Exam 1 Missed Practice Questions

A nurse was teaching a patient about NAFLD. Order the following statements of the nurse in the correct sequence based on the pathophysiology of NAFLD. Fat builds up in the liver Scar tissue replaces the entire liver Liver fibrosis develops Fat deposition & inflammation leads to scarring

1 Fat builds up in the liver 2 Liver fibrosis develops 3 Fat deposition & inflammation leads to scarring 4 Scar tissue replaces the entire liver

A client born as a male with the diagnosis of gender dysphoria has been dressing and functioning as a woman for 2 years and has decided to have sex-reassignment surgery. Place the following nursing interventions in order of priority: a. Treating the client with respect b. Encouraging the client to explore their feelings c. Investigating one's own feelings about sexuality d. Accepting the client's decision to have sex-reassignment surgery e. Exploring ways in which the decision can be shared with significant others.

1. c. Investigating one's own feelings about sexuality 2. a. Treating the client with respect 3. b. Encouraging the client to explore their feelings 4. d. Accepting the client's decision to have sex-reassignment surgery 5. e. Exploring ways in which the decision can be shared with significant others.

The nurse was comparing the benefits of Mesalamine with Sulfasalazine therapy for IBD mx. Which of the following are the advantages of Mesalamine? SATA. 5-ASA without sulfa Can be administered by per rectum route Can be administered by IV route Medications can be delivered at specific region of GI tract

5-ASA without sulfa Can be administered by per rectum route Medications can be delivered at specific region of GI tract

Which of the following outcomes are suggestive of the therapeutic outcomes of estrogen/antiandrogen therapy administered for trans-feminine individuals? SATA. Breast development Smoothening of the voice Change in bone structure Skin changes Fat redistribution

Breast development Skin changes Fat redistribution

Indicate whether the pain characteristic is for: diverticulitis, cholecystitis, pancreatitis: Radiating pain to the back shoulder

Cholecystitis, (Pancreatitis)

Which of the following descriptions best supports the role of immunomodulators in IBD mx? SATA. Reduce inflammation locally in the lining of the intestine Decreases the long term needs for steroids For the mx of active IBD not responding to conventional therapy Manages the dysmotility at particular segments

Decreases the long term needs for steroids For the mx of active IBD not responding to conventional therapy

A client has developed hepatic encephalopathy secondary to cirrhosis. The client's current medication regimen includes lactulose 4 times daily. Which of the following indicates the therapeutic response of this med? SATA. Improvement in indigestion 2-3 soft BMs daily Decrease in confusion Decreased AST and ALT Absence of blood or mucous in stool

Improvement in indigestion 2-3 soft BMs daily Decrease in confusion Decreased AST and ALT

Your patient has been prescribed Lamivudine for the mx of Hep B infection. Which of the following assessment findings indicates the adverse effects of this med? SATA. Increased blood sugar Neuropathy Depression Neutropenia Glaucoma

Increased blood sugar Neuropathy Neutropenia

Your patient has been diagnosed with IBD. Which of the following are the priority lab monitoring for this patient? SATA. Potassium Amylase Albumin CRP WBC Bilirubin

Potassium Albumin CRP WBC

A client's assessment and diagnostic tests are suggestive of acute pancreatitis. When the nurse is performing the health interview, what assessment questions likely address etiologic factors? SATA. a. How many alcoholic drinks do you typically consume in a week? b, Have you ever been tested for diabetes? c, Have you ever been diagnosed with gallstones? d, Does anyone in the family have pancreatitis? e, Do you smoke?

a. How many alcoholic drinks do you typically consume in a week? c, Have you ever been diagnosed with gallstones? d, Does anyone in the family have pancreatitis? e, Do you smoke?

Your patient was just diagnosed with Hep A. The patient is in the clinical (icteric) stage with acute presentation of symptoms. What S&S would you anticipate leading to that diagnosis? SATA. a. Jaundice b. Fector hepaticus c. Dark urine d. Increased liver enzymes e. Left lower quadrant pain

a. Jaundice c. Dark urine d. Increased liver enzymes

A client is hospitalized with acute pancreatitis. Which would be included in the client's plan of care? a. Use IV fluids b. Season foods sparingly. c. Eat small meals frequently d. Limit coffee to 3 cups/day.

a. Use IV fluids Acute pancreatitis requires NPO status.

