Nokea
Which manifestations may be seen in the patient with cirrhosis related to esophageal varices?
- A. Jaundice, peripheral edema, and ascites from increased intrahepatic pressure and dysfunction
- B. Loss of the small bile ducts and cholestasis and cirrhosis in patients with other autoimmune disorders
- C. Development of collateral channels of circulation in inelastic, fragile esophageal veins as a result of portal hypertension
- D. Scarring and nodular changes in the liver lead to compression of the veins and sinusoids, causing resistance of blood flow through the liver from the portal vein
Correct Answer: C
Rationale: Esophageal varices are caused by the development of collateral channels of circulation in the fragile, inelastic esophageal veins due to portal hypertension in cirrhosis.
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Urea is synthesized by the liver following _____ metabolism.
- A. carbohydrate
- B. protein
- C. lipid
- D. nucleic acid
Correct Answer: B
Rationale: The correct answer is B: protein. Urea is a waste product formed during the breakdown of proteins in the liver. Amino acids from protein metabolism are deaminated, leading to the formation of ammonia, which is then converted to urea in the urea cycle. Carbohydrates are not directly involved in urea synthesis. Lipids are primarily metabolized to produce energy and do not contribute to urea formation. Nucleic acids are broken down into nucleotides, not amino acids, and are not directly related to urea synthesis.
A patient has been on a 1000-calorie diet with a daily exercise routine. In 2 months
- A. the patient has lost 20 lb (9 kg) toward a goal of 50 lb (23 kg) but is now discouraged that no weight has been lost in the last 2 weeks. What should the nurse tell the patient about this?
- B. Plateaus where no weight is lost normally occur during a weight-loss program.
- C. A weight considered by the body to be most efficient for functioning has been reached.
- D. A return to former eating habits is the most common cause of not continuing to lose weight.
Correct Answer: A
Rationale: Weight loss plateaus are common as the body adapts to changes in diet and exercise. It is important to remain consistent and patient during this phase.
The tunica submucosa and mucosa of the stomach are thrown into large folds called
- A. epiploic appendages.
- B. rugae.
- C. plicae cirulares.
- D. villi.
Correct Answer: B
Rationale: The correct answer is B: rugae. Rugae are large folds in the tunica submucosa and mucosa of the stomach that allow for expansion when the stomach is full. Epiploic appendages (A) are fatty projections on the serosa of the large intestine. Plicae circulares (C) are circular folds in the small intestine for increasing surface area. Villi (D) are finger-like projections in the small intestine for absorption. Rugae specifically refer to the folds in the stomach lining, making them the correct answer.
The nurse is caring for a patient with chronic kidney disease. Which of the following laboratory results should the nurse prioritize?
- A. Potassium level of 3.5 mEq/L
- B. Blood urea nitrogen (BUN) level of 18 mg/dL
- C. Serum creatinine level of 4.0 mg/dL
- D. Hemoglobin level of 12 g/dL
Correct Answer: C
Rationale: The correct answer is C: Serum creatinine level of 4.0 mg/dL. This is prioritized as high serum creatinine indicates impaired kidney function in chronic kidney disease. Elevated creatinine levels suggest decreased glomerular filtration rate, which is crucial in monitoring kidney function. Option A (Potassium level of 3.5 mEq/L) may be important due to the risk of hyperkalemia in kidney disease, but it is not as critical as monitoring kidney function. Option B (BUN level of 18 mg/dL) is within normal range and typically fluctuates based on diet and hydration status. Option D (Hemoglobin level of 12 g/dL) is important but not the priority in this case.
During muscle contraction, local metabolites act to vasodilate arterioles supplying the working muscle(s). Which of the following would NOT contribute to a local vasodilation?
- A. an increase in carbon dioxide
- B. an increase in hydrogen ions
- C. an increase in oxygen
- D. none of the above contribute to vasodilation
Correct Answer: C
Rationale: The correct answer is C because an increase in oxygen does not contribute to local vasodilation during muscle contraction. Oxygen is typically consumed by working muscles and does not act as a vasodilator. On the other hand, increases in carbon dioxide and hydrogen ions lead to vasodilation by stimulating the release of vasodilatory substances. Choice D is incorrect because oxygen, in this context, does not contribute to vasodilation like carbon dioxide and hydrogen ions do.