371 final exam review

· Which patient does the nurse recognize as being most likely to be affected by sickle cell disease? o A 14-year-old African American boy o An 18-year-old Chinese woman o A 28-year-old Israeli man o A 26-year-old eastern European Jewish woman

14-year old African American boy

· The nurse cares for several clients with hematological conditions. Which assessment needs will the nurse prioritize for the client with aplastic anemia? Select all that apply. o Bleeding o Oxygenation o Perfusion o Injury o Infection

bleeding infection

· During a colonoscopy with moderate sedation, the patient groans with obvious discomfort and begins bleeding from the rectum. The patient is diaphoretic and has an increase in abdominal girth from distention. What complication of this procedure is the nurse aware may be occurring? o Colonic polyp o Rectal fissure o Bowel perforation o Infection

bowel perforation

· The most common symptom of esophageal disease is o odynophagia. o nausea. o vomiting. o dysphagia.

dysphagia

· Which enzyme aids in the digestion of fats? o Amylase o Lipase o Trypsin o Secretin

lipase

· Which is considered a diagnostic tool for breast cancer? o Ultrasonography o Breast biopsy o Mammography o Clinical breast exam

o Breast biopsy

· The nurse is caring for a client with breast cancer and removal of axillary lymph nodes. Which assessment finding is documented and brought to the physician's attention as potential lymphedema? o Fluid accumulation under in the axilla o Enlargement of the arm or hand o Drainage from the areola o A reddened area around the breast

o Enlargement of the arm or hand

· The nurse is assessing a client with an ulcer for signs and symptoms of hemorrhage. The nurse interprets which condition as a sign/symptom of possible hemorrhage? o Hematemesis o Hypertension o Bradycardia o Polyuria

o Hematemesis

· A patient is receiving continuous tube feedings. The nurse would maintain the patient in which position at all times? o Supine with a small pillow under the patient's head o Side-lying with the head slightly lower than the chest o Semi-Fowler's with the head of the bed elevated 30 to 45 degrees o High Fowler's with the patient sitting erect

o Semi-Fowler's with the head of the bed elevated 30 to 45 degrees

· The nurse is conducting a community education class on gastritis. The nurse includes that chronic gastritis caused by Helicobacter pylori is implicated in which disease/condition? o Systemic infection o Peptic ulcers o Pernicious anemia o Colostomy

peptic ulcers

· A patient with acute pancreatitis puts the call bell on to tell the nurse about an increase in pain. The nurse observes the patient guarding; the abdomen is board-like, and no bowel sounds are detected. What is the major concern for this patient? o The patient has developed renal failure o The patient requires more pain medication o The patient has developed peritonitis o The patient is developing a paralytic ileus

peritonitis

· A client is admitted to the health care facility with abdominal pain, a low-grade fever, abdominal distention, and weight loss. The physician diagnoses acute pancreatitis. What is the primary goal of nursing care for this client? o Preventing fluid volume overload o Reliving abdominal pain o Maintaining adequate nutritional status o Teaching about the disease and its treatment

relieving abdominal pain

· A client being treated for pancreatitis faces the risk of atelectasis. Which of the following interventions would be important to implement to minimize this risk? o Instruct the client to avoid coughing o Monitor pulse ox every hour o Withhold oral feeding for the client o Reposition the client every 2 hours

reposition every 2 hours

· The nurse is concerned about potassium loss when a diuretic is prescribed for a patient with ascites and edema. What diuretic may be ordered that spares potassium and prevents hypokalemia? o Bumetanide (Bumex) o Furosemide (Lasix) o Spironolactone (Aldactone) o Acetazolamide (Diamox)

spironolactone (think of "spare")

· A client with a brain tumor is undergoing radiation and chemotherapy for treatment of cancer. The client has recently reported swelling in the gums, tongue, and lips. Which is the most likely cause of these symptoms? o Neutropenia o Stomatitis o Extravasation o Nadir

stomatitis

· The nurse recognizes that bloodshed in sufficient quantities into the upper GI tract produces which color of stool? o Bright red o Milky white o Tarry black o Green

tarry black

· A client with cholelithiasis has a gallstone lodged in the common bile duct. When assessing this client, the nurse expects to note: o Black, tarry stools o Yellow sclerae o Circumoral pallor o Light amber urine

yellow sclerae

· The nurse is caring for a client recovering from an esophagogastroduodenoscopy (EGD). Which of the following client symptoms would require further nursing assessment? o Sore throat o Abdominal distention o Thirst o Drowsiness

o Abdominal distention

· Which nursing intervention should be incorporated into the plan of care to manage the delayed clotting process due to thrombocytopenia in a client with leukemia? o Implementing neutropenic precautions o Applying prolonged pressure to needle sites or other sources of external bleeding o Monitoring temperature at least once per shift o Eliminating direct contact with others who are infectious

o Applying prolonged pressure to needle sites or other sources of external bleeding

