Nokea
Which single statement about fat digestion and absorption is correct?
- A. Absorption of fatty acids in the intestine occurs mainly through FABP and FAT/CD36 transport proteins in the enterocytes of the distal duodenum
- B. After absorption, medium chain triglycerides (MCT) enter the lymphatic system, whereas long chain triglycerides enter the portal blood system.
- C. The products of partial digestion of triglycerides (triacylglycerols) can form mixed micelles with pancreatic cholesterol and phospholipids and this increases absorption
- D. Triglycerides (triacylglycerols) must be emulsified and digested before the fatty acids can be transported
Correct Answer: D
Rationale: Rationale for Correct Answer D (Triglycerides must be emulsified and digested before fatty acids can be transported):
1. Triglycerides are large molecules that cannot be directly absorbed by the intestinal cells.
2. Emulsification breaks down triglycerides into smaller droplets, increasing the surface area for enzyme action.
3. Enzymatic digestion of triglycerides by lipases results in the release of fatty acids and monoglycerides.
4. These breakdown products are then absorbed by enterocytes in the small intestine.
Summary of Why Other Choices are Incorrect:
A: FABP and FAT/CD36 proteins are involved in fatty acid transport, not triglyceride digestion.
B: Both medium and long-chain triglycerides are absorbed into the lymphatic system via chylomicrons.
C: While mixed micelles aid in lipid absorption, they are not essential for the initial digestion of triglycerides.
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What is the function of the gallbladder?
- A. producing bile
- B. storing bile
- C. secreting digestive enzymes
- D. neutralizing stomach acid
Correct Answer: B
Rationale: The correct answer is B: storing bile. The gallbladder functions to store bile produced by the liver and release it into the small intestine to aid in digestion. Bile helps in the breakdown of fats. Choices A, C, and D are incorrect because the gallbladder does not produce bile (the liver does), secrete digestive enzymes (pancreas does), or neutralize stomach acid (function of the stomach and duodenum).
Amylase secreted by the salivary glands into the oral cavity starts the digestion of:
- A. Proteins
- B. Lipids
- C. Starch
- D. Amino acids
Correct Answer: C
Rationale: The correct answer is C: Starch. Amylase is an enzyme that breaks down starch into maltose in the oral cavity. This process is the initial step in carbohydrate digestion. Proteins are primarily digested in the stomach by pepsin. Lipids are broken down by lipase in the small intestine. Amino acids are the end product of protein digestion, not the substrate for amylase. Therefore, the correct answer is C as amylase specifically targets starch for digestion.
A two-week-old boy develops persistent projectile vomiting. The most likely diagnosis is:
- A. pyloric stenosis
- B. esophageal atresia
- C. annular pancreas
- D. incomplete rotation of the gut
Correct Answer: A
Rationale: The correct answer is A: pyloric stenosis. In pyloric stenosis, there is hypertrophy of the pyloric sphincter muscle, leading to gastric outlet obstruction and projectile vomiting. This typically presents in infants around 2-6 weeks of age. Other choices (B) esophageal atresia presents with difficulty feeding and choking, (C) annular pancreas with duodenal obstruction, and (D) incomplete rotation of the gut with volvulus or obstruction due to malrotation. Pyloric stenosis is the most likely diagnosis in this scenario based on the age of the infant and the symptom of projectile vomiting.
The nurse is educating a patient who is starting treatment with warfarin. Which instruction is most important to include in the teaching plan?
- A. "You can continue taking your aspirin as prescribed."
- B. "Be sure to have regular blood tests to monitor your INR."
- C. "You should increase your intake of vitamin K-rich foods."
- D. "If you miss a dose, double the dose the next day."
Correct Answer: B
Rationale: The correct answer is B: "Be sure to have regular blood tests to monitor your INR." Warfarin is a medication that requires close monitoring of the International Normalized Ratio (INR) to ensure it is within the therapeutic range. Regular blood tests are crucial to prevent complications such as bleeding or blood clots.
Choice A is incorrect because aspirin increases the risk of bleeding when taken with warfarin. Choice C is incorrect because increasing vitamin K-rich foods can interfere with the effectiveness of warfarin. Choice D is incorrect because doubling the dose can lead to an increased risk of bleeding. Regular monitoring of INR levels is essential for safe and effective warfarin therapy.
Which of the following will have the greatest implication on a client scheduled for a percutaneous liver biopsy?
- A. History of coagulation studies
- B. Allergy to iodine
- C. Family history of GI disorders
- D. Presence of radioactive material in the work environment
Correct Answer: A
Rationale: The correct answer is A: History of coagulation studies. This is because coagulation studies assess the client's ability to form blood clots, which is crucial for a percutaneous liver biopsy to prevent excessive bleeding. It helps determine the risk of bleeding complications during the procedure.
Choice B, Allergy to iodine, is incorrect because an allergy to iodine is more relevant in procedures involving contrast media, not typically in percutaneous liver biopsies.
Choice C, Family history of GI disorders, is incorrect as it does not directly impact the client's safety or outcome during a percutaneous liver biopsy.
Choice D, Presence of radioactive material in the work environment, is also incorrect as it is not directly related to the procedure or its implications on the client's safety during a percutaneous liver biopsy.