NUR324 NearPod Final questions

A nurse is caring for a client with colorectal cancer who is receiving total parenteral nutrition (TPN). The provider has prescribed the TPN to infuse at 150 mL/hr. The TPN bag holds 2400 mL How long will it take for the TPN to infuse to the nearest whole hour?

16 hours

A client returns from surgery for placement of a colostomy secondary to ulcerative colitis. Two hours after the surgery the nurse is most concerned about which assessment?

A blood pressure below the baseline value

Which measurement would provide the most specific information about the outcome of a paracentesis for a client who has ascites?

Abdominal girth

Which information would the nurse include in the teaching plan for a client who is stable after treatment of recently diagnosed esophageal varices?

Avoid straining during defecation to keep venous pressure low

A client with a medical diagnosis of cirrhosis has been admitted to a medical unit, and the nurse is doing an assessment. What complaint from the client requires immediate follow up?

Bloody expectorant with coughing episodes

A client is returned to the surgical unit after an abdominal cholecystectomy. Which is the main reason why the nurse would assess for clinical indicators of respiratory complications?

Client is at risk for developing pneumonia

A client undergoes a laparotomy in the epigastric region for a small bowel obstruction. Which nursing intervention is indicated to prevent the most concerning complication of this surgery?

Coughing and using an incentive spirometer every 2 hours

A client on the surgical unit is preparing to be discharged after a colectomy for an intestinal obstruction. The nurse finds the client passed out on the bathroom floor. Which response by the nurse would be most appropriate?

Determine if the client is breathing and has a pulse

Which action is likely to exacerbate the condition of a client who has pancreatitis?

Eating three large meals

A client has chronic diarrhea, bloating, and abdominal pain. The healthcare provider is ruling out celiac disease. The client asks the nurse about dietary guidelines. What would be the best answer from the nurse?

Foods that you cannot eat include wheat proteins or gluten based starches or fillers

A client experiences occasional right upper quadrant pain attributed to cholecystitis. To prevent or minimize dyspepsia, the nurse would instruct the client to avoid which food items?

Fried chicken and buttered popcorn

Which clinical manifestations are seen with hepatitis? Select all that apply.

Hepatomegaly, Elevated liver enzymes, Jaundice, low grade fever

The nurse is providing discharge teaching for a client with newly diagnosed Crohn's disease about dietary measures to implement during exacerbation episodes. Which statement made by the client indicates a need for further instruction?

I need to increase the fiber in my diet.

The clinic nurse is interviewing a new client, who presents with increasing frequency of stools and says the last healthcare provider gave a diagnosis of ulcerative colitis. What statement by the client requires immediate follow-up?

I've developed a high fever and severe abdominal pain since yesterday

A client is admitted with ascites from cirrhosis with liver failure. Spironolactone 100 mg is administered. Which sign or symptom would indicate a serious complication for the client?

Increasing thirst

When planning care for a patient who has cirrhosis with significant abdominal ascites, which patient problem has the highest priority?

Ineffective breathing pattern

A client reports nausea and abdominal pain. The nurse notices bluish discoloration in the area between the client's last rib and the hip and records a body temperature of 99.1°F (37.3°C). The laboratory reports reveal a white blood cell count (WBC) of 12,000 cells/µL. Which condition would the nurse suspect in this client?

Pancreatitis

Which intervention(s) would the nurse expect in the treatment plan for a client who is admitted to the hospital with ascites?

Paracentesis, Monitor electrolytes, administer albumin

Which diagnostic test(s) would the nurse anticipate will be prescribed to confirm a client's diagnosis of acute pancreatitis? Select all that apply.

Serum lipase, Serum amylase, CT Scan

EMS transports a known IV drug user to the ED. The client reports flu-like symptoms for the last week, jaundice, and inability to keep food down. What safety precautions should the nurse utilize?

Standard precautions of gloves and handwashing

The health care provider prescribes lactulose for a client with hepatic encephalopathy. Which data would the nurse monitor for effectiveness of this medication?

Stool frequency, Ammonia levels

A 13 year old client is receiving total parenteral nutrition (TPN) as a treatment for Crohn's disease. The client asks the rationale for this treatment. Which statement by the nurse accurately describes the reason for this treatment?

TPN allows your intestines to rest and heal for a while

Which information would the nurse emphasize while teaching a patient ways to avoid exposure to hepatitis B infection? Select all that apply.

Use disposable needles and syringes, Avoid sharing toothbrushes and razors, Avoid unsafe sex with multiple partners, and always use condoms

Which instruction would the nurse include in the discharge teaching when a client with hepatitis A infection is leaving the hospital?

Wash your hands thoroughly after having a bowel movement

How is tissue perfusion improved or skin damaged prevented in patients with PAD?

avoid exposure to cold temperatures, avoid crossing legs, take steps to prevent trauma or injury to the skin

What health teaching will the nurse include as part of the discharge planning for DVT prevention/management of a new DVT?

elevate legs on pillows when in bed, wear knee-high graduated compression stockings , apply prolonged pressure over cuts and noses bleeds, avoid eating foods that are high in fat and cholesterol, increase your activity slowly and rest when needed take over the counter pain medications for mild pain, keep your scheduled appointments at warfarin clinic, contact your PCP if stool is black and tarry, monitor your HR and BP daily

How should patients with PAD position their legs?

keep legs in the dependent position, no constricting clothing/socks

Can patients with PAD go barefoot in the house?

no

Should patients with PAD soak their feet in water once a day to ensure they are clean?

no

The nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis who is scheduled for surgery in 2 hours. The client begins to complain of increased abdominal pain and begins to vomit. On assessment, the nurse notes that the abdomen is distended and bowel sounds are diminished. Which is the most appropriate nursing intervention?

notify the surgeon

What clinical manifestations of PAD are need for diagnosis?

paresthesia, elevation pallor, dependent rubor, rest pain at night

where should you assess for S/S of bleeding

stool, emesis, gums, nose, bruising

What signs do you expect to find with PAD?

thick brittle nails, cool or cold extremity, thin shiny and taut skin, decreased or absent pedal pulses