· A nurse is monitoring a client with peptic ulcer disease. Which assessment findings would most likely indicate perforation of the ulcer? Select all that apply. o Mild epigastric pain o Tachycardia o Diarrhea o A rigid, board-like abdomen o Hypotension

o tachycardia o hypotension o A rigid, board-like abdomen

· Which of the following is the single largest preventable cause of cancer? o Pesticides o Tobacco o Asbestos o Arsenic

tobacco

· A client has been diagnosed with pernicious anemia. During client education, the nurse emphasizes the importance of lifelong intramuscular administration of: o Vitamin B12 o Vitamin A o Folic acid o Vitamin C

vitamin B12

· During assessment, a patient with chronic liver dysfunction tells the nurse that he is experiencing spontaneous episodes of bleeding and has noticed increased areas of bruising on his chest and arms. The nurse suspects a deficiency in: o Vitamin K o Thiamine o Riboflavin o Vitamin C

vitamin K

· A client with a history of alcohol abuse comes to the emergency department and complains of abdominal pain. Laboratory studies help confirm a diagnosis of acute pancreatitis. The client's vital signs are stable, but the client's pain is worsening and radiating to his back. Which intervention takes priority for this client? o Maintaining NPO status o Placing the client in a semi-fowler's position o Providing mouth care o Administering morphine IV as ordered

administering morphine IV as ordered

· Hypocalcemia is associated with which of the following manifestations? o Fatigue o Polyuria o Bowel hypomotility o Muscle twitching

muscle twitching

· The nurse understands that the client should be given human papillomavirus (HPV) vaccine per the health care provider's orders. What does this vaccine help prevent? o Lung cancer o Cervical cancer o Leukemia o Breast cancer

o Cervical cancer

· The physician has written the following orders for a new client admitted with pancreatitis: bed rest, nothing by mouth (NPO), and administration of total parenteral nutrition (TPN). Which does the nurse attribute as the reason for NPO status? o To prevent the occurrence of fibrosis o To drain the pancreatic bed o To aid opening up of pancreatic duct o To avoid inflammation of the pancreas

to avoid inflammation in pancreas

· While the nurse is recording the health history of a client who is scheduled for a thyroid test, the client informs the nurse about an allergy to seafood. What is the nurse's most appropriate response? o Palpate the thyroid gland o Inquire about frequent urination o Consult the institution's procedure manual o Document the allergy and inform the physician

o Document the allergy and inform the physician

· A female client is a carrier for a gene mutation on one of her X chromosomes. Her spouse is unaffected. The nurse understands that which of the following is most likely? o The client has signs and symptoms of the condition o Any daughters of the client would be carriers for the disorder o The client's sons have a 50% chance of being affected o The risk of transmitting the disorder is negligible

o The client's sons have a 50% chance of being affected

· A nurse is aware that several laboratory results are present in a patient diagnosed with diabetes insipidus. Select all that apply. o Urine specific gravity of 1.001 o Serum sodium level of 149 o Serum osmolality of 310 o Serum ADH level of 2.3 o Urine osmolality of 800

o Urine specific gravity of 1.001 o Serum sodium level of 149 o Serum osmolality of 310

· A client receives tube feedings after an oral surgery. The nurse manages tube feedings to minimize the risk of aspiration. Which measure should the nurse include in the care plan to reduce the risk of aspiration? o Administer 15 to 30 mL of water before and after medications and feedings. o Avoid cessation of feedings and adjust patient head of bed. o Change the tube feeding container, tubing, and adjust patient head of bed . o Use semi-Fowler position during, and 60 minutes after, an intermittent feeding.

o Use semi-Fowler position during, and 60 minutes after, an intermittent feeding.

