Nokea
Which one of the connective tissue sheets listed below consists of two layers of serous membranes with a thin layer of connective tissue between them and attaches to the small intestine?
- A. lesser omentum
- B. mesentery proper
- C. greater omentum
- D. falciform ligament
Correct Answer: B
Rationale: The correct answer is B: mesentery proper. The mesentery proper consists of two layers of serous membranes with a thin layer of connective tissue between them, and it attaches to the small intestine. This structure provides support and allows for movement of the small intestine.
A: The lesser omentum attaches the stomach to the liver, not the small intestine.
C: The greater omentum is a large apron-like structure that hangs down from the stomach and covers the intestines, but it does not specifically attach to the small intestine.
D: The falciform ligament attaches the liver to the diaphragm and anterior abdominal wall, not the small intestine.
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The Mallory-Weiss syndrome refers to the occurrence of gastrointestinal hemorrhage as a result of:
- A. esophageal varices
- B. esophageal peptic ulcers
- C. mucosal tears at the esophagogastric junction
- D. iatrogenic perforation
Correct Answer: C
Rationale: The Mallory-Weiss syndrome is characterized by mucosal tears at the esophagogastric junction. This occurs due to forceful or prolonged vomiting causing the tears in the mucosa. Esophageal varices (A) are dilated veins in the esophagus typically associated with liver disease, not related to Mallory-Weiss syndrome. Esophageal peptic ulcers (B) are erosions in the lining of the esophagus caused by acid reflux or infection, not a characteristic of Mallory-Weiss syndrome. Iatrogenic perforation (D) refers to accidental perforation caused during a medical procedure, not related to Mallory-Weiss syndrome. Therefore, the correct answer is C as it directly correlates with the characteristic presentation of Mallory-Weiss syndrome.
Surface area of the stomach is increased by
- A. gastric pits.
- B. plicae circulares.
- C. villi.
- D. microvilli.
Correct Answer: A
Rationale: The correct answer is A: gastric pits. Gastric pits are invaginations in the stomach lining that contain specialized cells for secretion of gastric juices. These pits increase the surface area of the stomach by providing a larger area for nutrient absorption and digestion. Plicae circulares are folds in the small intestine, not the stomach. Villi and microvilli are found in the small intestine and further increase surface area for absorption, not in the stomach.
To treat a cirrhotic patient with hepatic encephalopathy, lactulose (Cephulac), rifaximin (Xifaxan), and a proton pump inhibitor are ordere The patient's family wants to know why the laxative is ordere What is the best explanation the nurse can give to the patient's family?
- A. It reduces portal venous pressure.
- B. It eliminates blood from the GI tract.
- C. It traps ammonia and eliminates it in the feces.
- D. It decreases bacteria to decrease ammonia formation.
Correct Answer: C
Rationale: The correct answer is C: "It traps ammonia and eliminates it in the feces." In hepatic encephalopathy, excessive ammonia levels lead to neurological symptoms. Lactulose works by acidifying the colon, converting ammonia to ammonium, trapping it, and promoting its excretion in feces. This reduces ammonia absorption, alleviating encephalopathy.
Explanation of other choices:
A: Incorrect. Lactulose does not directly reduce portal venous pressure.
B: Incorrect. Lactulose does not eliminate blood from the GI tract.
D: Incorrect. Lactulose does not directly decrease bacteria to reduce ammonia formation.
In summary, the nurse should explain to the patient's family that lactulose helps by trapping ammonia in the GI tract and facilitating its removal in the feces, thus reducing ammonia levels in the body and improving hepatic encephalopathy symptoms.
Which of these processes occurs throughout most of the alimentary canal?
- A. ingestion
- B. propulsion
- C. segmentation
- D. absorption
Correct Answer: B
Rationale: The correct answer is B: propulsion. Propulsion is the process of moving food along the alimentary canal through peristalsis, which is the contraction and relaxation of muscles in the digestive tract. This process occurs throughout most of the alimentary canal, including the esophagus, stomach, small intestine, and large intestine. Ingestion (choice A) occurs at the beginning of the digestive process when food enters the mouth. Segmentation (choice C) is a mixing movement that occurs mainly in the small intestine to aid in digestion. Absorption (choice D) takes place primarily in the small intestine, where nutrients are absorbed into the bloodstream. Therefore, propulsion is the correct answer as it is the continuous movement of food along the digestive tract.
In the small intestine, movement of chyme is regulated primarily by
- A. secretin and cholecystokinin.
- B. the parasympathetic nervous system via the vagus nerve.
- C. local and mechanical stimulation.
- D. the enterogastric reflex caused by pressure of irritating substances in the colon.
Correct Answer: C
Rationale: The correct answer is C: local and mechanical stimulation. In the small intestine, movement of chyme is primarily regulated by local and mechanical stimulation, which triggers peristalsis and segmentation. This allows for the mixing and propulsion of chyme along the digestive tract.
A: Secretin and cholecystokinin are hormones involved in regulating pancreatic and gallbladder secretions, not movement of chyme in the small intestine.
B: The parasympathetic nervous system via the vagus nerve plays a role in stimulating digestive processes but is not the primary regulator of movement of chyme.
D: The enterogastric reflex is related to regulating stomach emptying in response to irritating substances, not movement of chyme in the small intestine.