Nokea
What treatment for acute cholecystitis will prevent further stimulation of the gallbladder?
- A. NPO with NG suction
- B. Incisional cholecystectomy
- C. Administration of antiemetics
- D. Administration of anticholinergics
Correct Answer: A
Rationale: The correct answer is A: NPO with NG suction. This treatment prevents further stimulation of the gallbladder by resting the digestive system and reducing the secretion of bile. NPO stands for "nothing by mouth," which reduces gallbladder contractions. NG suction removes stomach contents, preventing bile from reaching the gallbladder. Incisional cholecystectomy is a surgical removal of the gallbladder and not a preventive measure. Antiemetics help control nausea and vomiting but do not directly prevent gallbladder stimulation. Anticholinergics inhibit the parasympathetic nervous system but are not typically used to prevent gallbladder stimulation.
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The optimum pH for trypsin and chymotrypsin is about
- A. 1-3.
- B. 5-7.
- C. 7-9.
- D. 10-12.
Correct Answer: C
Rationale: The correct answer is C (7-9) because trypsin and chymotrypsin are proteolytic enzymes that function optimally in slightly basic environments. At pH 7-9, these enzymes maintain their structural integrity and catalytic activity. Choices A, B, and D are incorrect because trypsin and chymotrypsin are not acidic enzymes, so pH ranges 1-3 and 10-12 would denature and inactivate them, while pH 5-7 is still on the acidic side, not optimal for these enzymes.
The stomach:
- A. Secretes pepsinogen, intrinsic factor and pepsin.
- B. Secretion increase following total vagus nerve cut.
- C. PH is always 7.2.
- D. Secretes intrinsic factor which is essential for vitamin B12 absorption.
Correct Answer: D
Rationale: The correct answer is D because the stomach secretes intrinsic factor, which is essential for vitamin B12 absorption in the small intestine. This is crucial for preventing vitamin B12 deficiency and maintaining neurological health. The other choices are incorrect because A is partially true but not the main function of the stomach, B is false as total vagus nerve cut decreases stomach secretion, and C is false as the stomach pH varies from acidic (around 1.5-3.5) depending on food intake.
Which esophageal disorder is described as a precancerous lesion associated with GERD?
- A. Achalasia
- B. Barrett's esophagus
- C. Esophageal strictures
- D. Esophageal diverticula
Correct Answer: B
Rationale: Barrett's esophagus is the correct answer because it is a precancerous condition resulting from long-term GERD. The constant exposure to stomach acid causes changes in the esophageal lining, increasing the risk of esophageal cancer.
Achalasia (A) is a motility disorder characterized by difficulty swallowing due to impaired esophageal muscle movement. Esophageal strictures (C) are narrowing of the esophagus, commonly caused by chronic inflammation or scarring, but not directly associated with GERD. Esophageal diverticula (D) are outpouchings in the esophageal wall, not specifically linked to GERD or cancer risk.
The nurse is educating a group of older adults on ways to prevent falls. Which statement made by an older adult indicates the need for further teaching?
- A. "I will make sure that I wear my glasses when I walk outside."
- B. "I should make sure my home is free of clutter to prevent tripping."
- C. "I'll make sure I get up slowly from a sitting position to prevent dizziness."
- D. "I won't need to wear shoes in the house since I am only walking a short distance."
Correct Answer: D
Rationale: The correct answer is D. Walking barefoot increases the risk of slipping and falling, especially for older adults with balance issues. Wearing shoes indoors provides stability and reduces the risk of falls. Choices A, B, and C all demonstrate good fall prevention strategies by addressing vision, home safety, and orthostatic hypotension respectively.
Which is the only area that can digest a double sugar?
- A. jejunum
- B. stomach
- C. duodenum
- D. pancreas
Correct Answer: C
Rationale: The correct answer is C: duodenum. The duodenum is the first part of the small intestine where digestion of double sugars, like disaccharides, occurs. Enzymes such as sucrase, lactase, and maltase are secreted in the duodenum to break down double sugars into simple sugars for absorption. The other choices are incorrect because the stomach primarily digests proteins, the jejunum is mainly involved in nutrient absorption, and the pancreas secretes enzymes into the duodenum but does not directly digest double sugars.