Nokea
Which of the following diagnostic tests can be given to a client who cannot retain dye tablets given to test his gallbladder?
- A. Oral cholecystography
- B. Cholangiography
- C. Barium enema
- D. Barium swallow
Correct Answer: B
Rationale: Cholangiography is used as an alternative to oral cholecystography when a client cannot retain the dye tablets.
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Regarding deglutition (swallowing):
- A. Pharyngeal phase is voluntary.
- B. Is controlled by a center in the medulla oblongata.
- C. Readily occurs with an open mouth.
- D. Buccal phase is accompanied by apnea.
Correct Answer: B
Rationale: The correct answer is B because swallowing is controlled by the swallowing center in the medulla oblongata. This center coordinates the complex sequence of muscle contractions involved in swallowing, ensuring food moves from the mouth to the esophagus without entering the airway. The pharyngeal phase is actually involuntary, not voluntary (Choice A). Swallowing usually occurs with a closed mouth, not an open one (Choice C). Additionally, the buccal phase is not accompanied by apnea; breathing typically continues during this phase (Choice D). Therefore, the correct answer is B due to the central control of swallowing in the medulla oblongata.
Which of the following is correct regarding the cells of the gastric pit?
- A. Mucous cells are enteroendocrine
- B. G cells are exocrine
- C. D cells secrete histamine
- D. G cells secrete histamine
Correct Answer: D
Rationale: The correct answer is D because G cells in the gastric pit secrete gastrin, not histamine. Gastrin stimulates the release of hydrochloric acid in the stomach. Mucous cells are not enteroendocrine, so A is incorrect. G cells are not exocrine, making B incorrect. D cells secrete somatostatin, not histamine, so C is also incorrect.
A nurse is providing care for a client who had a laparoscopic cholecystectomy. Which of the following is an appropriate nursing action?
- A. Place the client in a supine position postoperatively.
- B. Encourage ambulation once fully awake.
- C. Offer the client ice cream postoperatively.
- D. Instruct the client not to lift over 4.5 kg (10 lb).
Correct Answer: D
Rationale: The correct answer is D: Instruct the client not to lift over 4.5 kg (10 lb).
Rationale:
1. Lifting restrictions are crucial post-laparoscopic cholecystectomy to prevent strain on the surgical site.
2. Lifting heavy objects can lead to complications such as incisional hernias or wound dehiscence.
3. Following lifting restrictions aids in the proper healing of the surgical incisions.
4. Placing the client in a supine position (A) may be uncomfortable due to gas used during surgery. Ambulation (B) is important but not the priority immediately post-op. Offering ice cream (C) is not relevant to postoperative care.
Which information will the nurse provide for a patient with newly diagnosed gastroesophageal reflux disease (GERD)?
- A. Peppermint tea may reduce your symptoms.
- B. Keep the head of your bed elevated on blocks.
- C. You should avoid eating between meals to reduce acid secretion.
- D. Vigorous physical activities may increase the incidence of reflux.
Correct Answer: B
Rationale: The correct answer is B: Keep the head of your bed elevated on blocks. Elevating the head of the bed can help prevent stomach acid from flowing back into the esophagus during sleep, reducing nighttime symptoms of GERD. This position helps gravity keep the acid in the stomach.
A: Peppermint tea may actually worsen GERD symptoms as it can relax the lower esophageal sphincter, allowing acid to reflux back into the esophagus.
C: Avoiding eating between meals will not reduce acid secretion and may even lead to larger meals, which can trigger reflux symptoms.
D: Vigorous physical activities can worsen GERD symptoms by increasing intra-abdominal pressure, pushing stomach contents back up into the esophagus.
In summary, the correct answer is B because it directly addresses a practical measure to alleviate GERD symptoms during sleep, while the other choices do not effectively manage the condition.
Which neurotransmitter is involved in the regulation of many of the secretory cells of the gastric (stomach) mucosa?
- A. norepinephrine
- B. dopamine
- C. acetylcholine
- D. insulin
Correct Answer: C
Rationale: The correct answer is C: acetylcholine. Acetylcholine is involved in regulating secretory cells in the gastric mucosa by stimulating the release of gastric acid and enzymes. Norepinephrine and dopamine are not directly involved in gastric secretions. Insulin is a hormone involved in glucose metabolism, not gastric regulation. Acetylcholine's role in stimulating gastric secretions makes it the correct choice.