When examining a patient's mouth, the nurse notes white curd-like lesions surrounded by erythematous mucosa. Which condition does the nurse suspect?
a)
... [Show More] Cheilitis
b) Glossitis
c) Candidiasis
d) Leukoplakia - correct answer c) Candidiasis
Candidiasis manifests as white curd-like lesions that are surrounded by erythematous lesions in the mouth. Cheilitis is inflammation of the lips with fissuring, scaling, and crusting. Glossitis manifests as a reddened, ulcerated, swollen tongue. Leukoplakia refers to the presence of thick white patches on the tongue.
The nurse is performing a focused abdominal assessment of a hospitalized patient. To palpate the patient's liver, where should the nurse palpate the patient's abdomen?
a) Left lower quadrant
b) Left upper quadrant
c) Right lower quadrant
d) Right upper quadrant - correct answer d) Right upper quadrant
Although the left lobe of the liver is located in the left upper quadrant of the abdomen, the bulk of the liver is located in the right upper quadrant. The liver is not located in the right lower quadrant or the left lower quadrant. Only the left lobe of the liver is located in the left upper quadrant.
Which cells protect the mucosa of the small intestine?
a) Chief cells
b) Kupffer cells
c) Parietal cells
d) Intestinal goblet cells - correct answer d) Intestinal goblet cells
The intestinal goblet cells secrete mucus and protect the mucosa of the small intestine. Chief cells secrete pepsinogen that helps in protein digestion. Kupffer cells carry out phagocytic activity. Parietal cells secrete hydrochloric acid, which acts as a catalyst for the conversion of pepsinogen to pepsin.
A patient's history includes long-term treatment for arthritis and atherosclerosis. During a follow-up visit, the nurse finds that the patient has upper gastrointestinal bleeding. Which medication in the patient's prescriptions may be responsible for this condition?
a) Aspirin
b) Simvastatin
c) Amiodarone
d) Acetaminophen - correct answer a) Aspirin
Aspirin is a nonsteroidal antiinflammatory drug (NSAID) used to treat arthritis. Prolonged use of aspirin can cause upper gastrointestinal bleeding as a side effect. Simvastatin and amiodarone are used to lower the risk of stroke and heart attack and may cause hepatotoxicity as a side effect. Chronic high doses of acetaminophen may cause hepatotoxicity in the patient.
Which gastrointestinal secretion helps in the absorption of fatty acids and fat-soluble vitamins?
a) Bile
b) Ptyalin
c) Lactase
d) Peptidases - correct answer a) Bile
Bile helps in the absorption of fatty acids and fat-soluble vitamins like vitamin A, vitamin D, vitamin E, and vitamin K. Ptyalin is an enzyme that helps in the initiation of starch digestion. Lactase helps in the conversion of lactose to glucose and galactose. Peptidases help in protein digestion.
Which muscle guards the exit from the stomach?
a) Rectus muscle
b) Abdominal muscle
c) Pyloric sphincter muscle
d) Cricopharyngeal muscle - correct answer c) Pyloric sphincter muscle
The pyloric sphincter guards the exit from the stomach. The rectus muscle helps flex the torso and spine in the abdominal region. Abdominal muscles hold the abdominal organs in place. The cricopharyngeal muscle helps in peristaltic movement of the pharynx.
Inspection of an older patient's mouth reveals the presence of white, curd-like lesions on the patient's tongue. The nurse suspects that the condition is caused by what?
a) Herpes virus
b) Candida albicans
c) Vitamin deficiency
d) Irritation from ill-fitting dentures - correct answer b) Candida albicans
White, curd-like lesions surrounded by erythematous mucosa are associated with oral candidiasis. Herpesvirus causes benign vesicular lesions in the mouth. Vitamin deficiencies may cause a reddened, ulcerated, swollen tongue. Irritation from ill-fitting dentures will cause friable, edematous, painful, bleeding gingivae.
