A patient with a known history of PUD presents with sudden, severe epigastric pain and vomiting. The nurse suspects a perforation. What diagnostic test should be performed immediately?

Correct Answer: D

Rationale: The correct answer is D: CT scan of the abdomen. A CT scan is the most appropriate immediate diagnostic test for suspected perforated peptic ulcer disease (PUD). It provides detailed images to confirm the presence of perforation, assess extent of damage, and guide surgical intervention. Upper GI endoscopy (choice A) may delay diagnosis and treatment in a perforation scenario due to the risk of causing further injury. Abdominal X-ray (choice B) may show free air under the diaphragm, but CT scan is more sensitive and specific. Barium swallow (choice C) is contraindicated in suspected perforation as it can lead to barium leakage into the abdominal cavity, causing further complications.

Correct Answer: C

Rationale: The correct answer is C: Hydrogen potassium ATPase. This enzyme is not a hormone involved in the normal function of the gut. Gastrin, Secretin, and Cholecystokinin-pancreozymin (CCK-PZ) are all hormones that play important roles in regulating digestion and gut functions. Gastrin stimulates gastric acid secretion, Secretin regulates pancreatic and bile secretions, and CCK-PZ stimulates pancreatic enzyme secretion and gallbladder contraction. Therefore, C is the correct answer because Hydrogen potassium ATPase is not a hormone relevant to gut function.

Correct Answer: C

Rationale: Step 1: A broken down to B represents the breakdown of proteins into amino acids. Step 2: Proteins are made up of amino acids. Step 3: Therefore, A represents proteins and B represents amino acids. Summary: Choice A is incorrect as starch does not break down into proteins. Choice B is incorrect as starch breaks down into simple sugars, not amino acids. Choice D is incorrect as proteins do not break down into simple sugars.

Correct Answer: A

Rationale: The correct answer is A: The gullet. Food passes through the gullet, also known as the esophagus, between the mouth and the stomach. The gullet is a muscular tube that contracts to push the food down to the stomach for digestion. The other choices are incorrect because the rectum is where waste is stored before elimination, the small intestine is where most of the absorption of nutrients occurs, and the large intestine is where water is absorbed and waste is further processed before excretion.

Correct Answer: A

Rationale: The correct answer is A because the function of structure X's secretions is to increase the surface area of fats for better digestion and absorption in the small intestine. This is achieved by emulsifying fats into smaller droplets, aiding in their breakdown by lipase enzymes. Choices B, C, and D are incorrect as structure X is not involved in stomach acid secretion to decrease pH, protein digestion to peptides, or glycogen breakdown to maltose. The primary role of structure X is related to fat digestion, making choice A the most suitable option.