A 22-yr-old female patient with an exacerbation of ulcerative colitis is having 15 to 20 stools daily and has excoriated perianal skin. Which patient behavior indicates that teaching regarding maintenance of skin integrity has been effective?

Correct Answer: B

Rationale: The correct answer is B: The patient uses witch hazel compresses to soothe irritation. Witch hazel has astringent and anti-inflammatory properties, which can help reduce inflammation and soothe irritated skin. By using witch hazel compresses, the patient is actively taking steps to alleviate discomfort and promote skin healing. A: The patient using incontinence briefs to contain loose stools does not address the issue of skin integrity maintenance and may lead to prolonged exposure of the skin to stool, exacerbating the problem. C: Asking for antidiarrheal medication after each stool does not directly address the need for skin integrity maintenance. While it may help reduce stool frequency, it does not specifically target skin healing. D: Cleaning the perianal area with soap after each stool can be harsh on the already excoriated skin and may further irritate it. Using soap can strip the skin of its natural oils and hinder the healing process.

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.

Correct Answer: B

Rationale: The correct answer is B: obstructive jaundice. Gallstones can obstruct the bile duct, leading to the buildup of bile pigment in tissues, causing jaundice. This results in the characteristic yellowing of the skin and eyes. Hyperbilirubinemia (A) refers to elevated levels of bilirubin in the blood, which can occur in various liver conditions. Hepatitis (C) is inflammation of the liver, which can also lead to jaundice but is not directly caused by gallstones. Hepatocellular jaundice (D) is due to liver cell damage, not bile duct obstruction.

Correct Answer: A

Rationale: The correct answer is A: large intestine. The ileocecal valve is located between the ileum (part of the small intestine) and the cecum (part of the large intestine). Its primary function is to prevent the backflow of contents from the large intestine into the small intestine, specifically preventing chyme from entering the large intestine prematurely. This allows for proper digestion and absorption of nutrients in the small intestine before the remaining waste material enters the large intestine for further processing. Choices B, C, and D are incorrect as the ileocecal valve specifically regulates the flow of material between the small and large intestines, not other parts of the digestive system such as the stomach or duodenum.

Correct Answer: D

Rationale: The correct answer is D: Proteases. Proteases are enzymes that break down proteins, and they are known to function optimally in low pH environments, such as the acidic environment of the stomach. This is because the acidic pH helps in the activation and stability of proteases, allowing them to efficiently break down proteins into smaller peptides and amino acids. Rationale for why the other choices are incorrect: A: Peroxidases catalyze oxidation reactions and are not specifically known to act in low pH environments. B: Hydrolases are a broad category of enzymes that catalyze the hydrolysis of various molecules but are not specifically tailored for low pH conditions. C: Amylases are enzymes that break down carbohydrates and typically work best in neutral to slightly alkaline pH conditions, not in low pH environments like proteases.