Nokea
Where does the digestion of proteins begin?
- A. Mouth
- B. Stomach
- C. Small intestine
- D. Large intestine
Correct Answer: B
Rationale: The correct answer is B: Stomach. Protein digestion begins in the stomach where the enzyme pepsin is secreted. Pepsin breaks down proteins into smaller peptides. This process is aided by the acidic environment of the stomach. In contrast, the mouth primarily starts the digestion of carbohydrates through the enzyme salivary amylase. The small intestine is where further breakdown and absorption of nutrients occur, not the initial digestion of proteins. The large intestine is mainly responsible for absorbing water and electrolytes, not digestion.
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The liver combines a toxic by-product of amino acid metabolism, ammonia, with another waste product, carbon dioxide, to form the water-soluble ______, which is excreted in the kidneys.
- A. cholesterol
- B. bilirubin
- C. urea
- D. uric acid
Correct Answer: C
Rationale: Rationale: The correct answer is C: urea. Ammonia is toxic and needs to be converted into a less toxic form for excretion. The liver combines ammonia with carbon dioxide to form urea through the urea cycle. Urea is water-soluble and is excreted by the kidneys in urine. Cholesterol (A) is a lipid molecule, bilirubin (B) is a by-product of heme metabolism, and uric acid (D) is a by-product of purine metabolism. These molecules are not formed from the combination of ammonia and carbon dioxide and are not excreted in the kidneys.
A nurse is instructing a client who has GERD about positions that can help minimize the effects of reflux during sleep. Which of the following statements indicates to the nurse that the client understands the instructions?
- A. I will lie on my left side to sleep at night.'
- B. I will lie on my right side to sleep at night.'
- C. I will sleep on my back with my head flat.'
- D. I will sleep on my stomach with my head flat.'
Correct Answer: A
Rationale: The correct answer is A: "I will lie on my left side to sleep at night." This position helps prevent acid from flowing back into the esophagus due to the angle of the stomach in relation to the esophagus. Lying on the right side can worsen reflux. Sleeping on the back with the head flat can also worsen symptoms as gravity can allow acid to flow back up. Sleeping on the stomach with the head flat is not recommended as it can put pressure on the stomach, leading to increased reflux.
The patient has peritonitis, which is a major complication of appendicitis. What treatment will the nurse plan to include?
- A. Peritoneal lavage
- B. Peritoneal dialysis
- C. IV fluid replacement
- D. Increased oral fluid intake
Correct Answer: C
Rationale: The correct answer is C: IV fluid replacement. IV fluids are essential in managing peritonitis to maintain hydration and electrolyte balance. It helps to support the patient's circulation and prevent shock. Peritoneal lavage (choice A) is not typically used in the treatment of peritonitis. Peritoneal dialysis (choice B) is used for kidney failure, not peritonitis. Increased oral fluid intake (choice D) may not be sufficient in cases of peritonitis where IV fluids are needed for rapid rehydration and support.
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.
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.