The nurse is caring for a client with cirrhosis of the liver. The nurse anticipates a prescription for neomycin based on which abnormal laboratory test? a. ammonia level b. culture and sensitivity c. WBC count d. ALT level

a. ammonia level

Which medications increase the risk for an upper GI bleed? SATA. a. aspirin b. ibuprofen c. ciprofloxacin d. acetaminophen e. methylprednisolone

a. aspirin b. ibuprofen e. methylprednisolone

The nurse is caring for a client who is having difficulty digesting fatty foods. To which deficiency would the nurse attribute this problem? a. bile b. lipase c. amylase d. cholesterol

a. bile

Which autoantigens are responsible for the development of Crohn's disease? a. crypt epithelial cells b. thyroid cell surface c. basement membranes of the lungs d. basement membranes of the glomeruli

a. crypt epithelial cells

The nurse is performing a physical assessment of a client with ulcerative colitis. Which symptom is often associated with a serious complication of this disorder? a. decreased bowel sounds b. loose, blood-tinged stools c. distention of the abdomen d. intense abdominal discomfort

a. decreased bowel sounds

Which clinical manifestations does the nurse expect to report when admitted for surgical resection of a rectosigmoid colon cancer? SATA. a. feeling tired b. rectal bleeding c. inability to digest fat d. change in the shape of stools e. feeling of abdominal bloating f. stools float and are clay-colored

a. feeling tired b. rectal bleeding d. change in the shape of stools e. feeling of abdominal bloating

Which reported clinical manifestations would the nurse expect from a client with ulcerative colitis? SATA. a. fever b. diarrhea c. gain in weight d. spitting up blood e. abdominal cramps

a. fever b. diarrhea e. abdominal cramps

A client is admitted with the diagnosis of acute pancreatitis. Which clinical manifestations would the nurse assess in the client? SATA. a. jaundice b. acute pain c. HTN d. hypoglycemia e. increased amylase

a. jaundice b. acute pain e. increased amylase

Which finding indicates that a client is at an increased risk for colorectal cancer? a. presence of dark, tarry stools b. family hx of polyposis c. 20-year hx of ulcerative colitis d. unintentional 20-lb weight loss e. change in bowel pattern for 3 months

all answers are correct

The nurse educator of a college health course is discussing tattoos with the class. Which type of hepatitis associated with tattoos would the nurse include in the teaching plan? a. Hep A b. Hep C c. Hep D d. Hep E

b. Hep C

After many years of coping with ulcerative colitis, a client makes the decision to have a colectomy as advised by the primary HCP. Which is most likely the significant factor that affected this decision? a. It is temporary until the colon heals. b. Surgical treatment cures ulcerative colitis. c. Ulcerative colitis can progress to Crohn disease. d. Without surgery, eating table foods is c/i.

b. Surgical treatment cures ulcerative colitis.

A 5-year-old child complains of abdominal pain with nausea, anorexia, and a low-grade fever. Palpation of the RLQ of the abdomen elicits pain. Which condition would the nurse suspect? a. ulcerative colitis b. acute appendicitis c. Hirschsprung disease d. Hookworm infestation

b. acute appendicitis

Which information from a client's history would the nurse identify as risk factors for the development of colon cancer? SATA. a. hemorrhoids b. increased age c. high-fiber diet d. ulcerative colitis e. low hemoglobin level

b. increased age d. ulcerative colitis

The nurse is caring for a client with hepatic encephalopathy and ascites. Which elements are important to include in the client's diet? SATA. a. high fat b. low Na c. high vitamins d. moderate proteins e. low carbs

b. low Na c. high vitamins d. moderate proteins

The nurse is caring for a client with acute pancreatitis. Which elevated lab test result is most indicative of acute pancreatitis? a. BG b. serum lipase c. serum bilirubin level d. WBC count