· Lactulose (Cephulac) is administered to a patient diagnosed with hepatic encephalopathy to reduce which of the following? o Calcium o Alcohol o Ammonia o Bicarbonate

ammonia

· A patient has been diagnosed with Cushing's syndrome. The nurse would expect which of the following features to be present upon physical examination? Select all that apply. o Purple striae o Moon face o Thin extremities o Truncal obesity o Buffalo hump

o Purple striae o Moon face o Truncal obesity o Buffalo hump

· A client diagnosed with acute myelocytic leukemia has been receiving chemotherapy. During the last 2 cycles of chemotherapy, the client developed severe thrombocytopenia requiring multiple platelet transfusions. The client is now scheduled to receive a third cycle. How can the nurse best detect early signs and symptoms of thrombocytopenia? o Perform a cardiovascular assessment every 4 hours o Monitor daily platelet counts o Check the client's history for a congenital link to thrombocytopenia o Closely observe the client's skin for petechiae and bruising

o Closely observe the client's skin for petechiae and bruising

· The nurse is evaluating the client's risk for cancer. The nurse should recommend the client change which lifestyle choice? o Use the treadmill for 30 minutes on 5 days each week o Eat red meats such as steaks or hamburgers everyday o Works as a secretary at a medical radiation treatment center o Drinks one glass of wine a night with dinner

o Eat red meats such as steaks or hamburgers everyday

· The nurse is preparing a teaching plan for a client who is to undergo genetic screening. Which of the following would be most appropriate for the nurse to include? o It is used to test groups independent of a positive family history or symptoms. o A genotypic or phenotypic approach may be used for the testing. o It is used to determine if a person is a carrier for an inherited condition. o It is the primary tool for identifying a predisposition to specific genetic diseases.

o It is used to test groups independent of a positive family history or symptoms.

· The nursing instructor is discussing disorders of the hematopoietic system with the pre-nursing pathophysiology class. What disease would the instructor list with a primary characteristic of erythrocytosis? o Polycythemia vera o Pernicious anemia o Aplastic anemia o Sickle cell disease

o Polycythemia vera

· Which statement is true about malignant tumors? o They gain access to the blood and lymphatic channels o They grow by expansion o They usually grow slowly o They demonstrate cells that are well differentiated

o They gain access to the blood and lymphatic channels

· The nurse is assessing the skin graft site of a client who has undergone a radical neck dissection. The skin graft site is pink. The nurse documents which result? o Venous congestion of graft o Possible necrosis of graft o Healthy graft o Infection of graft

healthy graft

· A patient with acute myeloid leukemia (AML) has a neutrophil count that persists at less than 100/mm3. What should the nurse cautiously monitor this patient for? o Seizure activity o Abdominal cramps o Infection o Hypotension

infection

· A nurse is caring for a client who has a history of sleep apnea. The client understands the disease process when he says: o "I need to keep my inhaler at the bedside." o "I should sleep on my side all night long." o "I should become involved in a weight loss program." o "I should eat a high-protein diet."

o "I should become involved in a weight loss program."

· The nurse is inserting a nasogastric tube for a patient with pancreatitis. What intervention can the nurse provide to allow facilitation of the tube insertion? o Allow the patient to sip water as the tube is being inserted. o Spray the oropharynx with an anesthetic spray. o Have the patient eat a cracker as the tube is being inserted. o Have the patient maintain a backward tilt head position.

o Allow the patient to sip water as the tube is being inserted.

· A nurse working in a cardiac health care office notes increased risk of certain cardiac conditions as a result of obesity. Which conditions can be associated with obesity? Select all that apply. o Coronary artery disease o Myocardial infarction o Heart murmur o Hypertension o Heart failure

o Coronary artery disease o HTN o MI o heart failure

· A patient describes a burning sensation in the esophagus, pain when swallowing, and frequent indigestion. What does the nurse suspect that these clinical manifestations indicate? o Peptic ulcer disease o Gastroesophageal reflux disease o Diverticulitis o Esophageal cancer

o Gastroesophageal reflux disease

· A nurse is preparing a presentation about human immunodeficiency virus (HIV) for a local community group. What would the nurse include in the presentation about HIV transmission? Select all that apply. o HIV can be found in seminal fluid, vaginal secretions, and breast milk. o HIV transmission from mother-to child occurs primarily during pregnancy while the fetus is in utero. o The risk of acquiring HIV through the transfusion of blood products is almost nonexistent. o The amount of HIV contained in body fluids on exposure is associated with the risk for infection. o Sharing of infected equipment used to inject drugs increases the risk for infection.

o HIV can be found in seminal fluid, vaginal secretions, and breast milk. o The risk of acquiring HIV through the transfusion of blood products is almost nonexistent. o The amount of HIV contained in body fluids on exposure is associated with the risk for infection. o Sharing of infected equipment used to inject drugs increases the risk for infection.

