Nokea
Which phase of deglutition involves contraction of the longitudinal muscle layer of the muscularis?
- A. voluntary phase
- B. buccal phase
- C. pharyngeal phase
- D. esophageal phase
Correct Answer: D
Rationale: The correct answer is D: esophageal phase. During the esophageal phase of deglutition, the longitudinal muscle layer of the muscularis contracts to help propel the bolus of food downwards towards the stomach. This contraction occurs in a coordinated manner to create peristaltic waves that push the food along the esophagus. In contrast, the voluntary phase (A) involves the conscious initiation of swallowing, the buccal phase (B) involves the tongue pushing the bolus towards the pharynx, and the pharyngeal phase (C) involves the initiation of the swallowing reflex and closure of the airway to prevent aspiration.
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A nurse is assessing a client who is 3 days postoperative following abdominal surgery and notes the absence of bowel sounds, abdominal distention, and the client passing no flatus. Which of the following conditions should the nurse suspect?
- A. Ulcerative colitis
- B. Cholecystitis
- C. Paralytic ileus
- D. Wound dehiscence
Correct Answer: C
Rationale: The correct answer is C: Paralytic ileus. After abdominal surgery, the bowel can temporarily stop functioning due to anesthesia, handling of the intestines, or inflammation. This leads to absent bowel sounds, distention, and no flatus passage. Ulcerative colitis (A) is a chronic inflammatory bowel disease, not related to postoperative findings. Cholecystitis (B) is inflammation of the gallbladder, typically presenting with right upper quadrant pain. Wound dehiscence (D) is the separation of surgical incision edges, not related to bowel function.
Contractions that mix material in the small intestine are called
- A. peristalsis.
- B. deglutition.
- C. mass movements
- D. segmental contractions.
Correct Answer: D
Rationale: The correct answer is D: segmental contractions. Segmental contractions mix material in the small intestine by contracting and relaxing specific segments of the intestine to mix and move the contents. This process helps with digestion and nutrient absorption.
A: Peristalsis refers to the wave-like muscle contractions that propel food through the digestive system, not mixing.
B: Deglutition is the process of swallowing food, not mixing it in the small intestine.
C: Mass movements are large contractions that move material through the large intestine, not the small intestine where mixing occurs.
What is the priority action when caring for a patient with acute cholecystitis and suspected perforation?
- A. Prepare for surgery immediately.
- B. Administer IV fluids and pain medication.
- C. Administer antibiotics as ordered.
- D. Monitor the patient's vital signs closely for signs of shock.
Correct Answer: A
Rationale: The correct answer is A: Prepare for surgery immediately. This is the priority action because acute cholecystitis with suspected perforation is a surgical emergency that requires prompt intervention to prevent serious complications such as sepsis. Surgery is needed to remove the inflamed gallbladder and repair any perforation. Administering IV fluids, pain medication, and antibiotics are important supportive measures but do not address the underlying issue. Monitoring vital signs is also crucial, but immediate surgical intervention takes precedence in this critical situation.
Bilateral ovarian metastases presenting as tumor masses are most characteristically associated with carcinoma of the:
- A. esophagus
- B. stomach
- C. small intestine
- D. appendix
Correct Answer: B
Rationale: The correct answer is B, stomach. Ovarian metastases from gastric carcinoma are commonly bilateral due to the close anatomical relationship between the stomach and ovaries. Stomach cancer frequently spreads to the ovaries through direct extension or lymphatic dissemination. In contrast, esophageal, small intestine, and appendix carcinomas less commonly metastasize to the ovaries, making choices A, C, and D less likely. Thus, the characteristic bilateral ovarian metastases are most commonly associated with carcinoma of the stomach.
What type of pain does the nurse expect a patient with an ulcer of the posterior portion of the duodenum to experience?
- A. Pain that occurs after not eating all day
- B. Back pain that occurs 2 to 4 hours following meals
- C. Midepigastric pain that is unrelieved with antacids
- D. High epigastric burning that is relieved with food intake
Correct Answer: B
Rationale: The correct answer is B: Back pain that occurs 2 to 4 hours following meals. This type of pain is characteristic of duodenal ulcers due to increased acid secretion post-meals. Pain occurs when acidic stomach contents enter the duodenum, stimulating pain receptors. Back pain is common as the ulcer is located in the posterior portion of the duodenum. Choices A, C, and D are incorrect as they do not correspond to the typical pain pattern of a duodenal ulcer. Choice A is more indicative of gastritis, Choice C is suggestive of peptic ulcer disease, and Choice D is more characteristic of gastric ulcers.