How should the nurse explain esomeprazole (Nexium) to a patient with recurring heartburn?

Correct Answer: D

Rationale: The correct answer is D because esomeprazole (Nexium) is a proton pump inhibitor that works by decreasing stomach acid production, thereby treating gastroesophageal reflux disease. This explanation is important for the patient to understand the mechanism of action of the medication. Choice A is incorrect because esomeprazole does not increase the rate of gastric emptying; instead, it reduces acid production. Choice B is incorrect because esomeprazole does not neutralize stomach acid immediately; it takes a few days to reach its full effect. Choice C is incorrect because esomeprazole does not coat and protect the stomach and esophagus; it works by reducing acid production. In summary, the correct answer is D because it accurately describes how esomeprazole works to manage recurring heartburn by decreasing stomach acid production, which is essential for treating gastroesophageal reflux disease.

Correct Answer: B

Rationale: The falciform ligament separates the right and left lobes of the liver. This is because it attaches the liver to the anterior abdominal wall and suspends it from the diaphragm, dividing the liver into right and left lobes. The quadrate, caudate, and pancreatic lobes are not separated by the falciform ligament, making choices A, C, and D incorrect, respectively.

Correct Answer: C

Rationale: The correct answer is C: jejunum. The jejunum is the middle part of the small intestine where the majority of nutrient absorption takes place. Its large surface area, due to the presence of villi and microvilli, facilitates efficient absorption of nutrients. The duodenum (B) primarily aids in digestion, not absorption. The ileum (D) absorbs bile salts and vitamin B12, but most nutrient absorption occurs in the jejunum. The colon (A) primarily absorbs water and electrolytes, not nutrients. Therefore, the jejunum is the correct answer for the site of most nutrient absorption in the digestive system.

Correct Answer: D

Rationale: Carboxypeptidase is a metalloenzyme that requires zinc (Zn) for its activity as a cofactor. Zinc plays a crucial role in stabilizing the enzyme's structure and facilitating the catalytic reaction. Copper (A), niacin (B), and iron (C) are not directly involved in the enzymatic activity of carboxypeptidase. Copper is more commonly associated with other enzymes like cytochrome c oxidase, niacin is a vitamin, and iron is typically involved in heme-containing proteins like hemoglobin. Zinc is the correct choice as it directly supports carboxypeptidase function.

Correct Answer: C

Rationale: The correct answer is C: Insert nasogastric tube. In a paralytic ileus, the intestines are unable to contract and move contents, leading to bowel obstruction. Inserting a nasogastric tube helps decompress the intestines by removing gas and fluid, relieving discomfort and preventing further complications. Administering an antacid (A) is not indicated for paralytic ileus. Providing a bulk-forming agent (B) may exacerbate the obstruction. Applying a truss (D) is used for hernias, not for paralytic ileus.