· Which statement by a client undergoing external radiation therapy indicates the need for further teaching? o I'll wash my skin with mild soap and water only o I'll wear protective clothing when outside o I'm worried I'll expose my family members to radiation o I'll not use my heating pad during treatment

o I'm worried I'll expose my family members to radiation

· A client has been diagnosed with HIV and has been placed on antiretroviral therapy. What does the nurse inform the client will be required for determining the progression of the disease as well as guiding drug therapy? o The western blot test will be monitored every 6 months to see if the virus is still present o More antiretroviral medication will be added every 2 to 3 months o Viral load and t4-cell counts will be performed every 2 to 3 months o The client will be required to stop the medication for 2 weeks and then have laboratory studies drawn to determine if the antiretroviral therapy has cured the disease

o Viral load and t4-cell counts will be performed every 2 to 3 months

· A nurse is teaching a group of middle-aged men about peptic ulcers. When discussing risk factors for peptic ulcers, the nurse should mention: o a sedentary lifestyle and smoking. o a history of hemorrhoids and smoking. o alcohol abuse and smoking. o alcohol abuse and a history of acute renal failure.

o alcohol abuse and smoking.

· A client has cancer of the neck and is receiving external beam radiation therapy to the site. The client is experiencing trauma to the irradiated skin. The nurse does all of the following. (Select all that apply.) o applies an over-the-counter ointment to the skin o uses cool water to wash the neck area o assesses the client for any sun exposure o inspects for skin damage of the chest area o avoids shaving the irradiated skin

o assesses the client for any sun exposure o avoids shaving the irradiated skin

· Which are correct statements about the relationship between the hypothalamus and the pituitary gland? Select all that apply. o Under the influence of the hypothalamus, the lobes of the pituitary gland secrete various hormones o The pituitary gland is called the master gland because it regulates the function of the hypothalamus and other endocrine glands o Many endocrine glands respond to stimulation for the pituitary gland, which is connected by a stalk to the hypothalamus in the brain o The hypothalamus is called the master gland because is regulates the function of the pituitary gland

-Under the influence of the hypothalamus, the lobes of the pituitary gland secrete various hormones -Many endocrine glands respond to stimulation for the pituitary gland, which is connected by a stalk to the hypothalamus in the brain

· The nurse should advise a client with iron-deficiency anemia to take which action in order to prevent staining of the teeth? o Take iron with or immediately after meals o Dilute liquid preparations of iron with juice and drink with a straw o Do not combine iron with other prescribed or over the counter meds o Avoid taking iron simultaneously with an antacid

dilute liquid iron

· Increased appetite and thirst may indicate that a client with chronic pancreatitis has developed diabetes mellitus. Which of the following explains the cause of this secondary diabetes? o Ingestion of foods high in sugar o Dysfunction of the pancreatic islet cells o Renal failure o Inability for the liver to reabsorb serum glucose

dysfunction of pancreatic cell islets

· A client is diagnosed with megaloblastic anemia caused by vitamin B12 deficiency. The health care provider begins the client on cyanocobalamin (Betalin-12), 100 mcg I.M. daily. Which substance influences vitamin B12 absorption? o Intrinsic factor o Hydrochloric acid o Liver enzyme o Histamine

intrinsic factor

· A client is suspected of having cirrhosis of the liver. What diagnostic procedure will the nurse prepare the client for in order to obtain a confirmed diagnosis? o A liver biopsy o Platelet count o CT scan o Prothrombin time

liver biopsy

· A nurse educator is providing an in-service to a group of nurses working on a medical floor that specializes in liver disorders. What is an important education topic regarding ingestion of medications? o Metabolism of medications o Medications becoming ineffective in clients with liver disease o Need for more frequently divided doses o Need for increased drug dosages

metabolism of medications

· A client is scheduled for a Roux-en-Y bariatric surgery. When teaching the client about the surgical procedure, which statement will the nurse use? o "A prosthetic device binds the stomach and creates a very small pouch and restricts oral intake." o "The stomach is stapled to create a very small pouch and part of the small intestine is rerouted." o "85% of the stomach is removed surgically, leaving a much smaller tube-like structure." o "The stomach is stapled to a very small pouch and the entire small intestine is rerouted.

o "The stomach is stapled to create a very small pouch and part of the small intestine is rerouted."

