supervising students is part of the nursing role.
2. As a tutor, your responsibility is to guide and teach students.
3. Showing the student how to insert the suppository will help build their skills and confidence.
4. Talking to the instructor ensures proper supervision and support for the student's learning.
5. Reporting or dismissing the student is not constructive and goes against the principles of education and mentorship.
The three pairs of extrinsic salivary glands are:
- A. parotid sublingual and ethmoidal
- B. Parotid buccal and submaxillary
- C. Parotid sub mandibular and buccal
- D. Parotid Submandibular and sublingual
Correct Answer: D
Rationale: The correct answer is D because the extrinsic salivary glands are the parotid, submandibular, and sublingual glands. The parotid gland is located near the ear, the submandibular gland is under the mandible, and the sublingual gland is under the tongue.
A is incorrect because the ethmoidal gland is not an extrinsic salivary gland. B is incorrect because the buccal gland is not an extrinsic salivary gland. C is incorrect because the buccal gland is not an extrinsic salivary gland; it is a minor salivary gland located in the cheek.
What is the function of bile salts?
- A. emulsifying fats
- B. breaking down carbohydrates
- C. activating pepsin
- D. digesting proteins
Correct Answer: A
Rationale: The correct answer is A: emulsifying fats. Bile salts help emulsify fats by breaking them into smaller droplets, increasing the surface area for enzymes to act upon during digestion. This aids in the absorption of fats in the small intestine. Choices B, C, and D are incorrect because bile salts do not have a direct role in breaking down carbohydrates (choice B), activating pepsin (choice C), or digesting proteins (choice D). These functions are carried out by other digestive enzymes in the gastrointestinal tract.
The nurse caring for an 80-year-old woman who is undergoing extensive bowel preparation for a colonoscopy. The nurse should most closely monitor the patient for which potential complication?
- A. Diarrhea
- B. Metabolic acidosis
- C. Fatigue
- D. Dyspnea
Correct Answer: B
Rationale: The correct answer is B: Metabolic acidosis. During bowel preparation for a colonoscopy, the patient may experience fluid and electrolyte imbalances, leading to metabolic acidosis. The nurse should closely monitor for signs such as confusion, weakness, and increased respiratory rate. Diarrhea (choice A) is expected during bowel preparation but does not directly lead to metabolic acidosis. Fatigue (choice C) and dyspnea (choice D) are less likely complications of bowel preparation and do not directly relate to metabolic acidosis.