Nokea
What is the most common cause of secondary protein-calorie malnutrition in the United States?
- A. The unavailability of foods high in protein
- B. A lack of knowledge about nutritional needs
- C. A lack of money to purchase high-protein foods
- D. An alteration in ingestion absorption or metabolism
Correct Answer: D
Rationale: The correct answer is D because an alteration in ingestion, absorption, or metabolism can lead to secondary protein-calorie malnutrition. This can occur due to various medical conditions affecting the digestive system, such as malabsorption syndromes or metabolic disorders. The other choices are incorrect because the primary cause of secondary protein-calorie malnutrition in the US is not the unavailability of high-protein foods, lack of knowledge about nutritional needs, or lack of money to purchase such foods. These factors may contribute to malnutrition but are not the most common cause in this context.
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A patient who has chronic constipation asks the nurse about the use of psyllium (Metamucil). Which information will the nurse include in the response?
- A. Fiber-containing laxatives may reduce the absorption of fat-soluble vitamins.
- B. Dietary sources of fiber should be eliminated to prevent excessive gas formation.
- C. Use of this type of laxative to prevent constipation does not cause adverse effects.
- D. Large amounts of fluid should be taken to prevent impaction or bowel obstruction.
Correct Answer: D
Rationale: Rationale for Correct Answer D:
- Psyllium is a bulk-forming laxative that works by absorbing water in the intestines, forming a gel-like mass that helps with bowel movements.
- Taking large amounts of fluid is essential when using psyllium to prevent the gel-like mass from hardening and causing impaction or bowel obstruction.
- Adequate fluid intake is crucial for the safe and effective use of psyllium as a laxative.
Summary of Incorrect Choices:
- Choice A is incorrect because fiber-containing laxatives like psyllium do not directly impact the absorption of fat-soluble vitamins.
- Choice B is incorrect as dietary sources of fiber should not be eliminated entirely but rather balanced to prevent excessive gas.
- Choice C is incorrect as all medications, including laxatives, can have potential adverse effects; however, psyllium is generally well-tolerated when used appropriately.
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.
Which is not a feature of digestive motility?
- A. Peristalsis only involves forward movements
- B. Segmentation involves mechanical digestion of food
- C. Peristalsis is present in the oesophagus, stomach and small/large intestines
- D. Segmentation is present in the stomach, small and large intestines
Correct Answer: A
Rationale: The correct answer is A. Peristalsis involves coordinated waves of muscle contractions that propel food forward. However, peristalsis can also involve backward movements to help with mixing and digestion. Therefore, the statement that peristalsis only involves forward movements is incorrect. Segmentation involves mixing and breaking down food through contractions that occur in non-unidirectional patterns. Peristalsis can be found in the esophagus, stomach, and intestines, while segmentation is mainly present in the small intestine. Therefore, choices B, C, and D are incorrect based on the explanations provided.
Which of the following is an accessory organ of digestion?
- A. pancreas
- B. esophagus
- C. stomach
- D. small intestine
Correct Answer: A
Rationale: The correct answer is A: pancreas. The pancreas is an accessory organ of digestion because it produces digestive enzymes that help break down carbohydrates, fats, and proteins in the small intestine. It also secretes bicarbonate to neutralize stomach acid. The esophagus (B) is a part of the digestive tract but not an accessory organ. The stomach (C) and small intestine (D) are primary organs of digestion, not accessory organs.
A 40-year-old severely obese female patient with type 2 diabetes wants to lose weight. After learning about the surgical procedures
- A. she thinks a combination of restrictive and malabsorptive surgery would be best. Which procedure should the nurse teach her about?
- B. Lipectomy
- C. Roux-en-Y gastric bypass
- D. Adjustable gastric banding
Correct Answer: B
Rationale: The correct answer is B: Lipectomy. This procedure involves the removal of excess fat tissue, which can help the patient achieve weight loss. In contrast, options C and D are bariatric surgeries, which are not solely focused on fat removal and may not be suitable for this patient given her age and medical history. Option A, a combination of restrictive and malabsorptive surgery, may pose higher risks for complications in a severely obese patient with diabetes. Lipectomy is a more targeted and less invasive approach to weight loss, making it the most appropriate choice in this scenario.