When considering tube feedings for a patient with severe protein-calorie malnutrition, what is an advantage of a gastrostomy tube versus a nasogastric (NG) tube?

Correct Answer: A

Rationale: Step-by-step rationale for why option A is correct: 1. Gastrostomy tube is inserted directly into the stomach, bypassing the esophagus, reducing irritation to nasal and esophageal mucosa. 2. NG tube goes through the nose, potentially causing irritation and discomfort to the mucosa. 3. In severe protein-calorie malnutrition, preservation of mucosal integrity is crucial for nutrient absorption. 4. Hence, choosing a gastrostomy tube minimizes additional stress on already compromised mucosa. Summary of why other options are incorrect: - Option B: The sensory experience of eating is unrelated to the nutritional benefits of tube feeding. - Option C: Aspiration risk is not directly affected by the type of tube used but rather by proper feeding techniques and patient positioning. - Option D: All feeding tubes require periodic checking for placement to prevent complications, including gastrostomy tubes.

Correct Answer: C

Rationale: The correct answer is C because learning relaxation strategies to decrease stress can help manage peptic ulcer disease symptoms. Stress can exacerbate ulcer symptoms, so stress management is crucial. Choice A is incorrect as stopping medications abruptly can worsen the condition. Choice B is incorrect as treatment should be based on medical advice, not just pain presence. Choice D is incorrect as different antacids contain varying active ingredients and may not have the same effect.

Correct Answer: B

Rationale: The correct answer is B: NPO status in preparation for possible appendectomy. This patient presents with classic signs of appendicitis, such as persistent pain at McBurney's point, rebound tenderness, muscle guarding, and preference for lying still with the right leg flexed. NPO status is crucial to prevent complications if surgery is needed. Laxatives (choice A) are not indicated as the focus should be on diagnosing and treating appendicitis. Parenteral fluids and antibiotics (choice C) may be necessary but not specifically for 6 hours before surgery. Inserting an NG tube (choice D) is not necessary for appendicitis.

Correct Answer: C

Rationale: The correct answer is C. Maintaining a high-fiber diet and using bulk laxatives helps to increase fecal volume, which can prevent constipation and reduce the risk of diverticulitis flare-ups. High-fiber foods promote healthy bowel movements and prevent the formation of small pockets in the colon (diverticula). Anticholinergic drugs (choice A) are not typically used for diverticulosis. Annual colonoscopies (choice B) are important for colon cancer screening but not specific to diverticulosis management. Excluding whole grain breads and cereals (choice D) is not recommended as fiber from these foods is beneficial for digestive health and can help prevent diverticular disease complications.

Correct Answer: D

Rationale: Step 1: HBV vaccine is given to provide active immunity to the individual against Hepatitis B virus. Step 2: HBIG is given for immediate, short-term passive immunity by providing pre-formed antibodies. Step 3: Using both HBV vaccine and HBIG together provides both immediate and long-term protection. Step 4: Interferon is not used for prophylaxis against HBV as it is used for treatment rather than prevention. Summary: Choice D is correct because it combines active and passive immunity for comprehensive protection. Choices A, B, and C are incorrect as they do not provide the necessary dual protection against HBV post-needle stick exposure.