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Which one of the following enzymes is not part of the enzymatic component of the pancreatic juice?
- A. amylase
- B. lipase
- C. nucleases
- D. chymotrypsin
Correct Answer: D
Rationale: The correct answer is D: chymotrypsin. Chymotrypsin is not part of the enzymatic component of pancreatic juice. Pancreatic juice contains amylase for carbohydrate digestion, lipase for fat digestion, and nucleases for nucleic acid digestion. Chymotrypsin is produced in the pancreas but is not secreted directly into the pancreatic juice. It is released in an inactive form that is activated in the small intestine. Therefore, chymotrypsin is not directly involved in the initial breakdown of nutrients in the pancreatic juice.
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The nurse is performing pre-procedure teaching for a patient scheduled to undergo a liver biopsy. After listening to the information, the patient states, "I am so scareI just don't know if I can do this procedure." Which response is best?
- A. "The procedure will only last about 15 minutes."
- B. "Most patients say it feels similar to a punch in the shoulder."
- C. "You do not have to have the procedure."
- D. "I understand that you are afraiTell me more about your concerns."
Correct Answer: D
Rationale: The correct answer is D because it demonstrates empathy and active listening. By acknowledging the patient's fear and encouraging them to express their concerns further, the nurse can address specific fears and provide appropriate support. This approach helps build trust and rapport, leading to better patient outcomes.
A: Providing the duration of the procedure (choice A) may not effectively address the patient's underlying fear.
B: Comparing the sensation to a punch (choice B) may minimize the patient's concerns and not address the emotional aspect of their fear.
C: Telling the patient they do not have to have the procedure (choice C) could be misleading and may not be in the patient's best interest without further exploration of their concerns.
Which enzyme is responsible for the breakdown of carbohydrates in the mouth during the process of digestion?
- A. Amylase
- B. Lipase
- C. Pepsin
- D. Trypsin
Correct Answer: A
Rationale: The correct answer is A: Amylase. Amylase is responsible for breaking down carbohydrates in the mouth during digestion. It is produced in the salivary glands and helps to break down complex carbohydrates into simpler sugars like maltose. Lipase (B) breaks down fats, pepsin (C) breaks down proteins, and trypsin (D) is an enzyme that also breaks down proteins but is produced in the pancreas, not in the mouth. Amylase is the only enzyme among the choices that specifically targets carbohydrates in the mouth, making it the correct answer.
A nurse is planning care for a client who is to start receiving total parenteral nutrition (TPN). Which of the following interventions should the nurse include in the plan of care?
- A. Use a 1.2 micron filter when infusing TPN with fat emulsions added.
- B. Allow 18 hr for the lipids to infuse when not mixed with the TPN solution.
- C. Change the TPN solution after 36 hr.
- D. Change the TPN tubing every 48 hr.
Correct Answer: D
Rationale: The correct answer is D: Change the TPN tubing every 48 hr. This is essential to prevent bacterial growth and infection, maintaining the integrity of the TPN solution. Regular tubing changes reduce the risk of contamination and ensure patient safety.
A: Using a 1.2 micron filter is not directly related to tubing changes and is not a primary concern for TPN administration.
B: Allowing 18 hr for lipids to infuse is not a standard practice and does not address the need for tubing changes.
C: Changing the TPN solution after 36 hr is not a standard guideline and may not be necessary unless specific factors indicate a need for a change.
In a radical pancreaticoduodenectomy (Whipple procedure) for treatment of cancer of the pancreas, what anatomic structure is completely resected that will affect the patient's nutritional status?
- A. Stomach
- B. Pancreas
- C. Common bile duct
- D. Duodenum adjoining the pancreas
Correct Answer: D
Rationale: The Whipple procedure involves the removal of the duodenum, which plays a key role in digestion and nutrient absorption.
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.