Nokea
Which structure is located where the esophagus penetrates the diaphragm?
- A. esophageal hiatus
- B. cardiac orifice
- C. upper esophageal sphincter
- D. lower esophageal sphincter
Correct Answer: A
Rationale: The correct answer is A: esophageal hiatus. This is the opening in the diaphragm through which the esophagus passes, connecting the thoracic and abdominal cavities. The esophageal hiatus is specifically located at the level of the tenth thoracic vertebra. The other choices are incorrect because:
B: Cardiac orifice refers to the opening of the stomach into the esophagus, not where the esophagus penetrates the diaphragm.
C: Upper esophageal sphincter is a muscular valve at the upper end of the esophagus, not related to its passage through the diaphragm.
D: Lower esophageal sphincter is located at the junction of the esophagus and stomach, not at the point where the esophagus penetrates the diaphragm.
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Most of the enzymes produced in the large intestine and the formation of Vitamin K occurs in
- A. Goblet cells.
- B. simple columnar cells.
- C. teniae coli.
- D. bacteria.
Correct Answer: D
Rationale: The correct answer is D: bacteria. Enzymes in the large intestine are primarily produced by the gut microbiota, which are bacteria residing in the colon. These bacteria play a crucial role in the breakdown of complex carbohydrates and the production of certain vitamins, including Vitamin K. Goblet cells (A) produce mucus, simple columnar cells (B) are involved in absorption, and teniae coli (C) are muscle bands in the colon - none of which are directly responsible for enzyme production or Vitamin K synthesis in the large intestine.
A patient receives atropine, an anticholinergic drug, in preparation for surgery. The nurse expects this drug to affect the GI tract by doing what?
- A. Increasing gastric emptying
- B. Relaxing pyloric and ileocecal sphincters
- C. Decreasing secretions and peristaltic action
- D. Stimulating the nervous system of the GI tract
Correct Answer: C
Rationale: The correct answer is C: Decreasing secretions and peristaltic action. Atropine, as an anticholinergic drug, inhibits the action of acetylcholine, leading to decreased secretions and peristaltic movement in the GI tract. This results in reduced motility and secretion production.
A: Increasing gastric emptying - This is incorrect because atropine actually slows down gastric emptying by reducing peristaltic action.
B: Relaxing pyloric and ileocecal sphincters - This is incorrect because atropine does not directly relax these sphincters.
D: Stimulating the nervous system of the GI tract - This is incorrect because atropine inhibits the parasympathetic nervous system, leading to decreased GI tract activity.
A patient has been receiving high doses of corticosteroids for an extended perioWhich side effect is most commonly seen in patients receiving long-term corticosteroid therapy?
- A. Hyperglycemia
- B. Bradycardia
- C. Diarrhea
- D. Decreased appetite
Correct Answer: A
Rationale: The correct answer is A: Hyperglycemia. Long-term corticosteroid therapy can lead to insulin resistance and increased blood glucose levels. This occurs due to the corticosteroids interfering with insulin action and glucose metabolism. Hyperglycemia is a common side effect that can potentially lead to diabetes. Bradycardia (B), diarrhea (C), and decreased appetite (D) are not commonly associated with long-term corticosteroid therapy. Bradycardia is more commonly associated with medications such as beta-blockers, while diarrhea and decreased appetite are not typical side effects of corticosteroids.
A client is admitted to the hospital for a hemorrhoidectomy. Postoperatively, which of the following would a client's nurse be most concerned about?
- A. Pain at the incision site
- B. White blood count of 6.5
- C. Client's refusal of a stool softener
- D. Excessive bloody drainage on the external gauze dressing
Correct Answer: D
Rationale: The correct answer is D because excessive bloody drainage on the external gauze dressing could indicate hemorrhage, a serious complication post-hemorrhoidectomy. This requires immediate medical attention to prevent further complications.
A: Pain at the incision site is expected postoperatively and can be managed with pain medication.
B: A white blood count of 6.5 is within the normal range and not a cause for concern.
C: Client's refusal of a stool softener is important for bowel movement management but is not the most immediate concern compared to excessive bloody drainage.
Which of the following is a common risk factor for gallstones?
- A. High-fat diet
- B. Advanced age
- C. Gender (female)
- D. Family history of gallbladder disease
Correct Answer: C
Rationale: The correct answer is C: Gender (female). Women have a higher risk of developing gallstones due to hormonal factors, such as estrogen increasing cholesterol levels in bile. This imbalance can lead to gallstone formation. Advanced age (B) is a risk factor but not as common as gender. While a high-fat diet (A) can contribute to gallstone formation, it is not a primary risk factor. Family history (D) can increase the likelihood of gallstones, but it is not as common as being female.