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What is the priority action when caring for a patient with acute cholecystitis and suspected perforation?
- A. Prepare for surgery immediately.
- B. Administer IV fluids and pain medication.
- C. Administer antibiotics as ordered.
- D. Monitor the patient's vital signs closely for signs of shock.
Correct Answer: A
Rationale: The correct answer is A: Prepare for surgery immediately. This is the priority action because acute cholecystitis with suspected perforation is a surgical emergency that requires prompt intervention to prevent serious complications such as sepsis. Surgery is needed to remove the inflamed gallbladder and repair any perforation. Administering IV fluids, pain medication, and antibiotics are important supportive measures but do not address the underlying issue. Monitoring vital signs is also crucial, but immediate surgical intervention takes precedence in this critical situation.
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Which phase of deglutition involves contraction of the longitudinal muscle layer of the muscularis?
- A. voluntary phase
- B. buccal phase
- C. pharyngeal phase
- D. esophageal phase
Correct Answer: D
Rationale: The correct answer is D: esophageal phase. During the esophageal phase of deglutition, the longitudinal muscle layer of the muscularis contracts to help propel the bolus of food downwards towards the stomach. This contraction occurs in a coordinated manner to create peristaltic waves that push the food along the esophagus. In contrast, the voluntary phase (A) involves the conscious initiation of swallowing, the buccal phase (B) involves the tongue pushing the bolus towards the pharynx, and the pharyngeal phase (C) involves the initiation of the swallowing reflex and closure of the airway to prevent aspiration.
In planning a treatment and prevention program of chronic fecal incontinence for an elderly client, which intervention should you try first?
- A. Administer a glycerin suppository 15 minutes before evacuation time.
- B. Insert a rectal tube at specified intervals each day.
- C. Assist the client to the bedpan or toilet 30 minutes after meals.
- D. Use incontinence briefs or adult-sized diapers.
Correct Answer: C
Rationale: The correct answer is C: Assist the client to the bedpan or toilet 30 minutes after meals. This intervention is appropriate as it aligns with the natural physiological process of bowel movements after meals, increasing the likelihood of successful evacuation. This timing can help establish a routine and promote regular bowel movements, potentially reducing episodes of fecal incontinence.
Choice A is incorrect because administering a glycerin suppository may not address the underlying cause of fecal incontinence and may not promote regular bowel movements. Choice B is incorrect as inserting a rectal tube is an invasive intervention that should only be considered after less invasive methods have been exhausted. Choice D is incorrect as using incontinence briefs or adult-sized diapers only manages the symptoms without addressing the root cause or promoting bowel regularity.
Atrophy of the gastric mucosal glands is likely to result in:
- A. Diminished digestion of starch
- B. Failure of digestion and absorption of proteins
- C. High gastrin levels in the blood
- D. High secretin levels in the blood
Correct Answer: B
Rationale: The correct answer is B: Failure of digestion and absorption of proteins. Atrophy of gastric mucosal glands leads to decreased production of hydrochloric acid and pepsin, essential for protein digestion. This results in impaired breakdown of proteins, leading to failure of digestion and absorption. Choice A is incorrect as starch digestion primarily occurs in the mouth and small intestine. Choice C is incorrect because high gastrin levels are associated with increased acid production. Choice D is incorrect as secretin is not directly involved in protein digestion.
A 22-year-old patient calls the outpatient clinic complaining of nausea and vomiting and right lower abdominal pain. What should the nurse advise the patient to do?
- A. Use a heating pad to relax the muscles at the site of the pain.
- B. Drink at least 2 quarts of juice to replace the fluid lost in vomiting.
- C. Take a laxative to empty the bowel before examination at the clinic.
- D. Have the symptoms evaluated by a health care provider right away.
Correct Answer: D
Rationale: The correct answer is D because the patient is experiencing symptoms that could indicate appendicitis, a serious condition that requires immediate medical attention. Nausea, vomiting, and right lower abdominal pain are classic signs of appendicitis. Advising the patient to have the symptoms evaluated by a healthcare provider right away is crucial to prevent potential complications like a ruptured appendix.
Choice A is incorrect because using a heating pad may worsen the condition if it is indeed appendicitis. Choice B is incorrect because drinking juice may not address the underlying cause of the symptoms. Choice C is incorrect because taking a laxative is not recommended as it could potentially aggravate the condition.
In summary, choice D is the correct answer as it prioritizes the patient's health and safety by seeking prompt medical evaluation for the concerning symptoms.
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.