Metabolic rate is high in the following Except:

Correct Answer: B

Rationale: The correct answer is B: Sleep. During sleep, the body's metabolic rate decreases as it enters a state of rest and recovery. Pregnancy (A) requires increased energy expenditure for fetal development. Males generally have higher metabolic rates than females (C) due to higher muscle mass. Walking (D) requires more energy than resting, leading to a higher metabolic rate. In summary, sleep is the exception as it lowers metabolic rate compared to the other activities listed.

Correct Answer: D

Rationale: Pepsin is the correct answer as it is the enzyme specifically produced by gastric chief cells in the stomach to break down proteins into peptides. It works optimally in the acidic environment of the stomach. Amylase (choice A) breaks down carbohydrates, protease (choice B) refers to a general term for enzymes that break down proteins, and lipase (choice C) breaks down fats, making them incorrect for this question.

Correct Answer: A

Rationale: The correct answer is A: mouth. Salivary amylase, an enzyme in saliva, initiates the breakdown of starch into maltose in the mouth. This process marks the beginning of chemical digestion of starch foods. In contrast, the stomach primarily digests proteins, the small intestine further breaks down carbohydrates, proteins, and fats, while the large intestine absorbs water and minerals. Therefore, options B, C, and D are incorrect as they do not represent the initial site of starch digestion.

Correct Answer: D

Rationale: The correct answer is D: Cobalamin (B ) supplements. Patients with Crohn's disease often have malabsorption issues leading to megaloblastic anemia due to vitamin B12 deficiency. Cobalamin supplements are essential for treating such anemia. Iron dextran infusions (A) and oral ferrous sulfate tablets (B) are used to treat iron deficiency anemia, not megaloblastic anemia. Routine blood transfusions (C) do not address the underlying cause of megaloblastic anemia in Crohn's disease.

Correct Answer: D

Rationale: The correct answer is D, placing the patient on contact precautions. This is important because the patient has developed watery diarrhea after antibiotic therapy, which could indicate a Clostridium difficile infection. Placing the patient on contact precautions helps prevent the spread of this highly contagious infection to other patients and healthcare workers. It is the first priority to ensure the safety of others in the healthcare setting. A: Notifying the health care provider can be done after placing the patient on contact precautions. B: Obtaining a stool specimen for analysis is important but should be done after initiating contact precautions. C: Teaching the patient about hand washing is important for infection control but is not the first priority when dealing with a potential infectious disease outbreak.