The nurse inspects, auscultates, and palpates a patient's abdomen and notes no obvious abnormalities, except pain. When the nurse palpates the abdomen for rebound tenderness, there is severe pain. The nurse suspects what condition?
a) Hepatic cirrhosis
b) Hypersplenomegaly
c) Gall bladder distention
d) Peritoneal inflammation - correct answer d) Peritoneal inflammation
When palpating for rebound tenderness, the problem area of the abdomen will produce pain and severe muscle spasm when there is peritoneal inflammation. Hepatic cirrhosis, hypersplenomegaly, and gall bladder distention do not manifest with rebound tenderness.
Which clinical manifestation does the nurse expect to observe in a patient with ascites?
a) Curdlike lesions in the mouth
b) Burning in the epigastric area
c) Expulsion of gastric contents through the mouth
d) Accumulation of fluid within the abdominal cavity - correct answer d) Accumulation of fluid within the abdominal cavity
Liver dysfunction may lead to portal hypertension, causing the fluid to move from intravascular spaces to extravascular spaces. This fluid fills the space between the lining of the abdomen and the organs and is called ascites. Curdlike lesions in the mouth are a symptom of candidiasis. A burning sensation in the epigastric area is a sign of pyrosis. Expulsion of gastric contents through the mouth indicates nausea and vomiting.
A patient experiences a recent onset of diarrhea following a new medication regimen. The nurse reviews the patient's medication profile and suspects that which medication is the cause of the diarrhea?
a) Antacid
b) Antibiotic
c) Amphetamine
d) Nonsteroidal antiinflammatory drug (NSAID) - correct answer b) Antibiotic
Antibiotics disturb the normal bacterial composition of the large intestine and result in diarrhea. Diarrhea is not a known side effect of NSAIDs, amphetamines, and antacids. High doses of NSAIDs can cause hepatotoxicity. Amphetamines cause distention of the stomach. Antacids cause interference with the absorption of other drugs.
A student nurse is performing an abdominal examination after receiving instructions from the registered nurse. Which action performed by the student nurse indicates the need for further teaching?
a) Instructs the patient to breathe slowly through the mouth
b) Places the patient in the supine position with flexed knees
c) Uses cool hands while performing the patient's examination
d) Instructs the patient to empty the bladder before examination - correct answer c) Uses cool hands while performing the patient's examination
Using cool hands while performing an abdominal examination may elicit muscle guarding. Therefore the nurse should use warm hands while performing abdominal examinations. Placing the patient in the supine position with flexed knees will help relax the abdominal muscles. Instructing the patient to breathe slowly through the mouth will help in obtaining an accurate test result. The patient may feel relaxed after emptying the bladder before examination and can coordinate properly.
An 85-year-old patient reports a loss of appetite and no desire to eat at mealtimes. The nurse recalls what age-related changes that may be affecting the patient's appetite? Select all that apply.
a) Difficulty swallowing food
b) Decreased sense of smell
c) Increased saliva production
d) Loss of ability to feel satiety
3) Diminished sense of taste, especially salty and sweet - correct answer a) Difficulty swallowing food
b) Decreased sense of smell
3) Diminished sense of taste, especially salty and sweet
Several age-related changes may affect the older adult's appetite and ability to eat. Older adults have decreased numbers of taste buds and a decreased sense of smell. This diminishes the sense of taste, especially salty and sweet. Dysphagia is often the result of decreased lower esophageal sphincter pressure and decreased motility. The sense of satiety, a feeling or condition of being full after eating food, is not diminished with aging. Older adults have decreased (not increased) saliva production, which causes dry mouth and may interfere with swallowing.
What is the function of the hormone gastrin?
a) Increasing the flow of bile into the duodenum
b) Maintaining lower esophageal sphincter tone
c) Stimulating the pancreatic bicarbonate secretion
d) Contracting the gallbladder and relaxing the sphincter of Oddi - correct answer c) Stimulating the pancreatic bicarbonate secretion
Gastrin is secreted by the gastric and duodenal mucosa. Its function is to maintain lower esophageal sphincter tone and aid in motility. Cholecystokinin increases the flow of bile into the duodenum. Secretin stimulates the pancreatic bicarbonate secretion. Cholecystokinin helps contract the gallbladder and relaxes the sphincter of Oddi.
