Nokea
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.
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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.
In preparing a client for a colonoscopy procedure, which task is most suitable to delegate to the nursing assistant?
- A. Explain the need for clear liquids 1-3 days prior to procedure.
- B. Reinforce NPO status 8 hours prior to procedure.
- C. Administer laxatives 1-3 days prior to procedure.
- D. Administer an enema the night before the procedure.
Correct Answer: B
Rationale: Step 1: Delegation Principle - The task should be within the nursing assistant's scope of practice.
Step 2: NPO reinforcement is a basic instruction that does not require clinical judgment.
Step 3: Nursing assistant can remind the client about NPO status without interpreting medical information.
Step 4: Administering laxatives (C) and enema (D) require clinical judgment and should be done by licensed staff.
Step 5: Explaining the need for clear liquids (A) involves providing medical information, not just a reminder.
The role of parietal cells is to:
- A. Secretes hydrogen ions and chloride ions into lumen and are responsible for maintaining the acidic pH
- B. alkaline mucous for shielding the epithelium from hydrochloric acid
- C. Secretes histamine which stimulates gastric acid secretion
- D. Secretes gastric lipase
Correct Answer: A
Rationale: The correct answer is A because parietal cells secrete hydrogen ions and chloride ions into the lumen, which combine to form hydrochloric acid, maintaining the acidic pH of the stomach essential for digestion. Option B is incorrect as alkaline mucous is produced by goblet cells, not parietal cells. Option C is incorrect as histamine is secreted by enterochromaffin-like cells, not parietal cells. Option D is incorrect as gastric lipase is primarily secreted by chief cells in the stomach.
Priority Decision: In instituting a bowel training program for a patient with fecal incontinence, what should the nurse first plan to do?
- A. Teach the patient to use a perianal pouch.
- B. Insert a rectal suppository at the same time every morning.
- C. Place the patient on a bedpan 30 minutes before breakfast.
- D. Assist the patient to the bathroom at the time of the patient's normal defecation.
Correct Answer: D
Rationale: The correct answer is D because assisting the patient to the bathroom at the time of their normal defecation helps establish a routine for bowel movements, which is crucial in bowel training. This step maximizes the chances of success by utilizing the body's natural cues. Teaching the patient to use a perianal pouch (A) does not address the underlying issue of incontinence. Inserting a rectal suppository (B) may provide temporary relief but does not promote long-term bowel control. Placing the patient on a bedpan (C) at a specific time does not actively involve the patient in the process of bowel training.
Using MyPlate as a guide, what changes could the nurse suggest to bring the man's diet more in line with nutrition recommendations?
- A. Increase fruits and vegetables
- B. Decrease protein intake
- C. Increase fat intake
- D. Increase calorie intake
Correct Answer: A
Rationale: The correct answer is A: Increase fruits and vegetables. MyPlate recommends filling half of your plate with fruits and vegetables. By suggesting this change, the nurse can help the man consume more essential nutrients, fiber, and antioxidants. This will improve his overall diet quality. Decreasing protein intake (B) may lead to inadequate protein consumption, which is essential for muscle health. Increasing fat intake (C) may lead to excess calorie intake and weight gain. Increasing calorie intake (D) may not be necessary and could lead to weight gain if not balanced with physical activity.