· A patient is scheduled for a Billroth I procedure for ulcer management. What does the nurse understand will occur when this procedure is performed? o A sectioned portion of the stomach is joined to the jejunum. o The antral portion of the stomach is removed and a vagotomy is performed. o A partial gastrectomy is performed with anastomosis of the stomach segment to the duodenum. o The vagus nerve is cut and gastric drainage is established.

o A partial gastrectomy is performed with anastomosis of the stomach segment to the duodenum.

· The nurse is reading the chart of a new client at the genetics clinic. The chart notes that the client, her brother, and her mother all have inherited a particular condition. The nurse plans care for a condition with which type of inheritance pattern? o Autosomal recessive o Autosomal dominant o X-linked o Multifactorial

o Autosomal dominant

· A nurse is caring for a client with a BMI of 35 kg/m2 who is wanting to lose weight. What is the initial recommendation the nurse will expect from the client's health care provider? o Surgical interventions o Lifestyle modification o Pharmacological management o Nonsurgical interventions

o Lifestyle modification

· A nurse cares for a client who is post op bariatric surgery and the nurse offers the client a sugar-free beverage. What is the primary purpose of offering a sugar-free beverage? o These ease nausea. o These are less likely to raise the blood sugar. o These ease gastric distention. o These are less likely to cause dumping syndrome.

o These are less likely to cause dumping syndrome.

· A nurse is caring for a client who is undergoing a diagnostic workup for a suspected gastrointestinal problem. The client reports gnawing epigastric pain following meals and heartburn. What would the nurse suspect this client has? o peptic ulcer disease o diverticulitis o appendicitis ulcerative colitis

o peptic ulcer disease

· The nurse is caring for an older adult client who has a hemoglobin of 9.6 g/dL and a hematocrit of 34%. To determine where the blood loss is coming from, what intervention can the nurse provide? o Observe client for facial droop o Observe the gums for bleeding after the client brushed teeth o Observe the sputum for signs of blood o Observe stools for blood

observe stools for blood

· A client has a blockage of the passage of bile from a stone in the common bile duct. What type of jaundice does the nurse suspect this client has? o Hepatocellular jaundice o Hemolytic jaundice o Cirrhosis of the liver o Obstructive jaundice

obstructive jaundice

· A client has an autosomal-dominant disorder. His wife is unaffected. When explaining the risk for inheritance of the disorder in their offspring, which statement by the nurse would be most appropriate? o "The female determines whether your children will have the disorder." o "There is a 50% chance that each of your children will have the condition." o "You have a 1 in 4 chance of a child being affected by the disorder." o "Any child you have would most likely have the disorder."

"There is a 50% chance that each of your children will have the condition."

· Which of the following terms describes the involuntary flapping movements of the hands associated with metabolic liver dysfunction? o Paracentesis o Ascites o Asterixis o Dialysis

Asterixis

· Which is an accurate statement regarding cancer of the esophagus? o It is three times more common in women than men in the United States. o Chronic irritation of the esophagus is a known risk factor. o It is seen more frequently in European Americans than in African Americans. o It usually occurs in the fourth decade of life.

Chronic irritation of the esophagus is a known risk factor.

· A nurse is preparing a presentation for a local community group about hepatitis. Which of the following would the nurse include? o Hep B is transmitted primarily by the oral-fecal route o Hep A is frequently spread by sexual contact o Infection with Hep G is similar to hep A o Hep C increases a person's risk for liver cancer

Hep c increases risk for developing liver cancer

· A nursing student is preparing a teaching plan for a client with an immunodeficiency disorder. The student is going to include the cardinal symptoms in teaching. Which of the following would the student include? Choose all that apply. o Facial edema o Poor response to treatment of infections o Chronic diarrhea o Chronic fatigue o Chronic or recurrent severe infections

Poor response to treatment of infections chronic diarrhea chronic or recurrent severe infections

· A client visits the physician's office complaining of agitation, restlessness, and weight loss. The physical examination reveals exophthalmos, a classic sign of Graves' disease. Based on history and physical findings, the nurse suspects hyperthyroidism. Exophthalmos is characterized by: o More than 10 beats/minute difference between apical and radial pulse rates o Dry, waxy swelling and abnormal mucin deposits in the skin o Protruding eyes and a fixed stare o A wide, staggering gait

Protruding eyes and a fixed stare

· A client with a peptic ulcer is diagnosed with Helicobacter pylori infection. The nurse is teaching the client about the medications prescribed, including metronidazole, omeprazole, and clarithromycin. Which statement by the client indicates the best understanding of the medication regimen? o "My ulcer will heal because these medications will kill the bacteria." o "These medications will coat the ulcer and decrease the acid production in my stomach." o "I should take these medications only when I have pain from my ulcer." o "The medications will kill the bacteria and stop the acid production."

