Carcinoma of the esophagus:

Correct Answer: B

Rationale: B: Carcinoma of the esophagus is difficult to cure due to local spread. Esophageal cancer often presents at advanced stages, making complete surgical resection challenging. Local spread to nearby structures like the trachea or blood vessels hinders curative treatment. This is supported by the fact that esophageal cancer has a poor prognosis, with a 5-year survival rate of around 20%. A: This is incorrect because esophageal carcinoma is often diagnosed at advanced stages when symptoms appear, making it less curable than early-stage cancers. C: Early widespread metastases are not a defining feature of esophageal carcinoma. Metastases typically occur at later stages of the disease. D: Esophageal carcinoma can be differentiated or undifferentiated, but this does not impact the difficulty in curing the cancer due to local spread.

Correct Answer: A

Rationale: Rationale: Loperamide is an opioid receptor agonist that acts on the gut to slow down intestinal motility. This results in the slowed transit of intestinal contents, similar to how morphine works. This helps in alleviating diarrhea. Therefore, the correct answer is A. Choices B and C are incorrect because loperamide and morphine do not cause more rapid gastric emptying or increased colonic secretion of chloride ion. Choice D is incorrect as the correct answer has been explained.

Correct Answer: C

Rationale: The correct answer is C: Water absorption and feces formation. The primary function of the large intestine is to absorb water from the undigested food material and form feces. This process helps in maintaining the body's water balance and producing solid waste for excretion. The large intestine does not primarily absorb nutrients like the small intestine (Choice A), nor does it digest proteins (Choice D). Choice B is irrelevant and does not describe the main function of the large intestine in digestion.

Correct Answer: C

Rationale: The most appropriate initial question is C: "Do you have any difficulty in preparing or eating food?" This question directly assesses the patient's ability to obtain and consume food, which is crucial in determining malnutrition risk. By asking about difficulties in food preparation and eating, the nurse can identify any physical or cognitive impairments that may impact the patient's nutritional intake. A: "How do you get to the store to buy your food?" is irrelevant to assessing malnutrition risk and does not directly address the patient's ability to eat. B: "Can you tell me the food that you ate yesterday?" does not assess the patient's current ability to obtain and consume food. D: "Are you taking any medications that alter your taste for food?" is important but not as crucial as assessing the patient's ability to prepare and eat food.

Correct Answer: C

Rationale: The correct action is C: Manually remove the impacted stool. This is the first priority to relieve the impaction causing incontinence. Administering laxatives (choice A) may worsen incontinence. Assisting the patient to sit on the toilet (choice B) will not address the impaction. Increasing oral fluid intake (choice D) may help prevent future impactions but will not address the urgent need to relieve the current impaction.