NCM 116 – Metabolism

Activity 1

__A___ 1. Metabolism is:

A. the sum of all chemical reactions in the organisms, that produce energy or
synthesize organic matter.
B. Metabolic reactions also include those that make organic material like the
storage form of sugar and fat. These reactions are important in daily life, in
survival, development, growth, reproduction, and many other facets of living
things.
C. Large proteins called enzymes catalyze chemical reactions so they occur much
quicker. These reactions are involved in catabolizing food molecules into the
universal energy molecule, ATP.
D. All of the above
Rationale: Metabolism, the sum of the chemical reactions that take place within
each cell of a living organism and that provide energy for vital processes and for
synthesizing new organic material.

____D_ 2. Which of the following is true about enzymes:

A. Enzymes are catalysts, and, therefore, increase the rate of a reaction while not
being permanently altered by the reaction.
B. Enzymes are proteins that can be denatured by changes in pH or temperature
C. Enzymes are highly specific for the substrates they react with and catalyze only
one or a limited set of possible reactions with those substrates
D. All of these are true about enzymes

__A___ 3. Enzymes catalyze a reaction by:

A. Decreasing the amount of energy released by the reaction
B. Increasing the amount of energy released by the reaction
C. Decreasing the amount of activation energy needed to drive the reaction
D. Increasing the amount of activation energy needed to drive the reaction

__A___ 4. It is the exergonic breakdown of substrates.

A. Metabolism
B. Anabolism
C. Catabolism
D. Exernism
___A__ 5. It is the endergonic synthesis of molecules.
A. Metabolism
B. Anabolism
C. Catabolism
D. Exernism

__D___ 6. A client has undergone esophagogastroduodenoscopy. The nurse should

place highest priority on which item as part of the client’s care plan?
A. Monitoring the temperature
B. Monitoring complaints of heartburn
C. Giving warm gargles for a sore throat
D. Assessing for the return of the gag reflex
Rationale: The nurse places highest priority on assessing for return of the gag
reflex. This assessment addresses the client's airway. The nurse also monitors the
client's vital signs and for a sudden increase in temperature, which could indicate
perforation of the gastrointestinal tract. This complication would be accompanied
by other signs as well, such as pain. Monitoring for sore throat and heartburn are
also important; however, the client's airway is the priority.

__C___ 7. The nurse has taught the client about an upcoming endoscopic retrograde
cholangiopancreatography (ERCP) procedure. The nurse determines that the
client needs further information if the client makes which statement?
A. “I know I must sign the consent form.”
B. “I hope the throat spray keeps me from gagging.”
C. “I’m glad I don’t have to lie still for this procedure.”
D. “I’m glad some intravenous medication will be given to relax me.”

___B__ 8. A client has been admitted to the hospital with a diagnosis of acute
pancreatitis and the nurse is assessing the client’s pain. What type of pain is
consistent with this diagnosis?
A. Burning and aching, located in the left lower quadrant and radiating to the hip
B. Severe and unrelenting, located in the epigastric area and radiating to the back
C. Burning and aching, located in the epigastric area and radiating to the
umbilicus
D. Severe and unrelenting, located in the left lower quadrant and radiating to the
groin.
Rationale: The pain associated with acute pancreatitis is often severe and
unrelenting, is located in the epigastric region, and radiates to the back. The other
options are incorrect.
___B__ 9. The nurse is assessing a client who is experiencing an acute episode of
cholecystitis. Where should the nurse anticipate the location of the pain?
A. Right lower quadrant, radiating to the back
B. Right lower quadrant, radiating to the umbilicus
C. Right upper quadrant, radiating to the left scapula and shoulder
D. Right upper quadrant, radiating to the right scapula and shoulder
Rationale: During an acute "gallbladder attack," the client may complain of severe right
upper quadrant pain that radiates to the right scapula and shoulder. This is governed by
the pattern on dermatomes in the body.

___C__ 10. After a subtotal gastrectomy, care of the client’s nasogastric tube and
drainage system should include which of the following nursing interventions?
A. Irrigate the tube with 30 ml of sterile water every hour as needed
B. Reposition the tube if it is not draining well
C. Monitor the client for nausea, vomiting and abdominal distention
D. Turn the machine to high suction if the drainage is sluggish on low suction
Rationale: Nausea, vomiting, or abdominal distention indicated that gas and secretions
are accumulating within the gastric pouch due to impaired peristalsis or edema at the
operative site and may indicate that the drainage system is not working properly. Saline
solution is used to irrigate nasogastric tubes. Hypotonic solutions such as water increase
electrolyte loss. In addition, a physician's order is needed to irrigate the NG tube, because
this procedure could disrupt the suture line. After gastric surgery, only the surgeon
repositions the NG tube

