What instruction should be given to a client scheduled for a gallbladder series test?
- A. To remain on a low-residue diet 1 to 2 days before the test
- B. To take a laxative the evening before the test
- C. Not to eat or drink until the test is complete
- D. To take cleansing enemas the morning of the test
Correct Answer: C
Rationale: The correct instruction for a client scheduled for a gallbladder series test is not to eat or drink until the test is complete. This is because the test requires fasting to ensure clear visualization of the gallbladder and surrounding structures. Eating or drinking could interfere with the results by causing gallbladder contraction or obscuring the images.
A) Instructing the client to remain on a low-residue diet is not necessary for this specific test and may not provide the required fasting.
B) Taking a laxative or cleansing enemas is not typically required for a gallbladder series test and can be unnecessary and may even be harmful.
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How should the nurse explain esomeprazole (Nexium) to a patient with recurring heartburn?
- A. It reduces gastroesophageal reflux by increasing the rate of gastric emptying.
- B. It neutralizes stomach acid and provides relief of symptoms in a few minutes.
- C. It coats and protects the lining of the stomach and esophagus from gastric acid.
- D. It treats gastroesophageal reflux disease by decreasing stomach acid production.
Correct Answer: D
Rationale: The correct answer is D because esomeprazole (Nexium) is a proton pump inhibitor that works by decreasing stomach acid production, thereby treating gastroesophageal reflux disease. This explanation is important for the patient to understand the mechanism of action of the medication.
Choice A is incorrect because esomeprazole does not increase the rate of gastric emptying; instead, it reduces acid production. Choice B is incorrect because esomeprazole does not neutralize stomach acid immediately; it takes a few days to reach its full effect. Choice C is incorrect because esomeprazole does not coat and protect the stomach and esophagus; it works by reducing acid production.
In summary, the correct answer is D because it accurately describes how esomeprazole works to manage recurring heartburn by decreasing stomach acid production, which is essential for treating gastroesophageal reflux disease.
Which enzyme is responsible for breaking down carbohydrates in the mouth?
- A. Amylase
- B. Protease
- C. Lipase
- D. Pepsin
Correct Answer: A
Rationale: The correct answer is A: Amylase. Amylase is an enzyme that specifically breaks down carbohydrates into sugars in the mouth. It is produced by both salivary glands and pancreas. Protease (B) breaks down proteins, Lipase (C) breaks down fats, and Pepsin (D) breaks down proteins in the stomach. Therefore, A is the correct answer for the enzyme responsible for breaking down carbohydrates in the mouth.
Mechanical digestion begins in the:
- A. mouth
- B. stomach
- C. small intestine
- D. large intestine
Correct Answer: A
Rationale: The correct answer is A: mouth. Mechanical digestion begins in the mouth where food is chewed and mixed with saliva, breaking down into smaller pieces for easier swallowing and digestion. This process increases the surface area of food for enzymes to act upon. The stomach (B) primarily performs chemical digestion, the small intestine (C) is where most chemical digestion and absorption occur, and the large intestine (D) is mainly responsible for water absorption and formation of feces. Thus, the mouth is the correct choice for the beginning of mechanical digestion.
Gastric secretions:
- A. Decrease when a person thinks of food.
- B. Contain a substance which is essential for absorption of vitamin B12 from terminal ileum.
- C. Contain HCL secreted by chief cells.
- D. Are essential for fat digestion and absorption.
Correct Answer: B
Rationale: Step-by-step rationale:
1. Gastric secretions contain intrinsic factor, essential for vitamin B12 absorption from the terminal ileum.
2. Intrinsic factor binds to vitamin B12 to facilitate its absorption.
3. Without intrinsic factor, vitamin B12 absorption is impaired, leading to pernicious anemia.
4. Therefore, choice B is correct.
Summary:
- Choice A is incorrect as gastric secretions increase, not decrease, when a person thinks of food.
- Choice C is incorrect as hydrochloric acid (HCl) is secreted by parietal cells, not chief cells.
- Choice D is incorrect as fat digestion primarily occurs in the small intestine with the help of pancreatic enzymes, not gastric secretions.
When obtaining a nursing history from the patient with colorectal cancer, the nurse should specifically ask the patient about
- A. dietary intake.
- B. sports involvement.
- C. environmental exposure to carcinogens.
- D. long-term use of nonsteroidal antiinflammatory drugs (NSAIDs).
Correct Answer: A
Rationale: The correct answer is A: dietary intake. This is crucial in colorectal cancer management as certain dietary factors can influence the risk of developing or exacerbating the condition. High intake of red and processed meats, low fiber intake, and obesity are known risk factors. Asking about dietary intake helps assess the patient's risk profile and allows for tailored interventions.
Explanation for other choices:
B: Sports involvement is not directly related to colorectal cancer risk factors.
C: Environmental exposure to carcinogens may be relevant in other types of cancer, but it is not a primary risk factor for colorectal cancer.
D: Long-term use of NSAIDs is more relevant in preventing colorectal cancer rather than obtaining a history from a patient already diagnosed with the condition.