To treat a cirrhotic patient with hepatic encephalopathy, lactulose (Cephulac), rifaximin (Xifaxan), and a proton pump inhibitor are ordere The patient's family wants to know why the laxative is ordere What is the best explanation the nurse can give to the patient's family?

Correct Answer: C

Rationale: The correct answer is C: "It traps ammonia and eliminates it in the feces." In hepatic encephalopathy, excessive ammonia levels lead to neurological symptoms. Lactulose works by acidifying the colon, converting ammonia to ammonium, trapping it, and promoting its excretion in feces. This reduces ammonia absorption, alleviating encephalopathy. Explanation of other choices: A: Incorrect. Lactulose does not directly reduce portal venous pressure. B: Incorrect. Lactulose does not eliminate blood from the GI tract. D: Incorrect. Lactulose does not directly decrease bacteria to reduce ammonia formation. In summary, the nurse should explain to the patient's family that lactulose helps by trapping ammonia in the GI tract and facilitating its removal in the feces, thus reducing ammonia levels in the body and improving hepatic encephalopathy symptoms.

Correct Answer: D

Rationale: The correct answer is D because obesity and type 1 diabetes are known risk factors for developing gallstones. Obesity leads to increased cholesterol production in the liver, which can contribute to gallstone formation. Type 1 diabetes can also increase the risk of gallstones due to impaired gallbladder function. Both factors combined in the 50-year-old obese Mexican American woman put her at the highest risk for developing gallstones. Choice A is less likely as long-term corticosteroid use for asthma is not a major risk factor for gallstones. Choice B, smoking, is a risk factor but not as significant as obesity and diabetes in this context. Choice C, recent radiation treatment and being underweight, are not as strongly associated with gallstone formation compared to obesity and diabetes.

Correct Answer: A

Rationale: The correct answer is A: esophagus. The esophagus is supported by a layer of adventitia, which is a connective tissue layer, instead of serosa, a serous membrane. The esophagus is located in the thoracic cavity, where it is surrounded by connective tissue rather than a serous membrane like the other choices. The stomach, small intestine, and large intestine are all intraperitoneal organs, meaning they are covered by a serosa layer. The esophagus, being a retroperitoneal organ, lacks a serosa layer and is instead supported by adventitia. This structural difference is important for understanding the anatomy and function of these organs.

Correct Answer: B

Rationale: The correct answer is B: propulsion. Propulsion is the process of moving food along the alimentary canal through peristalsis, which is the contraction and relaxation of muscles in the digestive tract. This process occurs throughout most of the alimentary canal, including the esophagus, stomach, small intestine, and large intestine. Ingestion (choice A) occurs at the beginning of the digestive process when food enters the mouth. Segmentation (choice C) is a mixing movement that occurs mainly in the small intestine to aid in digestion. Absorption (choice D) takes place primarily in the small intestine, where nutrients are absorbed into the bloodstream. Therefore, propulsion is the correct answer as it is the continuous movement of food along the digestive tract.

Correct Answer: A

Rationale: The correct answer is A: Decreased hydrochloric acid. As people age, there is a natural decline in hydrochloric acid production in the stomach, leading to decreased digestion and absorption of nutrients. This can result in digestive disorders such as malabsorption. Increased enzyme levels (B) would actually be beneficial for digestion. Inadequate chewing (C) can lead to issues like choking but is not specifically related to age. Diminished intestinal motility (D) can occur with age but is not directly linked to digestive disorders in older adults.