Nurs 309 Quiz 18

What is the most common and serious complication after a Whipple procedure? a. Diabetes mellitus b. wound infection c. fistula development d. bowel obstruction

c. fistula development

The UAP asks, "Why can't Ms. T (ulcerative colities) get out of bed and do things for herself? She's only 29 years old." What is the team leader's best response? 1. "The HCP ordered bed rest for a few days." 2. "Decreasing activity helps to decrease the diarrhea." 3. "I see you're frustrated; just do your best to help." 4. "She is too depressed to get out bed."

2. "Decreasing activity helps to decrease the diarrhea."

For which clinical indicators should the nurse monitor when caring for a client with cholelithiasis and obstructive jaundice? SATA a. dark urine b. yellow skin 3. pain on urination 4. clay-colored stool 5. coffee ground vomitus

a. dark urine b. yellow skin 4. clay-colored stool

Which factor renders a patient the least likely to benefit from extracorporeal shock wave lithotripsy (ESWL) for treatment of gallstones? a. height 5 feet 10 inches, 325 lbs b. cholesterol-based stones c. height 5 feet 7 inches, 138 lbs d. small gallstones

a. height 5 feet 10 inches, 325 lbs

The nurse detects an epigastric mass while assessing patient with acute pancreatitis. The patient describes epigastric pain that radiates to his back. What does the nurse suspect? a. liver cirrhosis b pancreatic pseudocyst c. gallstones d. chronic pancreatitis

b pancreatic pseudocyst

Which are manifestations of pancreatic cancer? SATA a. light-colored urine and dark-colored stools b. anorexia and weight loss c. splenomegaly d. ascites e. leg or calf pain f. weakness and fatigue

b. anorexia and weight loss c. splenomegaly d. ascites e. leg or calf pain f. weakness and fatigue

The nurse is teaching a patient and family how to prevent exacerbations of chronic pancreatitis. which teaching point does the nurse include? a. moderation in the use of caffeinated beverages b. avoidance of alcohol and nicotine c. consume a bland, high-fat, low-protein diet d. regular exercise, emphasizing aerobic activities

b. avoidance of alcohol and nicotine

The nurse is caring for an older adult patient with acute biliary pain. Which drug order does the nurse question? a. ketorolac b. meperidine c. morphine d. hydromorphone

b. meperidine

The patient with acute necrotizing pancreatitis experiences a temperature spike to 104 F (40 C). What does the nurse suspect? a. pancreatic pseudocyst b. pancreatic abscess c. chronic pancreatitis d. pancreatic cancer

b. pancreatic abscess

The daughter of a patient with cholelithiasis has heard that there is a genetic disposition for cholelithiasis. The daughter asks the nurse about the risk factors. How does the nurse respond? a. "there is no evidence that first degree relatives have an increased risk for this disease." b. "Cholelithiasis is sen more frequently in patients who are underweight." c. "Hormone replacement therapy has been associated with increased risk for cholelithiasis." d. "Patients with diabetes mellitus are at increased risk for cholelithiasis."

c. "Hormone replacement therapy has been associated with increased risk for cholelithiasis."

Which patient would the nurse assess as low risk for the development of gallbladder disorders? a. Patient with sickle cell anemia b. Patient who is Mexican American c. Patient who is 20 years old and male d. Patient with a history of prolonged parenteral nutrition

c. Patient who is 20 years old and male

The nurse is assessing a patient with acute cholecystitis whose abdominal pain is severe. The patient is pale, is diaphoretic, and describes extreme fatigue. Vital signs are: heart rate of 118/minutes, BP 95/70, respirations 32/min, temperature 101 F (38.33C). What is the nurses's priority action at this time? a. instruct the unlicensed assistive personnel (UAP) to reposition the patient for comfort b. auscultate the patient's abdomen in all four quadrants c. notify the patient's health care provider d. administer the ordered opioid analgesic

c. notify the patient's health care provider

The health care provider has assessed a patient's abdomen and found rebound tenderness on deep palpation. What does the nurse recognize? a. steatorrhea b. eructation c. biliary colic d. blumberg's sign

d. blumberg's sign

A client is admitted with a tentative diagnosis of pancreatitis. The medical and nursing measures for this client are aimed toward maintaining nutrition, promoting rest, maintaining fluid and electrolyte balance, and decreasing anxiety. Which interventions should the nurse implement? SATA 1. Provide a low-fat diet 2. administer analgesics 3. teach relaxation exercises 4. encourage walking in the hall 5. monitor cardiac rate and rhythm 6. observe for signs of hypercalcemia

