Nokea
You're performing an abdominal assessment on Brent who is 52 y.o. In which order do you proceed?
- A. Inspection, percussion, palpation, auscultation
- B. Inspection, auscultation, percussion, palpation
- C. Percussion, palpation, auscultation, observation
- D. Palpation, percussion, observation, auscultation
Correct Answer: A
Rationale: The correct order for an abdominal assessment is inspection, percussion, palpation, and auscultation (A). Inspection allows observation of any visible abnormalities. Percussion helps assess the density of underlying structures. Palpation is performed last to avoid altering bowel sounds before auscultation. Auscultation is done last to prevent altering bowel sounds while palpating. Choices B, C, and D are incorrect because they do not follow the proper sequence for an abdominal assessment, which can lead to inaccurate findings.
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Parasympathetic stomach impulses cause all of the following except which one?
- A. secretion of somatostatin
- B. inhibition of somatostatin
- C. secretion of gastrin
- D. promotes histamine
Correct Answer: A
Rationale: The correct answer is A because parasympathetic impulses do not lead to the secretion of somatostatin. Somatostatin is released in response to low pH in the stomach to inhibit further acid secretion. Parasympathetic impulses stimulate the secretion of gastrin, promote histamine release, and inhibit somatostatin secretion. This is important for enhancing gastric acid secretion and promoting digestion. Therefore, choices B, C, and D are incorrect as they are effects of parasympathetic stomach impulses.
A patient is transferred from the recovery room to a surgical unit after a transverse colostomy. The nurse observes the stoma to be deep pink with edema and a small amount of sanguineous drainage. What action should the nurse take?
- A. Place ice packs around the stoma.
- B. Notify the surgeon about the stoma.
- C. Monitor the stoma every 30 minutes.
- D. Document stoma assessment findings.
Correct Answer: D
Rationale: The correct answer is D: Document stoma assessment findings. The rationale for this choice is that documentation is crucial in providing a clear and accurate record of the stoma's condition for ongoing monitoring and evaluation. By documenting the stoma assessment findings, the nurse can track any changes in color, edema, or drainage over time, which helps in identifying any potential issues or improvements.
Choice A is incorrect because placing ice packs around the stoma can cause vasoconstriction and worsen the edema. Choice B is unnecessary at this point as the nurse can first assess and document the stoma before escalating to the surgeon if needed. Choice C is not the best action as monitoring every 30 minutes may be excessive and not practical, especially if the patient is stable.
A patient comes to the hospital complaining of vomiting and diarrhoea. The doctor suggested that the patient take glucose and electrolyte solution orally. Which one of following membrane proteins is likely to be involved in rehydrating the patient?
- A. Cystic fibrosis transmembrane regulator (CFTR)
- B. Sodium glucose transporter protein! (SGLT1)
- C. Insulin receptor protein (IRP)
- D. Sucrase-isomaltase protein (SIP)
Correct Answer: B
Rationale: The correct answer is B: Sodium glucose transporter protein 1 (SGLT1). SGLT1 is responsible for the active transport of glucose and sodium across the intestinal membrane. When a patient is experiencing vomiting and diarrhea, they are losing fluids and electrolytes. By taking a glucose and electrolyte solution orally, the SGLT1 protein helps in the reabsorption of glucose and sodium to facilitate rehydration.
Incorrect choices:
A: Cystic fibrosis transmembrane regulator (CFTR) is associated with cystic fibrosis and does not play a direct role in rehydration.
C: Insulin receptor protein (IRP) is involved in glucose uptake regulation in response to insulin, not rehydration.
D: Sucrase-isomaltase protein (SIP) is involved in the breakdown of sugars in the small intestine, not rehydration.
Although HAV antigens are not tested in the blood, they stimulate specific immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies. Which antibody indicates there is acute HAV infection?
- A. Anti-HBc IgG
- B. Anti-HBc IgM
- C. Anti-HAV IgG
- D. Anti-HAV IgM
Correct Answer: D
Rationale: The correct answer is D: Anti-HAV IgM. IgM antibodies indicate acute infection as they are the first antibodies produced in response to a new infection. In the case of HAV, the presence of Anti-HAV IgM suggests recent exposure to the virus.
A: Anti-HBc IgG is not relevant to HAV infection. It indicates past or chronic hepatitis B infection.
B: Anti-HBc IgM is specific to hepatitis B infection, not HAV.
C: Anti-HAV IgG indicates past exposure or immunity to HAV, not acute infection.
Which one of the following is the correct pathway of bile from the hepatocytes to the gallbladder?
- A. bile canaliculus → hepatic duct → common hepatic duct → common bile duct → gallbladder.
- B. bile canaliculus → hepatic duct → cystic duct → common hepatic duct → gallbladder.
- C. hepatic sinusoid → central vein → hepatic vein → gall bladder.
- D. bile canaliculus → hepatic duct → common hepatic duct → cystic duct → gallbladder.
Correct Answer: D
Rationale: The correct answer is D: bile canaliculus → hepatic duct → common hepatic duct → cystic duct → gallbladder. This pathway reflects the anatomical sequence of bile flow from the smallest bile ducts within the liver (bile canaliculi) to the gallbladder. Bile canaliculi collect bile from hepatocytes, which then flows through larger ducts (hepatic duct, common hepatic duct) before reaching the cystic duct, which connects to the gallbladder for bile storage.
Choices A, B, and C are incorrect because they do not follow the correct anatomical pathway of bile flow. For example, in choice A, the common hepatic duct should connect directly to the cystic duct, not the common bile duct. In choice B, the cystic duct should not connect to the common hepatic duct. In choice C, bile does not flow through the central vein or hepatic vein