Nokea
Which statement about intestinal 'brakes' and 'accelerators' is FALSE?
- A. Dietary starch is a potent stimulator of small intestinal motility because it causes insulin release from the pancreas
- B. Food in the stomach causes gastrin release, which stimulates acid secretion
- C. Short-chain fatty acids which move from colon to caecum (reflux) promote ileo-caecal motility
- D. The arrival of lipid in the duodenum causes an immediate reduction in motility and a switch from the 'fasting' to the 'feeding' pattern.
Correct Answer: A
Rationale: The correct answer is A because dietary starch does not cause insulin release from the pancreas, but rather stimulates the release of incretin hormones like glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). These incretins help regulate blood sugar levels postprandially and do not directly affect intestinal motility.
Incorrect choices:
B: Food in the stomach causing gastrin release is true and stimulates acid secretion.
C: Short-chain fatty acids moving from colon to caecum promoting ileo-caecal motility is true.
D: The arrival of lipid in the duodenum causing a reduction in motility is true.
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The nurse caring for an 80-year-old woman who is undergoing extensive bowel preparation for a colonoscopy. The nurse should most closely monitor the patient for which potential complication?
- A. Diarrhea
- B. Metabolic acidosis
- C. Fatigue
- D. Dyspnea
Correct Answer: B
Rationale: The correct answer is B: Metabolic acidosis. During bowel preparation for a colonoscopy, the patient may experience fluid and electrolyte imbalances, leading to metabolic acidosis. The nurse should closely monitor for signs such as confusion, weakness, and increased respiratory rate. Diarrhea (choice A) is expected during bowel preparation but does not directly lead to metabolic acidosis. Fatigue (choice C) and dyspnea (choice D) are less likely complications of bowel preparation and do not directly relate to metabolic acidosis.
Which of the following pretest evaluation measures should the nurse ensure before a client undergoes the gallbladder series test?
- A. Determining the work environment of the client
- B. Determining whether the client has a family history of GI disorders
- C. Determining whether the client is pregnant
- D. Determining whether the client is allergic to seafood or iodine
Correct Answer: C
Rationale: Step-by-step rationale for the correct answer (C): Determining whether the client is pregnant is crucial before a gallbladder series test because the test involves radiation exposure, which can be harmful to a developing fetus. It is essential to ensure the safety of both the client and the unborn child.
Summary:
- A: Determining the work environment of the client is not directly related to the safety or appropriateness of a gallbladder series test.
- B: Determining whether the client has a family history of GI disorders is important for overall health assessment but not specifically necessary for the pretest evaluation of a gallbladder series test.
- D: Determining whether the client is allergic to seafood or iodine is relevant for contrast materials used in some imaging tests but not specifically for a gallbladder series test.
The nurse monitors the laboratory results of the patient with protein-calorie malnutrition during treatment. Which result is an indication of improvement in the patient's condition?
- A. Decreased lymphocytes
- B. Increased serum transferrin
- C. Increased serum potassium
- D. Decreased serum prealbumin
Correct Answer: B
Rationale: The correct answer is B because an increase in serum transferrin levels indicates improvement in protein-calorie malnutrition as transferrin is a protein that binds and transports iron, which is essential for various body functions. When protein intake increases, transferrin levels also increase to support iron transport.
A: Decreased lymphocytes do not directly reflect improvement in protein-calorie malnutrition.
C: Increased serum potassium is not specific to improvement in protein-calorie malnutrition.
D: Decreased serum prealbumin levels indicate ongoing malnutrition, not improvement.
Which of the following ligaments attaches the liver to the anterior abdominal wall?
- A. coronary ligament
- B. falciform ligament
- C. quadrate ligament
- D. caudate ligament
Correct Answer: B
Rationale: The correct answer is B: falciform ligament. The falciform ligament attaches the liver to the anterior abdominal wall and separates the right and left lobes of the liver. It is a broad, thin ligament that resembles a sickle. The other choices are incorrect because:
A: The coronary ligament attaches the liver to the diaphragm, not the abdominal wall.
C: The quadrate ligament attaches the liver to the gallbladder and the lesser curvature of the stomach.
D: The caudate ligament attaches the liver to the diaphragm and is not directly related to the abdominal wall attachment.
Which of these cells in the stomach secrete mucus?
- A. parietal cells
- B. chief cells
- C. mucous neck cells
- D. enteroendocrine cells
Correct Answer: C
Rationale: The correct answer is C: mucous neck cells. These cells secrete mucus to protect the stomach lining from the acidic environment and aid in lubrication. Parietal cells secrete hydrochloric acid, chief cells secrete pepsinogen, and enteroendocrine cells secrete hormones like gastrin. Mucous neck cells are specifically responsible for mucus secretion in the stomach, making them the correct choice.