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Which is most characteristic of carcinoma of the cecum or right colon (in contrast to carcinoma of the rectum)?
- A. anemia
- B. associated polyposis
- C. bowel obstruction
- D. diarrhea
Correct Answer: A
Rationale: The correct answer is A: anemia. Carcinoma of the cecum or right colon often presents with chronic blood loss, leading to iron deficiency anemia. This is due to the longer transit time in the right colon allowing for more time for blood to be lost and for the iron in the blood to be absorbed. Choices B, C, and D are less characteristic of carcinoma of the cecum or right colon. Polyposis is more commonly associated with familial adenomatous polyposis, bowel obstruction is more common in advanced stages regardless of location, and diarrhea is more commonly seen in rectal carcinomas due to irritation of the rectal mucosa.
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Which of the following mismatches pancreatic enzyme with its function?
- A. Proteolytic -> break down proteins
- B. Amylase -> break down carbohydrates
- C. Nuclease -> breaks down nucleic acids
- D. Pro-carboxypeptidase -> breaks down proteins
Correct Answer: D
Rationale: The correct answer is D because pro-carboxypeptidase is an inactive form of carboxypeptidase, which is involved in breaking down proteins. It is not a mismatch. A is correct as proteolytic enzymes indeed break down proteins. B is correct as amylase breaks down carbohydrates. C is correct as nuclease enzymes break down nucleic acids. Therefore, the mismatch is only seen in option D.
On examining a patient 8 hours after having surgery to create a colostomy, what should the nurse expect to find?
- A. Hyperactive, high-pitched bowel sounds
- B. A brick-red, puffy stoma that oozes blood
- C. A purplish stoma, shiny and moist with mucus
- D. A small amount of liquid fecal drainage from the stoma
Correct Answer: C
Rationale: The correct answer is C because 8 hours post colostomy surgery, a purplish stoma that is shiny and moist with mucus indicates adequate blood supply and tissue perfusion, which are signs of a healthy stoma. A is incorrect as hyperactive, high-pitched bowel sounds are not expected immediately post-surgery. B is incorrect as a brick-red, puffy stoma oozing blood could indicate poor perfusion. D is incorrect as liquid fecal drainage is not expected immediately post-surgery; it usually starts a few days later.
The major secretory product of the colon is
- A. bicarbonate ions.
- B. mucus.
- C. digestive enzymes.
- D. hydrochloric acid.
Correct Answer: B
Rationale: The correct answer is B: mucus. The colon secretes mucus to protect the lining from digestive enzymes and acids, aid in the passage of stool, and maintain proper intestinal function. Bicarbonate ions (A) are secreted in the pancreas to neutralize stomach acid. Digestive enzymes (C) are primarily secreted in the small intestine to break down nutrients. Hydrochloric acid (D) is secreted by the stomach to aid in digestion but not by the colon.
The ileocecal valve prevents chyme from entering the _____.
- A. large intestine
- B. small intestine
- C. stomach
- D. duodenum
Correct Answer: A
Rationale: The correct answer is A: large intestine. The ileocecal valve is located between the ileum (part of the small intestine) and the cecum (part of the large intestine). Its primary function is to prevent the backflow of contents from the large intestine into the small intestine, specifically preventing chyme from entering the large intestine prematurely. This allows for proper digestion and absorption of nutrients in the small intestine before the remaining waste material enters the large intestine for further processing. Choices B, C, and D are incorrect as the ileocecal valve specifically regulates the flow of material between the small and large intestines, not other parts of the digestive system such as the stomach or duodenum.
Priority Decision: During the treatment of the patient with bleeding esophageal varices, what is the most important thing the nurse should do?
- A. Prepare the patient for immediate portal shunting surgery.
- B. Perform guaiac testing on all stools to detect occult blood.
- C. Maintain the patient's airway and prevent aspiration of blood.
- D. Monitor for the cardiac effects of IV vasopressin and nitroglycerin.
Correct Answer: C
Rationale: Rationale: The correct answer is C because maintaining the patient's airway and preventing aspiration of blood is the top priority in a patient with bleeding esophageal varices. This is crucial to prevent respiratory compromise and potential life-threatening complications. Immediate portal shunting surgery (A) is not the priority as stabilizing the patient comes first. Guaiac testing (B) is not the priority as it does not address the immediate risk of airway obstruction. Monitoring cardiac effects (D) is important but not as critical as ensuring the patient's airway is secure.