The medications will kill the bacteria and stop the acid production."

· The nurse is assisting the physician with a procedure to remove ascitic fluid from a client with cirrhosis. What procedure does the nurse ensure the client understands will be performed? o Thoracentesis o Abdominal paracentesis o Abdominal CT scan Upper endoscopy

abdominal paracentesis

· An important message for any nurse to communicate is that drug-induced hepatitis is a major cause of acute liver failure. The medication that is the leading cause is: o Acetaminophen o Ibuprofen o Dextromethorphan o Benadryl

acetaminophen

· When caring for a client with cirrhosis, which symptom(s) should the nurse report immediately? o Anorexia and dyspepsia o Change in mental status o Fatigue and weight loss o Diarrhea or constipation

change in mental status

· Which foods should be avoided following acute gallbladder inflammation? o Cheese o Cooked fruits o Coffee o Mashed potatoes

cheese

· A client with calculi in the gallbladder is said to have o Choledocholithiasis o Cholecystitis o Choledochotomy o Cholelithiasis

cholelithiasis

· A client who has just been diagnosed with hepatitis A asks, "How did I get this disease?" What is the nurse's best response? o You could have gotten it by using IV drugs o You may have eaten contaminated restaurant food o You may have received an infected blood transfusion o You probably got it by engaging in unprotected sex

contaminated food/water

· Which nursing assessment is most important in a client diagnosed with ascites? o Daily measurement of weight and abdominal girth o Auscultation of abdomen o Assessment of the oral cavity for foul smelling breath o Palpation of abdomen for a fluid shift

daily weight and ab girth ascites: swelling of ab. due to build up of fluid (usually from liver failure)

· A client with end-stage renal disease has a decreased red blood cell production. What medication can the nurse administer with physician's order that will increase the production of erythrocytes? o Epoetin alfa o Filgrastim o Pepfligrastim o Interleukin 2

epoetin alfa

· Which is a clinical manifestation of diabetes insipidus? o Weight gain o Excessive thirst o Low urine output o Excessive activities

excessive thirst (polydipsia)

· When assessing a client with anemia, which assessment is essential? o Age and gender o Family history o Lifestyle assessments, such as exercise routines o Health history, including menstrual history in women

health history

· What does a positive Chvostek's sign indicate? o Hyponatremia o Hypokalemia o Hypermagnesemia o Hypocalcemia

hypoCalcemia

· A client who can't tolerate oral feedings begins receiving intermittent enteral feedings. When monitoring for evidence of intolerance to these feedings, what must the nurse remain alert for? o diaphoresis, vomiting, and diarrhea. o constipation, dehydration, and hypercapnia. o manifestations of electrolyte disturbances. o manifestations of hypoglycemia.

o diaphoresis, vomiting, and diarrhea.

· Rebound hypoglycemia is a complication of parenteral nutrition caused by o feedings stopped too abruptly. o fluid infusing rapidly. o glucose intolerance. o a cap missing from the port.

o feedings stopped too abruptly.

· A nurse reviews a client's laboratory results and notes the client has a decreased lymphocyte count. What nursing diagnosis will the nurse use when planning the client's care? o Risk for bleeding o Risk for infection o Impaired tissue integrity o Impaired oxygenation

risk for infection

· A client comes to the ED with severe abdominal pain, nausea, and vomiting. The physician plans to rule out acute pancreatitis. The nurse would expect the diagnosis to be confirmed by an elevated result on which laboratory test? o Serum amylase o Serum potassium o Serum calcium o Serum bilirubin

serum amylase

· Which symptoms will a nurse observe most commonly in clients with pancreatitis? o Increased appetite and weight gain o Black, tarry stools and dark urine o Severe, radiating abdominal pain o Increased and painful urination

severe radiating ab. pain

· A client is receiving a parenteral nutrition admixture that contains carbohydrates, electrolytes, vitamins, trace minerals, and sterile water and is now scheduled to receive an intravenous fat emulsion (Intralipid). What is the best action by the nurse? o Connects the tubing for the fat emulsion above the 1.5-micron filter o Attach the fat emulsion tubing to a Y connector close to the infusion site o Stops the admixture while the fat emulsion infuses o Starts a peripheral IV site to administer the fat emulsion