b. serum lipase

A client with Crohn disease is admitted to the hospital with abdominal pain, fever, poor skin turgor, and having experienced 10 liquid bowel movements in the past 24 hours. The nurse suspects that the client is dehydrated based on which findings? SATA. a. moist skin b. sunken eyes c. decreased apical pulse d. dry mucous membranes e. increased BP

b. sunken eyes d. dry mucous membranes

Which medication will be crushed by a nurse caring for a client with difficulty swallowing? a. Metoprolol extended release b. Felodipine sustained released c. Acetaminophen extra strength d. Potassium chloride extended release

c. Acetaminophen extra strength

The nurse reviews a medical record of a client with ascites. Which client condition is a contributing factor to the development of ascites? a. portal hypotension b. kidney malfunction c. diminished plasma protein level d. decreased production of K

c. diminished plasma protein level Albumin is the primary plasma protein.

Indicate whether the pain characteristic is for: diverticulitis, cholecystitis, pancreatitis: N/V

cholecystitis, pancreatitis *Nausea is an acute symptom of diverticulitis.

The nurse is caring for a patient with a diagnosis of acute pancreatitis and alcoholism. The client asks, "How does my drinking relate to my diagnosis?" Which effect of alcohol would the nurse include when responding? a. It promotes the formation of calculi in the cystic duct. b. It stimulates the pancreas to secrete more insulin than it can immediately produce. c. It alters the composition of enzymes so they are capable of damaging the pancreas. d. It increases enzyme secretion and pancreatic duct pressure that causes backflow of enzymes into the pancreas.

d. It increases enzyme secretion and pancreatic duct pressure that causes backflow of enzymes into the pancreas.

Which additional supplement will be needed by a client with chronic liver disease who reports, "My gums have been bleeding spontaneously. and has small hemorrhagic lesions on the face? a. bile salts b. folic acid c. Vitamin A d. Vitamin K

d. Vitamin K

The nurse is caring for a client admitted with peritonitis. Which finding in the medical record is the most likely cause? a. gastritis b. hiatal hernia c. diverticulitis d. bowel obstruction

d. bowel obstruction

Which information about malignant tumors of the colon would the nurse consider when providing care for a client with an obstruction of the bowel? a. detection of malignant tumors is empty b. malignant tumors usually localize to one area c. women are more at risk than men d. colon obstructions are usually malignant

d. colon obstructions are usually malignant

The nurse is performing a physical assessment of a client admitted to the hospital with a diagnosis of cirrhosis. The nurse expects to observed which skin conditions? a. vitiligo b. hirsutism c. melanosis d. ecchymoses e. telangiectasia

d. ecchymoses e. telangiectasia

A client with a hx of ulcerative colitis has a large portion of the large intestine removed, and an ileostomy is created. For which potential life-threatening complication would the nurse assess the client after this surgery? a. infection caused by the excretion of feces b. injury caused by exposed intestinal mucosa c. altered bowel elimination caused by the ostomy d. limited water reasbsorption caused by removal of the large intestine

d. limited water reasbsorption caused by removal of the large intestine

The nurse is creating a dietary plan for a client with cholecystitis who has been placed on a modified diet. Which is appropriate in the client's dietary plan? a. soft-textured foods to reduce digestive burden b. low-cholesterol foods to avoid further formation of gallstones c. increased protein to promote tissue healing and improve energy reserves d. reduced fat intake to avoid stimulation of the cholecystokinin mechanism for bile release

d. reduced fat intake to avoid stimulation of the cholecystokinin mechanism for bile release

A client is diagnosed with acute pancreatitis. The HCP's prescriptions include NPO and TPN. The nurse explains that the TPN therapy provides which benefit? a. is the easiest method for administering needed nutrition b. is the safest method for meeting the client's nutritional needs c. will satisfy the client's hunger without the discomfort associated with eating d. will meet the client's nutritional needs without causing the discomfort precipitated by eating

d. will meet the client's nutritional needs without causing the discomfort precipitated by eating TPN does not stimulate the pancreas.