Liver/Pancreas pre-class quiz

When caring for a client with cirrhosis, which symptoms should a nurse report immediately? Select all that apply. A. diarrhea or constipation B. signs of GI bleeding C. anorexia and dyspepsia D. change in mental status

B & D

A client with liver and renal failure has severe ascites. On initial shift rounds, his primary nurse finds his indwelling urinary catheter collection bag too full to store more urine. The nurse empties more than 2,000 ml from the collection bag. One hour later, she finds the collection bag full again. The nurse notifies the physician, who suspects that a bladder rupture is allowing the drainage of peritoneal fluid. The physician orders a urinalysis to be obtained immediately. The presence of which substance is considered abnormal? A. Albumin B. Chloride C. Urobilinogen D. Creatinine

A

A client is admitted with severe epigastric abdominal pain radiating to the back and elevated amylase/lipase levels. He is vomiting, reports difficulty breathing, and complaining of numbness and tingling of lips and extremities. Upon assessment, the nurse determines that the client is experiencing tachycardia and hypotension. Which actions are priority interventions for this client? Select all that apply. A. Administer pain-relieving medication B. Administer a low-fat diet C. Administer IV fluids D. Administer replacement electrolytes E. Assist the client to a semi-Fowler position

A, C, D, E

While conducting a physical examination of a client, which of the following skin findings would alert the nurse to the possibility of liver problems? Select all that apply. A. Aphthous stomatitis B. Cyanosis of the lip C. Ecchymoses D. Petechiae E. Jaundice

C, D, E

After undergoing a liver biopsy, a client should be placed in which position? A. Semi-Fowler's position B. Prone position C. Supine position D. Right lateral decubitus position

D

The nurse is administering Cephulac (lactulose) to decrease the ammonia level in a patient who has hepatic encephalopathy. What should the nurse carefully monitor for that may indicate a medication overdose? A. Asterixis B. Ringing in the ears C. Vomiting D. Watery diarrhea

D

A physician orders lactulose (Cephulac), 30 ml three times daily, when a client with cirrhosis develops an increased serum ammonia level. To evaluate the effectiveness of lactulose, the nurse should monitor _________________. A. level of consciousness (LOC). B. stool frequency. C. urine output. D. abdominal girth.

A

When caring for the patient with acute pancreatitis, the nurse must consider pain relief measures. What nursing interventions could the nurse provide? (Select all that apply.) A. Encouraging bed rest to decrease the metabolic rate B. Assisting the patient into the prone position C. Withholding oral feedings to limit the release of digestive enzymes D. Administering IV opioid analgesics as ordered E. Administering prophylactic antibiotics

A, C, D

A nurse is caring for a client who has been admitted for the treatment of advanced cirrhosis. What assessment should the nurse prioritize in this client's plan of care? A. Measurement of abdominal girth and body weight B. Assessment for variceal bleeding C. Assessment for signs and symptoms of jaundice D. Monitoring of results of liver function testing

B

Which of the following would the nurse expect to assess in a client with hepatic encephalopathy? A. Increased motor activity B. Asterixis C. Negative Babinski reflex D. Irritability

B

Which position should be used for a client undergoing a paracentesis? A. Right Side B. Upright at the edge of the bed C. Prone D. Trendeleburg E. Supine

B

A client with portal hypertension has been admitted to the medical floor. The nurse should prioritize what assessments? A. Assessment of blood pressure and assessment for headaches and visual changes B. Assessments for signs and symptoms of venous thromboembolism C. Daily weights and abdominal girth measurement D. Blood glucose monitoring q4h

C

The nurse is asking the client with acute pancreatitis to describe the pain. What pain symptoms does the client describe related to acute pancreatitis? A. Dull pain, points to epigastric area B. Sharp, stabbing pain in the left lower quadrant of the abdomen C. Severe mid-abdominal to upper abdominal pain radiating to both sides and to the back D. Severe abdominal pain that radiates to the right shoulder

C

A client has received a diagnosis of portal hypertension. What does portal hypertension treatment aim to reduce? Select all that apply. A. fluid output B. blood coagulation C. venous pressure D. fluid accumulation

C & D

A 37-year-old male client presents at the emergency department (ED) reporting nausea, vomiting and severe abdominal pain in all quadrants. The client's abdomen is rigid, and there is bruising to the client's flank. The client's wife states that he has a history of smoking and alcohol use and was on a drinking binge for the past 2 days. The ED nurse should assist in assessing the client for what health problem? A. Severe pancreatitis with possible peritonitis B. Acute cholecystitis C. Chronic pancreatitis D. Acute appendicitis with possible perforation

A

The nurse identifies a potential collaborative problem of electrolyte imbalance for a client with severe acute pancreatitis. Which assessment finding alerts the nurse to an electrolyte imbalance associated with acute pancreatitis? A. Muscle twitching and finger numbness B. Paralytic ileus and abdominal distention C. Hypotension D. Decreased blood glucose concentration

A

Which nursing action is most appropriate for a client hospitalized with severe acute pancreatitis? A. Withholding all oral intake, as ordered, to decrease pancreatic secretions B. Administering tylenol, as ordered, for pain C. Limiting I.V. fluids, as ordered, to decrease cardiac workload D. Keeping the client supine to increase comfort

A

A nurse educator is teaching a group of recent nursing graduates about their occupational risks for contracting hepatitis B. What preventative measures should the educator promote? Select all that apply. A. Immunization B. Use of standard precautions C. Consumption of a vitamin-rich diet D. Annual vitamin K injections E. Annual vitamin B12 injections

A & B