Attach the fat emulsion tubing to a Y connector close to the infusion site

· A client is suspected of having leukemia and is having a series of laboratory and diagnostic studies performed. What does the nurse recognize as the hallmark signs of leukemia? Select all that apply o Easy bruising o Frequent infections o Diarrhea o Fatigue from anemia o Nausea and vomiting

easy bruising frequent infections fatigue

· A patient has been diagnosed with an allergy to peanuts. What is a priority for this patient to carry at all times? o An H1 blocker o An oral airway o An EpiPen o A medical alert bracelet

epipen

· Which type of jaundice is the result of increased destruction of red blood cells? o Hemolytic o Obstructive o Hepatocellular o Nonobstructive

hemolytic

· After undergoing a thyroidectomy, a client develops hypocalcemia and tetany. Which electrolyte should the nurse anticipate administering? o Calcium gluconate o Sodium phosphorus o Potassium chloride o Sodium bicarbonate

o Calcium gluconate

· A nurse working at a clinic interprets which treatment plan as a sign that clinic has transitioned to a genomic approach to personalized medicine? o Trial and error approach to disease treatment o Waiting to treat until disease symptoms appear o Treatment of underlying genetic cause of disease o Treatment of presenting disease symptoms

o Treatment of underlying genetic cause of disease

· A nurse works in an employee health department of a hospital. She was asked to treat a staff nurse who was exposed to blood from a patient with an HIV infection. The nurse practitioner instituted a PEP protocol that includes which of the following actions? Select all that apply. o Continue HIV medications for 4 weeks postexposure. o Initiate postexposure testing after 4 weeks. o Finish postexposure testing at 6 months. o Start prophylaxis medications between 3 to 6 hours after exposure. o Practice safe sex for 2 weeks (time for HIV medications to reach a satisfactory blood level).

o Continue HIV medications for 4 weeks postexposure. o Initiate postexposure testing after 4 weeks. o Finish postexposure testing at 6 months.

· A group of students are studying for an examination on the gastrointestinal (GI) system and are reviewing the structures of the esophagus and stomach. The students demonstrate understanding of the material when they identify which of the following as the opening between the stomach and duodenum? o Hypopharyngeal sphincter o Pyloric sphincter o Ileocecal valve o Cardiac sphincter

o Pyloric sphincter

· A client has hereditary hemochromatosis. Laboratory test results indicate an elevated serum iron level, high transferrin saturation, and normal complete blood count (CBC). What is most important action for the nurse to take? o Educate about precautions to follow after liver biopsy o Instruct the client to limit iron intake in the diet o Remove the prescribed one unit of blood o Inform the client to limit ingestion of alcohol

o Remove the prescribed one unit of blood

· Which disorder results from excessive secretion of somatotropin (growth hormone)? o Dwarfism o Acromegaly o Cretinism o Adrenogenital syndrome

acromegaly

· When reviewing the history of a client with pancreatic cancer, the nurse would identify which of the following as a possible risk factor? o History of pancreatitis o One-time exposure to petrochemicals o Ingestion of caffeinated coffee o Ingestion of a low-fat diet

history

· A patient has been diagnosed with thrombocytopenia. What are the primary nursing interventions while instituting corticosteroid therapy in this patient? o Gradually taper the dose and frequency of medication o Examine the extremities for redness o Palpate the lymph nodes and tonsils every shift o Eliminate aspirin and NSAIDS

gradually taper dose

· Upon receiving the dinner tray for a client admitted with acute gallbladder inflammation, the nurse will question which of the following foods on the tray? o Hot roast beef sandwich with gravy o White rice o Mashed potatoes o Vanilla pudding

hot roast beef w/ gravy

· The nurse is preparing to interview a client with cirrhosis. Based on an understanding of this disorder, which question would be most important to include? o Have you had an infection recently? o How often do you drink alcohol? o Does your work expose you to chemicals? o What type of over-the-counter pain reliver do you use?

how often do you drink alc

· A client with cirrhosis has a massive hemorrhage from esophageal varices. Balloon tamponade is used temporarily to control hemorrhage and stabilize the client. In planning care, the nurse gives the highest priority to which goal? o Relieving the client's anxiety o Maintaining the airway o Maintaining fluid volume o Controlling bleeding

maintaining airway

· The nurse asks a client to point to where pain is felt. The client asks why this is important. What is the nurse's best response? o "This determines the pain medication to be ordered." o "Often the area of pain is referred from another area." o "If the health care provider massages over the exact painful area, the pain will disappear." o "The area may determine the severity of the pain."

o "Often the area of pain is referred from another area."

