Which of the following cell(s) produce a compound that insulates nerve axons and greatly increases the speed of transmission (conductance)?

Correct Answer: B

Rationale: The correct answer is B: Schwann cells and oligodendrocytes. Schwann cells produce myelin in the peripheral nervous system, while oligodendrocytes produce myelin in the central nervous system. Myelin insulates nerve axons, allowing for saltatory conduction, greatly increasing the speed of transmission. Nodes of Ranvier are gaps in the myelin sheath where action potentials are regenerated, not where myelin is produced. Neurons themselves do not produce myelin. Astrocytes and ependymal cells have supportive roles in the nervous system but do not produce myelin.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Secure the tape if the client accidentally dislodges the tube, which can be delegated to the experienced nursing assistant. This task falls within the scope of practice for a nursing assistant as it involves basic maintenance and safety of the NG tube without the need for specialized medical knowledge or training. Option A) Removing the NG tube per physician order requires a trained healthcare professional, typically a nurse or physician, due to the potential risks and complications associated with removing a tube incorrectly. Option C) Disconnecting the suction to allow ambulation to the toilet and D) reconnecting the suction after the client has ambulated involve adjusting the suction settings, which requires clinical judgment and understanding of the patient's condition. These tasks should be performed by a licensed nurse who can assess the patient's condition and determine the appropriate course of action based on their assessment. In an educational context, it is important for healthcare providers to understand the principles of delegation to ensure safe and effective patient care. Delegating tasks to appropriate team members based on their skill level and training helps optimize workflow, increase efficiency, and improve patient outcomes. Nurses must be knowledgeable about delegation guidelines to assign tasks effectively and promote a collaborative healthcare environment.

Correct Answer: B

Rationale: In this scenario, the most appropriate nursing action is to consult the physician about decreasing the infusion rate of the tube feeding. This is because the client is experiencing diarrhea likely due to the high carbohydrate and electrolyte content of the feeding solution. By decreasing the infusion rate, the client's gastrointestinal system may be better able to tolerate and absorb the nutrients provided by the tube feeding, reducing the likelihood of diarrhea. Option A, instructing the client to remain in a semi-Fowler's position, is not the most appropriate action in this situation as it does not address the root cause of the diarrhea. Option C, administering the tube feedings continuously, can exacerbate the issue by continuously overwhelming the client's gastrointestinal system. Option D, maintaining the tube patency, is important for preventing complications related to tube blockages but does not directly address the current issue of diarrhea. In an educational context, it is crucial for nurses to understand the importance of monitoring and adjusting tube feeding rates based on the client's tolerance and response. This case highlights the significance of assessing and responding to gastrointestinal symptoms in clients receiving enteral feedings, emphasizing the need for individualized care and prompt intervention to optimize outcomes.

Correct Answer: A

Rationale: After the removal of a nasogastric tube following liver surgery, it is crucial for a nurse to consider providing small sips of clear liquids to the client. The rationale behind choosing option A is that clear liquids are easier to digest and are less likely to cause discomfort or complications in the immediate postoperative period. Clear liquids help prevent dehydration and provide essential hydration without putting excessive strain on the digestive system, which may still be recovering from the surgery. Option B, providing small sips of fruit juice or soup, may not be ideal immediately after the removal of the nasogastric tube as these options may contain pulp or solid pieces that could be difficult for the client's digestive system to handle. In the early stages of recovery, it is essential to start with easily digestible and gentle options like clear liquids. Option C, providing a small meal of soft foods, and option D, providing a meal of protein-rich foods, are both inappropriate choices after nasogastric tube removal in a client recovering from liver surgery. Introducing solid or heavy foods too soon can overwhelm the digestive system and may lead to complications such as vomiting, discomfort, or delayed healing. In an educational context, it is important for nurses to understand the rationale behind postoperative dietary interventions to promote optimal recovery and prevent complications. Clear communication with patients and their families regarding dietary recommendations post-surgery is essential to ensure the best possible outcomes for the client's recovery.

Correct Answer: C

Rationale: The correct answer is C) Both bile and pancreatic enzymes enter the duodenum at the ampulla of Vater. This is because the ampulla of Vater serves as the opening through which both bile from the liver and pancreatic enzymes from the pancreas are released into the duodenum, the first part of the small intestine. Option A is incorrect because while bile is responsible for emulsifying fats, it is not involved in the digestion of all nutrients and vitamins. Option B is incorrect because although intestinal digestive enzymes are released into the small intestine, they are not released through the ampulla of Vater. Option D is incorrect because the ampulla of Vater is specifically related to the release of bile and pancreatic enzymes, not gastric contents. Understanding the role of the ampulla of Vater is crucial in comprehending the digestive process. By knowing that both bile and pancreatic enzymes are released at this point, students can grasp how the body processes and absorbs nutrients from the food we consume. This knowledge is fundamental for healthcare professionals in diagnosing and treating gastrointestinal disorders related to nutrient digestion and absorption.