Nokea
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.
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A male client with a recent history of rectal bleeding is being prepared for a colonoscopy. How should the nurse position the client for this test initially?
- A. Lying on the right side with legs straight
- B. Lying on the left side with knees bent
- C. Prone with the torso elevated
- D. Bent over with hands touching the floor
Correct Answer: B
Rationale: The correct answer is B: Lying on the left side with knees bent. This position allows for better visualization and access to the colon during the colonoscopy procedure. By lying on the left side, the client's colon is in a more optimal position for the scope to navigate through the colon. Additionally, bending the knees helps to relax the abdominal muscles and make the procedure more comfortable for the client.
Incorrect choices:
A: Lying on the right side with legs straight - This position does not provide optimal access to the colon and may make the procedure more difficult.
C: Prone with the torso elevated - This position is not suitable for a colonoscopy as it does not allow for proper access to the colon.
D: Bent over with hands touching the floor - This position is not recommended for a colonoscopy as it is not conducive to the procedure and may cause discomfort for the client.
The nurse is teaching a patient with diabetes about foot care. Which statement by the patient indicates that further teaching is needed?
- A. "I should wash my feet daily with warm water and mild soap."
- B. "I should inspect my feet daily for blisters, redness, or cuts."
- C. "I can use heating pads to warm my feet if they are cold."
- D. "I should trim my toenails straight across."
Correct Answer: C
Rationale: Correct Answer: C - "I can use heating pads to warm my feet if they are cold."
Rationale:
1. Using heating pads can cause burns or injuries due to reduced sensation in diabetic feet.
2. Patients with diabetes should avoid direct heat on their feet.
3. Optimal foot care for diabetics includes inspecting feet, washing with mild soap, and trimming nails correctly.
Summary:
A: Correct - Washing feet daily is recommended.
B: Correct - Inspecting feet daily is essential for early detection of issues.
C: Incorrect - Using heating pads can be harmful to diabetic feet.
D: Correct - Trimming toenails straight across is an appropriate practice.
What is the primary function of the large intestine?
- A. absorbing nutrients
- B. absorbing water and electrolytes
- C. digesting proteins
- D. secreting digestive enzymes
Correct Answer: B
Rationale: The primary function of the large intestine is to absorb water and electrolytes from the indigestible food residue passed from the small intestine. This absorption process helps in forming solid waste (feces) and maintaining body fluid balance. Absorbing nutrients (Option A) primarily occurs in the small intestine. Digesting proteins (Option C) mainly takes place in the stomach and small intestine. The secretion of digestive enzymes (Option D) also primarily occurs in the stomach and small intestine, not in the large intestine. Therefore, the correct answer is B.
The presence of bilirubin in bile is important because:
- A. It gives bile its color
- B. It leads to production of stercobilinogen in the intestine
- C. It facilitates absorption of lipids
- D. It gives faces their color
Correct Answer: A
Rationale: The correct answer is A: It gives bile its color. Bilirubin is a pigment produced from the breakdown of hemoglobin in the liver, giving bile its characteristic yellow-green color. This is important for bile to aid in the emulsification and digestion of fats. Choices B and D are incorrect as stercobilinogen is produced from bilirubin in the intestine, contributing to stool color, not bile color. Choice C is incorrect as bile salts, not bilirubin, facilitate the absorption of lipids in the small intestine.
Which of the following characterizes the biologic nature of carcinoid tumors (argentaffinomas)?
- A. benign but produce systemic symptoms
- B. production of systemic symptoms when they metastasize to the liver
- C. especially malignant when primary in the appendix
- D. production of jejunal ulceration due to gastrin elaboration
Correct Answer: B
Rationale: Step-by-step rationale for why choice B is correct:
1. Carcinoid tumors can produce systemic symptoms due to the release of bioactive substances.
2. Metastasis to the liver can lead to the production of systemic symptoms like flushing and diarrhea.
3. This systemic symptom production is a characteristic feature of carcinoid tumors.
4. Choice B accurately describes the biologic nature of carcinoid tumors in relation to systemic symptoms.
Summary of why other choices are incorrect:
A: Carcinoid tumors can be malignant and produce systemic symptoms, so they are not always benign.
C: Carcinoid tumors originating in the appendix are typically associated with a more favorable prognosis.
D: Jejunal ulceration due to gastrin elaboration is more commonly seen in gastrinomas, not carcinoid tumors.