Nokea
You were able to collect the chyme from the small intestine and isolate the various enzymes. Most of the enzymes would have been produced by the
- A. stomach.
- B. liver.
- C. pancreas.
- D. small intestine.
Correct Answer: C
Rationale: The correct answer is C: pancreas. The pancreas is responsible for producing various digestive enzymes such as proteases, lipases, and amylases that aid in breaking down nutrients in the small intestine. These enzymes are released into the small intestine to further digest chyme. The stomach (A) primarily produces gastric juices, not digestive enzymes. The liver (B) produces bile, which helps in fat digestion but is not classified as an enzyme. The small intestine (D) absorbs nutrients but does not produce the majority of digestive enzymes.
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Concerning deglutition (swallowing):
- A. Pharyngeal phase of swallowing is voluntary.
- B. Normally the lower esophageal sphincter (LES) is open.
- C. Dysphagia is caused by a lesion in the swallowing reflex.
- D. In the esophageal stage of swallowing, if the bolus is liquid it travels by peristalsis.
Correct Answer: C
Rationale: The correct answer is C because dysphagia, which is difficulty swallowing, can be caused by various factors such as neurological disorders affecting the swallowing reflex or physical obstructions in the esophagus. This is a key point in understanding the causes of swallowing difficulties.
Choice A is incorrect because the pharyngeal phase of swallowing is actually involuntary, not voluntary. Choice B is incorrect as the lower esophageal sphincter (LES) is normally closed to prevent acid reflux and only opens during swallowing. Choice D is incorrect because in the esophageal stage of swallowing, both liquid and solid boluses travel through the esophagus by peristalsis, not just liquid boluses.
A nurse is assessing a client who has peptic ulcer disease. Which of the following findings should the nurse identify as the priority?
- A. Epigastric discomfort
- B. Dyspepsia
- C. Constipation
- D. Hematemesis
Correct Answer: D
Rationale: The correct answer is D, Hematemesis. This is the priority finding because it indicates upper gastrointestinal bleeding, which can be life-threatening. The nurse should address this immediately to prevent further complications. Epigastric discomfort (A) and dyspepsia (B) are common symptoms of peptic ulcer disease but do not indicate active bleeding. Constipation (C) is not directly related to peptic ulcer disease and does not pose an immediate threat to the client's health.
A hiatal hernia is a weakness in the _____ muscle, which allows a portion of the digestive tract to enter the thoracic cavity.
- A. diaphragm
- B. stomach
- C. intestinal
- D. thoracic wall
Correct Answer: A
Rationale: The correct answer is A: diaphragm. The diaphragm is a dome-shaped muscle that separates the thoracic and abdominal cavities. A hiatal hernia occurs when the stomach pushes through the opening in the diaphragm known as the esophageal hiatus, allowing a portion of the stomach to enter the thoracic cavity. The other choices, B: stomach, C: intestinal, and D: thoracic wall, are incorrect because a hiatal hernia specifically involves a weakness in the diaphragm muscle, not in these other structures. The stomach is the organ affected by the hernia, but the primary issue lies in the diaphragm's weakness. The intestinal and thoracic wall choices are not directly related to the development of a hiatal hernia.
In preparing a client for a colonoscopy procedure, which task is most suitable to delegate to the nursing assistant?
- A. Explain the need for clear liquids 1-3 days prior to procedure.
- B. Reinforce NPO status 8 hours prior to procedure.
- C. Administer laxatives 1-3 days prior to procedure.
- D. Administer an enema the night before the procedure.
Correct Answer: B
Rationale: Step 1: Delegation Principle - The task should be within the nursing assistant's scope of practice.
Step 2: NPO reinforcement is a basic instruction that does not require clinical judgment.
Step 3: Nursing assistant can remind the client about NPO status without interpreting medical information.
Step 4: Administering laxatives (C) and enema (D) require clinical judgment and should be done by licensed staff.
Step 5: Explaining the need for clear liquids (A) involves providing medical information, not just a reminder.
A patient asks the nurse about taking phentermine and topiramate (Qsymia) for weight loss. To avoid side effects
- A. it is important for the nurse to determine whether the patient has a history of
- B. glaucoma.
- C. hypertension.
- D. valvular heart disease.
Correct Answer: A
Rationale: The correct answer is A because it is essential to determine if the patient has a history of certain conditions before prescribing Qsymia. This medication can worsen glaucoma (not just a history of it) making option B incorrect. Option C is incorrect because Qsymia can actually help manage hypertension. Option D is incorrect because while valvular heart disease can be a concern, it is not the primary factor to consider before prescribing this medication.