The nurse is interviewing a patient with chronic constipation. The nurse finds that the patient performs a Valsalva maneuver to facilitate passing of feces. How is this maneuver helpful in aiding the elimination process?
a) It stimulates peristalsis
b) It increases intraabdominal pressure
c) It stimulates the parasympathetic nerve fibers
d) It initiates the gastrocolic and the duodenocolic reflex - correct answer b) It increases intraabdominal pressure
The Valsalva maneuver involves contraction of the chest muscles with closed glottis and simultaneous contraction of the abdominal muscles. This increases the intraabdominal pressure, which facilitates defecation. The Valsalva maneuver does not stimulate peristalsis, stimulate the parasympathetic nerve fibers, or initiate the gastrocolic and duodenocolic reflex. Peristalsis, which propels the food towards the rectum, refers to the contraction of the smooth muscles of the intestine. The stimulation of parasympathetic nerve fibers from the sacral portions of the spinal cord relaxes the internal anal sphincter. It also contracts the rectal muscles leading to defecation. The gastrocolic and the duodenocolic reflex stimulate propulsive peristalsis in the large intestine.
The nurse is providing post-procedural care to a patient who had a colonoscopy. The nurse should report what assessment finding to the primary health care provider immediately?
a) Vomiting
b) Blood in the feces
c) Abdominal cramps
d) An urge to defecate - correct answer b) Blood in the feces
Blood in the feces can be indicative of rectal bleeding and should be immediately reported to the health care provider. Blood in feces is common after colonoscopy, but it can lead to serious complications if it remains untreated. An urge to defecate occurs when there is administration of barium enema. Barium enema is not administered in a colonoscopy procedure. Abdominal cramps are normal because the bowel is constantly inflated with air during the procedure. Vomiting is not a sign associated with a colonoscopy procedure.
After a patient has undergone an esophagogastroduodenoscopy (EGD), what is the nursing priority?
a) Provide warm saline gargles for relief of sore throat.
b) Warn the patient that excessive intestinal gas may be present.
c) Keep the patient nothing by mouth (NPO) until the gag reflex returns.
d) Assess the patient's level of consciousness as the patient awakens from anesthesia. - correct answer c) Keep the patient nothing by mouth (NPO) until the gag reflex returns.
After an EGD, it is essential to keep patient NPO until gag reflex returns. Gently tickle the back of throat to determine reflex. The patient should remain NPO until the gag reflex returns, so offering warm saline gargles is not safe. It is appropriate to use warm saline gargles for relief of sore throat, but this is not the most important priority after an EGD. Gas is present following a colonoscopy, not an EGD. The patient will not undergo anesthesia for this procedure.
What is the function of the hormone ghrelin?
a) Fat digestion
b) Appetite stimulation
c) Breakdown of proteins
d) Breakdown of starches to maltose - correct answer b) Appetite stimulation
Ghrelin is released from the stomach mucosa; it stimulates appetite. Lipase causes fat digestion. Pepsin breaks down proteins. Ptyalin breaks down starches to maltose.
A nurse assesses an elderly patient who reports abdominal pain. Which assessment finding may indicate a serious gastrointestinal disorder?
a) Loss of appetite
b) A slow metabolic rate
c) Diminished sense of smell
d) Bright red blood in the stool - correct answer d) Bright red blood in the stool
Blood in the stool may be indicative of a serious gastrointestinal disorder that has caused bleeding in some part of the GI tract. Loss of appetite, a slow metabolic rate, diminished sense of taste and smell, and moderate constipation are some of the common problems associated with older age. These can be treated by modifying lifestyle and types of food consumed.
A patient is suspected to have acute pancreatitis after presenting to the emergency department with severe abdominal pain. The nurse identifies that which important diagnostic laboratory value peaks in 24 hours and then drops to normal in 48 to 72 hours?
a) Gastric pH
b) Blood glucose
c) Serum amylase
d) Serum potassium - correct answer c) Serum amylase
Elevated serum amylase levels indicate early pancreatic dysfunction and are used to diagnose acute pancreatitis. Serum lipase levels stay elevated longer than serum amylase in acute pancreatitis. Blood glucose, gastric pH, and potassium levels are not direct indicators of acute pancreatic dysfunction. [Show Less]