Occult fecal blood may be an indication of:

Correct Answer: C

Rationale: The correct answer is C: both. Occult fecal blood can indicate bleeding anywhere along the gastrointestinal tract. Upper gastrointestinal bleeding typically presents as melena (black, tarry stools), while lower gastrointestinal bleeding can manifest as occult blood in the stool. Therefore, occult fecal blood can be an indication of both upper and lower gastrointestinal bleeding. Choices A and B are incorrect because occult fecal blood is not exclusive to either upper or lower gastrointestinal bleeding alone. Choice D is incorrect since occult fecal blood can indeed be an indication of gastrointestinal bleeding.

Correct Answer: D

Rationale: The correct answer is D because bile pigments, such as bilirubin, increase in the blood in liver disease due to impaired liver function. Bilirubin is a waste product from the breakdown of red blood cells and is normally processed by the liver. Elevated levels of bile pigments in the blood are a common indicator of liver dysfunction. Choice A is incorrect because bile pigments are derived from heme, not the globin portion of hemoglobin. Choice B is incorrect because bile pigments aid in the emulsification of fats but do not directly help in fat digestion and absorption. Choice C is incorrect as bile pigments are conjugated with glucuronic acid, not sulphate, in the liver.

Correct Answer: B

Rationale: The correct answer is B: Stomach and Duodenum. Submucosal glands are found in the submucosa of the stomach and duodenum. In the stomach, these glands secrete mucus and bicarbonate to protect the lining from stomach acid. In the duodenum, they secrete mucus to protect the lining from the acidic chyme entering from the stomach. Choices A, C, and D are incorrect because submucosal glands are not typically found in the oesophagus or ileum. The rationale for the correct answer is based on the anatomical location and function of submucosal glands in the gastrointestinal tract.

Correct Answer: A

Rationale: The primary function of the small intestine is the absorption of nutrients. Step 1: Digestive enzymes break down food in the small intestine. Step 2: Villi and microvilli in the intestine absorb nutrients like glucose and amino acids. Step 3: Nutrients are then transported to the bloodstream for distribution to cells. Thus, choice A is correct. Choices B and C are incorrect because mechanical digestion primarily occurs in the stomach, and digestive enzymes are produced by other organs like the pancreas. Choice D is incorrect as the small intestine does not store bile; it is produced by the liver and stored in the gallbladder.

Correct Answer: B

Rationale: The correct answer is B: Providing skin care to the area around the tube site. This task can be safely delegated to an LPN/VN because it involves basic wound care and monitoring for signs of infection or skin breakdown. LPNs/VNs are trained to provide this type of care under the supervision of a registered nurse (RN). A: Assessing the patient's nutritional status weekly requires a higher level of assessment and interpretation of data, which is typically within the scope of an RN. C: Teaching the patient how to administer the feedings involves patient education and requires a higher level of critical thinking and assessment skills, typically performed by an RN. D: Determining the need for adding water to the feedings involves making clinical judgments and adjustments to the enteral nutrition plan, which should be overseen by an RN.