· The nurse confirms placement of a client's nasogastric (NG) tube using a combination of visual and pH assessment of the aspirate. The nurse determines that the NG tube remains properly placed when the pH of the aspirate is o Neutral o Unmeasurable o Acidic o Alkaline

acidic

· Health teaching for a patient with GERD is directed toward decreasing lower esophageal sphincter pressure and irritation. The nurse instructs the patient to do which of the following? Select all that apply. o Avoid beer, especially in the evening. o Drink three, 8 oz. glasses of regular milk daily to coat the esophagus. o Elevate the upper body on pillows. o Elevate the head of the bed on 6- to 8-inch blocks. o Eat 1 hour before bedtime so there will be food in the stomach overnight to absorb excess acid.

o Avoid beer, especially in the evening. o Elevate the upper body on pillows. o Elevate the head of the bed on 6- to 8-inch blocks.

· The nurse should teach the patient who is being radiated about protecting his skin and oral mucosa. An important teaching point would be to tell the patient to: o Use an ointment after treatment to decrease the feeling of burning which may last for several hours o Apply a small ice compress to the treated area afterward to decrease localized redness, post-radiation o Use an approved emollient 2 hours before the radiation to give the skin time to absorb the medication and provide a shield for damage o Cleanse the skin with a mild soap using his fingertips not a rough was cloth

o Cleanse the skin with a mild soap using his fingertips not a rough was cloth

· What intervention should the nurse provide to reduce the incidence of renal damage when a patient is taking a chemotherapy regimen? o Encourage fluid intake to dilute the urine o Take measures to acidify the urine and prevent uric crystallization o Limit fluids to 1,000 ml daily to prevent accumulation of the drugs end products after cell lysis o Withhold medication when the blood urea nitrogen level exceeds 20 mg/dl

o Encourage fluid intake to dilute the urine

· The nurse is managing a gastric (Salem) sump tube for a patient who has an intestinal obstruction and will be going to surgery. What interventions should the nurse perform to make sure the tube is functioning properly? o Maintain intermittent or continuous suction at a rate greater than 120 mm Hg. o Irrigate only through the vent lumen. o Tape the tube to the head of the bed to avoid dislodgement. o Keep the vent lumen above the patient's waist to prevent gastric content reflux.

o Keep the vent lumen above the patient's waist to prevent gastric content reflux.

· A client recovering from gastric bypass surgery accidentally removes the nasogastric tube. What is the best action by the nurse? o Place the nasogastric tube to the level of the esophagus. o Document the discontinuation of the nasogastric tube. o Notify the surgeon about the tube's removal. o Reinsert the nasogastric tube to the stomach.

o Notify the surgeon about the tube's removal.

· The nurse determines a client scheduled to undergo an abdominal ultrasonography should receive which instruction? o Restrict eating of solid food for 6 to 8 hours before test o Do not consume anything sweet for 24 hours before the test o Avoid exposure to sunlight for at least 6 to 8 hours before the test o Do not undertake any strenuous exercise for 24 hours before the test

o Restrict eating of solid food for 6 to 8 hours before test

· A client with end-stage liver disease is scheduled to undergo a liver transplant. The client tells the nurse, "I am worried that my body will reject the liver." Which statement is the nurse's best response to the client? o You would not be scheduled for transplant if there was a concern about rejection o It is easier to get a god tissue match with liver transplants than with other types of transplants o You will need to take daily medication to prevent rejection of the transplanted liver. The new liver has a good chance of survival with the use of these drugs o The problem of rejection is not as common in liver transplants as in other organ transplants

o You will need to take daily medication to prevent rejection of the transplanted liver. The new liver has a good chance of survival with the use of these drugs

· A client is in the initial stages of oral cancer diagnosis and is frightened about the side effects of treatment and subsequent prognosis. The client has many questions regarding this type of cancer and asks where oral cancer typically occurs. What is the nurse's response? o inside of the cheeks o base of the tongue o roof of the mouth o floor of the mouth

o floor of the mouth