Nokea
Which one of the following cells in the gastric glands produce pepsinogen?
- A. endocrine cells
- B. mucous neck cells
- C. chief or zymogenic cells
- D. parietal or oxyntic cells
Correct Answer: C
Rationale: The correct answer is C: chief or zymogenic cells. These cells are responsible for producing pepsinogen, the inactive form of pepsin, which is an enzyme that helps in protein digestion. Chief cells secrete pepsinogen into the gastric lumen. Endocrine cells (A) produce hormones like gastrin, mucous neck cells (B) secrete mucus to protect the stomach lining, and parietal cells (D) secrete hydrochloric acid to create an acidic environment for pepsinogen activation. Therefore, the correct choice is C as it directly produces pepsinogen.
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The secretion of the exocrine pancreas is increased by the following except:
- A. Vagal stimulation
- B. Acetylcholine
- C. Secretin
- D. CCK
Correct Answer: A
Rationale: The correct answer is A: Vagal stimulation. Vagal stimulation does not directly increase the secretion of the exocrine pancreas. Acetylcholine, Secretin, and CCK are known to stimulate pancreatic secretion through various mechanisms. Acetylcholine acts through muscarinic receptors, Secretin is released in response to acidic chyme in the duodenum, and CCK is released in response to fat and proteins in the duodenum, all leading to increased pancreatic enzyme secretion. Vagal stimulation plays a role in the parasympathetic nervous system but does not directly stimulate pancreatic secretion.
A nurse is caring for a client who has an active upper gastrointestinal bleed. After inserting a NG tube into the client, which of the following findings should the nurse anticipate?
- A. Frothy pink drainage
- B. Dark amber drainage
- C. Coffee-ground drainage
- D. Greenish-yellow drainage
Correct Answer: C
Rationale: The correct answer is C: Coffee-ground drainage. This indicates upper GI bleed, where blood mixes with gastric acid, forming a coffee-ground appearance. Frothy pink drainage (A) is more common in respiratory issues. Dark amber drainage (B) is typical for lower GI bleeds. Greenish-yellow drainage (D) is not associated with GI bleeding. In this case, the nurse should monitor for coffee-ground drainage to assess the severity of the upper GI bleed.
The actions of secretin include:
- A. Increased salivary secretion
- B. Relaxation of the oesophageal sphincters
- C. Stimulation of gastric secretion
- D. Stimulation of secretion of bicarbonate by pancreatic duct cells
Correct Answer: D
Rationale: The correct answer is D because secretin is a hormone that stimulates the secretion of bicarbonate by pancreatic duct cells. This helps neutralize the acidic chyme entering the duodenum from the stomach. A is incorrect because secretin does not directly affect salivary secretion. B is incorrect because secretin does not relax the esophageal sphincters. C is incorrect because secretin inhibits gastric secretion rather than stimulating it. Therefore, the correct choice is D as it aligns with the physiological role of secretin in pancreatic bicarbonate secretion.
Regarding pancreatic secretion:
- A. Trypsin is secreted in the active form.
- B. CCK stimulates the secretion of bicarbonate.
- C. Secretin stimulates the secretion of enzymes.
- D. Chemotrypsinogen is activated by trypsin.
Correct Answer: D
Rationale: Correct Answer: D
Rationale:
1. Chemotrypsinogen is the inactive precursor of chymotrypsin.
2. Trypsin activates chemotrypsinogen to form active chymotrypsin.
3. This activation occurs in the small intestine, enabling protein digestion.
Summary:
A: Trypsin is secreted as an inactive zymogen, not in the active form.
B: CCK stimulates enzyme secretion, not bicarbonate.
C: Secretin mainly stimulates bicarbonate secretion, not enzymes.
Compounds containing aspirin are discontinued at least how many weeks before ileostomy surgery?
- A. 1
- B. 2
- C. 3
- D. 4
Correct Answer: B
Rationale: Aspirin and other anticoagulants should be stopped at least two weeks before surgery to minimize bleeding risks.