Carcinoma of the esophagus has a poor prognosis because:

Correct Answer: C

Rationale: The correct answer is C because carcinoma of the esophagus often spreads locally, making complete removal difficult. This local spread can involve nearby structures, leading to a poor prognosis. Metastases to the liver or lung (choice A) typically occur later in the disease course, not before diagnosis. While some esophageal tumors may be challenging to access surgically (choice B), this alone does not explain the poor prognosis. Esophageal cancer can respond to radiotherapy (choice D), so radioresistance is not the primary reason for the poor prognosis. In summary, the local spread preventing complete removal is the key factor contributing to the poor prognosis in esophageal carcinoma.

Correct Answer: D

Rationale: The correct answer is D: Submucosa. The submucosa is the layer of tissue beneath the mucosa in the gastrointestinal tract. It contains blood vessels, nerves, and glands that support the mucosa. Muscularis externa (A) is the layer of smooth muscle responsible for peristalsis. Circular muscle (B) is a type of muscle fiber found within the muscularis externa. Serosa (C) is the outermost layer of the digestive tract that provides protection and secretes fluid. The submucosa (D) is the correct answer because it is the layer directly beneath the mucosa and plays a crucial role in supporting and nourishing the mucosal layer.

Correct Answer: B

Rationale: The correct answer is B: To increase surface area for absorption. Villi and microvilli are tiny finger-like projections in the small intestine that greatly increase the surface area for nutrient absorption. This increased surface area allows for more efficient absorption of nutrients into the bloodstream. Choice A is incorrect because villi and microvilli do not secrete digestive enzymes; rather, they facilitate absorption of nutrients already broken down by enzymes. Choice C is incorrect as villi and microvilli do not transport nutrients to the liver; they absorb nutrients into the bloodstream for circulation to various body tissues. Choice D is incorrect because villi and microvilli do not store excess nutrients; their primary function is absorption.

Correct Answer: A

Rationale: The correct answer is A: Obtain a venous blood glucose specimen. This is the appropriate action because capillary blood glucose levels can be inaccurate during PN infusions due to the high glucose content of the PN solution. Venous blood glucose levels provide a more accurate assessment of the patient's glycemic status. Slowing the infusion rate (Choice B) may not address the underlying issue of inaccurate readings. Rechecking capillary blood glucose levels (Choice C) will likely yield the same inaccurate results. Contacting the healthcare provider for infusion rate changes (Choice D) may be necessary but should be based on accurate glucose levels.

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.