What contributes to increased protein-calorie needs?

Correct Answer: A

Rationale: The correct answer is A: Surgery. Surgery increases protein-calorie needs due to the body's increased demand for nutrients to support healing and recovery. The body requires more protein and calories to repair tissues and maintain immune function post-surgery. Choice B: A vegan diet does not necessarily contribute to increased protein-calorie needs as it is possible to meet nutritional requirements with proper planning. Choice C: Lowered temperature does not directly affect protein-calorie needs. Choice D: Cultural or religious beliefs do not inherently increase protein-calorie needs, as dietary choices can still meet nutritional requirements.

Correct Answer: A

Rationale: The correct answer is A because a 55-year-old female who is a smoker and experiencing symptoms of nausea and vomiting has multiple risk factors for developing a gastric ulcer. Smoking and older age are established risk factors for gastric ulcers. Nausea and vomiting can be indicative of underlying gastrointestinal issues. Choice B is less likely as illicit drug use typically does not directly increase the risk of gastric ulcers. Choice C is less likely as the male falling while looking for a job does not directly relate to gastric ulcer development. Choice D is less likely as divorce and back pain are not direct risk factors for gastric ulcers.

Correct Answer: C

Rationale: The correct answer is C. Assessing the onset, location, intensity, duration, and character of the pain is the priority because it helps determine the potential cause of the abdominal pain. This information guides further interventions and informs the healthcare team about the urgency of the situation. Choice A (Measurement of vital signs) can be important but assessing the pain characteristics takes precedence as it directly informs the urgency of the situation. Choice B (Administration of prescribed analgesics) should be delayed until the cause of the pain is identified to prevent masking symptoms that could aid in diagnosis. Choice D (Physical assessment of the abdomen) is important but assessing the pain characteristics comes first to guide the physical assessment and subsequent interventions.

Correct Answer: D

Rationale: The correct answer is D because in the event of leakage from the pouch, it is important to promptly remove it, clean the skin, and apply a new pouch to prevent skin irritation and infection. This step is crucial for maintaining skin integrity and preventing complications. Choice A is incorrect as ileostomy pouches typically need to be changed more frequently, usually every 3-7 days, to prevent skin breakdown and odor. Choice B is incorrect because decreasing fluid intake can lead to dehydration and electrolyte imbalances, which are especially risky for ileostomy patients who have increased fluid losses. Choice C is incorrect because the pouch should not be removed until the stoma and bowel movements have been evaluated and regulated to ensure proper functioning.

Correct Answer: D

Rationale: The correct answer is D because HBV DNA quantitation measures the amount of HBV genetic material in the blood, reflecting viral replication. This helps monitor the effectiveness of therapy in chronic HBV patients. Choice A is incorrect as the test does not specifically indicate ongoing infection. Choice B is incorrect as it refers to co-infection with HDV, which is not the purpose of HBV DNA quantitation. Choice C is incorrect as the test does not differentiate between previous infection and ongoing viral replication, which is crucial in managing chronic HBV.