Nokea
Which of the following tests is contraindicated for pregnant women?
- A. Barium enema
- B. Barium swallow
- C. Radionuclide imaging
- D. Gallbladder series test
Correct Answer: C
Rationale: The correct answer is C: Radionuclide imaging. This test involves exposing the patient to radiation, which can be harmful to the developing fetus. Pregnant women should avoid unnecessary exposure to radiation to prevent potential harm to the baby.
A: Barium enema and B: Barium swallow involve the use of contrast material that is generally considered safe during pregnancy as it does not expose the fetus to radiation.
D: Gallbladder series test, such as ultrasound or MRI, are also safe for pregnant women as they do not involve radiation exposure.
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What is a common complication following a laparoscopic cholecystectomy?
- A. Bile leak
- B. Wound infection
- C. Deep vein thrombosis
- D. Pulmonary embolism
Correct Answer: A
Rationale: The correct answer is A: Bile leak. After a laparoscopic cholecystectomy, bile leak is a common complication due to injury to the bile ducts during surgery. This can lead to abdominal pain, infection, and other serious complications. Wound infection (B) is less common in laparoscopic surgeries. Deep vein thrombosis (C) and pulmonary embolism (D) are more associated with prolonged immobility post-surgery, which is less of a concern in laparoscopic cholecystectomy.
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.
The nurse is teaching a client about sexual modifications for clients with an ostomy. Which of the following strategies would the nurse suggest when anticipating sexual activity?
- A. Leave the stoma open to air and cover with a towel.
- B. Instruct the client to limit foods that activate the bowel.
- C. Bathe and apply a fresh pouch after having sex.
- D. Consult with members of a local ostomy support group.
Correct Answer: B
Rationale: The correct answer is B because limiting foods that activate the bowel can help reduce the chances of embarrassing situations during sexual activity. Certain foods can cause gas or increase stool output, which may affect the client's confidence and comfort. Leaving the stoma open to air and covering with a towel (choice A) is not recommended during sexual activity as it may lead to odor and potential leakage. Bathing and applying a fresh pouch after sex (choice C) is important for hygiene but does not directly address preparation for sexual activity. Consulting with an ostomy support group (choice D) is beneficial for emotional support but does not specifically address strategies for anticipating sexual activity.
Water transport can occur from the lumen of the intestine to the blood stream, or from the blood stream to the intestinal lumen. Which single statement about this phenomenon, below, is actually correct?
- A. A 'flip-flop' mechanism efficiently transports water directly across the enterocyte membrane
- B. Water flows into the gut from the mucosa, during digestion of starch and protein, in order to reduce luminal osmolality
- C. Water is mostly absorbed by movement between the cells lining the gut (enterocytes) via tight junctions
- D. Dietary intake of water is always greater than water movement in the small intestine
Correct Answer: C
Rationale: The correct answer is C because water is indeed mostly absorbed by movement between the cells lining the gut (enterocytes) via tight junctions. This is known as paracellular transport. Water moves through the spaces between the cells due to osmotic gradients and is then taken up by blood vessels. A: The 'flip-flop' mechanism is not a recognized mechanism for water transport in the intestine. B: Water does not flow into the gut from the mucosa during digestion, rather it moves from the gut lumen into the blood. D: Dietary intake of water can vary and may not always be greater than water movement in the small intestine.
When the stomach is empty, it folds up into wrinkles called:
- A. shincters
- B. bolus
- C. rugae
- D. chyme
Correct Answer: C
Rationale: The correct answer is C: rugae. When the stomach is empty, it folds up into wrinkles called rugae. These folds allow the stomach to expand when food is consumed and contract when it is empty. Shincters (A) are muscular valves that control the flow of food in and out of the stomach, not the folds of the stomach itself. Bolus (B) refers to a small rounded mass of a substance, typically food that has been chewed and is ready to be swallowed, not the wrinkles of the stomach. Chyme (D) is the semi-fluid mass of partly digested food that is expelled by the stomach into the small intestine, not the folds of the stomach.