A 72-yr-old male patient with dehydration caused by an exacerbation of ulcerative colitis is receiving 5% dextrose in normal saline at 125 mL/hour. Which assessment finding by the nurse is most important to report to the health care provider?

Correct Answer: B

Rationale: The correct answer is B: Patient has not voided for the last 2 hours. This is the most important assessment finding to report because it indicates potential acute kidney injury or renal failure, especially in a dehydrated patient. The lack of urine output suggests the kidneys are not functioning properly, which can lead to serious complications. A: Skin dryness and poor turgor are expected findings in a dehydrated patient and may improve with fluid resuscitation. C: Crackles heard halfway up the posterior chest may indicate fluid overload, but the lack of urine output is a more immediate concern. D: 5 loose stools over 6 hours can contribute to dehydration but is not as critical as the lack of urine output indicating potential renal issues.

Correct Answer: D

Rationale: Secretin is released by the duodenum in response to acidic chyme. It stimulates the pancreas to produce bicarbonate-rich secretions to neutralize the acidic chyme entering the small intestine. Bicarbonate helps maintain the optimal pH for pancreatic enzymes to function effectively. Proteolytic enzymes, amylase, and lipase are pancreatic enzymes but are not specifically influenced by secretin.

Correct Answer: B

Rationale: The correct answer is B: somatostatin. Somatostatin inhibits acid production by blocking the release of gastrin and histamine, which stimulate acid secretion. Secretin (A) stimulates bicarbonate secretion, cholecystokinin (C) stimulates gallbladder contraction, and gastrin (D) stimulates acid secretion. Somatostatin directly inhibits acid secretion by acting on the parietal cells of the stomach.

Correct Answer: C

Rationale: Cholecystokinin (CCK) is the correct answer as it specifically stimulates the release of bile from the gallbladder. It is released in response to the presence of fats and proteins in the duodenum, signaling the gallbladder to contract and release bile to aid in digestion. Insulin is involved in regulating blood sugar levels, while gastrin stimulates gastric acid secretion. Secretin stimulates the release of bicarbonate-rich pancreatic juice to neutralize stomach acid, not bile secretion. Therefore, CCK is the most appropriate choice in this context.

Correct Answer: A

Rationale: The correct answer is A: Lower left quadrant. This is because diverticular disease commonly affects the sigmoid colon, which is located in the lower left quadrant of the abdomen. Pain in this area is a hallmark symptom of diverticular disease. The other choices (B, C, D) are incorrect because diverticular disease typically causes pain in the lower left quadrant due to inflammation and infection of the diverticula in that area. Upper quadrants are less likely to be affected by diverticular disease.