___A.__ 11. The client is scheduled to have an upper gastrointestinal tract series. Which
of the following treatments should the nurse anticipate after the
examination?
A. Administering a laxative
B. Placing the client on a clear liquid diet
C. Giving the client a tap water enema
D. Starting an intravenous infusion

__B___ 12. The client with colon cancer has an abdominal-perineal resection with a
colostomy. Which of the following nursing interventions is most appropriate
for this client in the postop period?
A. Maintain the client in semi-Fowler’s position
B. Assist the client with warm sitz bath
C. Administer 30 ml of milk of magnesia to stimulate colostomy activity
D. Remove the ostomy pouch as needed so the stoma can be assessed

___B__ 13. The nurse evaluates the client’s stoma during the initial postoperative
period.
Which of the following observations should be reported immediately to the
 physician?
A. The stoma is slightly edematous
B. The stoma is dark red to purple
C. The stoma oozes a small amount of blood
D. The stoma does not expel stool

___B__ 14. While changing the client’s colostomy bag and dressing, the nurse assesses
that the client is ready to participate on her care by noting which of the
following?
A. The client asks what time the doctor will visit that day
B. The client asks on the supplies used during the dressing change
C. The client talks about something she read in the morning newspaper
D. The client complains about the way the night nurse changed the dressing

____C_ 15. When planning diet teaching for a client with a colostomy, the nurse would
develop a plan that emphasizes which of the following dietary instructions?
A. Foods containing roughage should not be eaten
B. Liquid is best limited to prevent diarrhea
C. Clients should experiment to find the diet that is best for them
D. A high-fiber diet will produce a regular passage of stool

___B__ 16. An adult client is scheduled for gallbladder x-rays in the morning for
suspected cholelithiasis. While preparing the client for the x-rays, it is most
important for the nurse to ask the client if he:
A. Has ever had trouble with uncontrolled bleeding
B. Have any known allergies
C. Received teaching regarding a low-fat diet
D. Understands the procedure for local anesthesia

Rationale: Before doing any test to the client you should ask if they know any allegies.
And there are certain x-ray that need to give an oral meds to see the clear result and the
main component of the meds are iodine. May be the client has an allergy to iodine.

_____ 17. The nurse is planning care for a client who is having a gastroscopy
performed. Included in the plan of care for the immediate post-gastroscopy
period will be before giving food or fluids
A. Maintain nasogastric tube to intermittent suction
B. Assess gag reflex prior to administration of fluids
C. Assess frequently for pain and medicate according to orders
D. Measure abdominal girth every 4 hours
 RATIONALE: B. You have to Assess gag reflex prior to administration of
fluids because you will not be able to have food and liquid until your gag reflex
returns.

____B_ 18. A toddler is admitted with a history of vomiting and diarrhea for two days,
accompanied by abdominal pain. The admitting diagnosis is gastroenteritis.
What type of room assignment should the nurse make?
A. A room near the nurses’ station so that he can be checked frequently and heard
if he vomits
B. A single room with a sink near the doorway for isolation use
C. A double room with another toddler who also has vomiting and diarrhea
D. A bed in the pediatric intensive care unit, in case dehydration develops
Rationale: The child should be placed on enteric isolation until the lab reports no
contagious organism in the stool. If the stool is infected, isolation is continued after the
antibiotic are completed until three consecutive daily stool specimens are negative.

____C_ 19. An adult client is admitted to the nursing care unit with intestinal obstruction
and has a Miller-Abbott tube in place. How should the nurse assess for
proper placement and function of the tube?
A. Inject air and auscultate over the stomach
B. Aspirate the tube for stomach contents
C. Check the distance markings on the tube
D. Assess for signs of respiratory compromise
RATIONALE: C. The Miller Abbot tube is a double lumen intestinal tube weighted with
mercury inserted to decompress the small intestine. As the tube moves through the
intestine, progress can be assessed by comparing distance marks on the tube.

___D__ 20. When developing a teaching plan for a client with GERD, the nurse should
include which of the following instructions?
A. Elevate the foot of the bed by 6 to 8 inches
B. Lie down immediately after a meal
C. Take antidiarrheal medication after each loose stool
D. Avoid caffeine, tobacco and peppermint
RATIONALE: D. Like caffeine, caffeine a major component of many varieties of
both coffee and tea has been identified as a possible trigger for heartburn in some
people. Caffeine, tobacco and peppermint may trigger GERD symptoms because it can
relax the LES (Lower esophageal sphincter)