2. administer analgesics 3. teach relaxation exercises 5. monitor cardiac rate and rhythm

The patient comes to the emergency department (ED) with severe abdominal pain in the midepigastric area. The patient states that the pain began suddenly, is continuous, radiates to his back, and is worst when he lies flat on his back. What condition does the nurse suspect? a. acute cholecystitis b. Pancreatic cancer c. acute pancreatitis d. pancreatic pseudocyst

c. acute pancreatitis

A client underwent an exploratory laparotomy 2 days ago. The health care provider (HCP) should be called immediately for which physical assessment finding? 1. Abdominal distention and rigidity 2. Displacement of the nasogastric (NG) tube 3. Absent or hypoactive bowel sounds 4. Nausea and occasional vomiting

1. Abdominal distention and rigidity

Which tasks can be delegated to the UAP? SATA 1. Assisting Ms. T with perineal care after diarrheal episodes 2. Measuring vital signs every 2 hours for Mr. R 3. Transporting Ms. H off the unit for a procedure 4. Gently cleansing the nares around Ns. D's NG tube 5. Removing Mr. A's dressing 6. Helping Mr. K to brush his teeth

1. Assisting Ms. T with perineal care after diarrheal episodes 2. Measuring vital signs every 2 hours for Mr. R 3. Transporting Ms. H off the unit for a procedure 4. Gently cleansing the nares around Ns. D's NG tube 5. Removing Mr. A's dressing 6. Helping Mr. K to brush his teeth

Psychosocial assessment reveals that Mr. A (appendectomy) faces several financial and personal problems. Which finding has the most impact on discharge teaching for wound care and other follow-up issues? 1. He is homeless and has no family in the city. 2. He has no money for the prescribed medications 3. He has no transportation to the follow- up appointment 4. He cannot read or write very well

1. He is homeless and has no family in the city.

To provide good continuity of care for Mr. A (appendectomy), who is homeless, which members of the interdisciplinary team should routinely have access to Mr. A's medical records? SATA 1. Hospital social worker who is helping Mr. A to locate resources 2. Surgeon who performed Mr. A's appendectomy 3. An epidemiologist who is collecting data on the homeless 4. All of the UAPs who work in the medical-surgical area 5. Administer of the shelter where Mr. A frequently stays 6. Nurse who works at the shelter where Mr. A frequently stays

1. Hospital social worker who is helping Mr. A to locate resources 2. Surgeon who performed Mr. A's appendectomy 6. Nurse who works at the shelter where Mr. A frequently stays

Which clients would be best to assign to the new RN? SATA 1. Ms. H (acute cholecystitis) 2. Ms. D (bowel obstruction) 3. Ms. T (ulcerative colitis) 4. Mr. A (appendectomy) 5. Mr. K (PEG-tube) 6. Mr. R (acute pancreatitis)

1. Ms. H (acute cholecystitis) 2. Ms. D (bowel obstruction) 4. Mr. A (appendectomy)

A patient is admitted with obstructive jaundice. Which sign/symptom does the nurse expect to find upon assessment of the patient? a. pruritus b. pale urine in increased amounts c. pink discoloration of sclera d. dark, tarry stools

a. pruritus

Mr. K (PEG tube) need 1200 kcal/day. The enteral feeding formula provides 1 kcal/mL. Yesterday's formula feedings were 100 mL at 7:00AM, 50 mL at 11:00AM, 200 mL at 3:00PM, and 100 mL at 7:00PM. What should the nurse do first? 1. Give additional feedings to catch up on nutritional needs 2. Look at the original prescription to determine frequency and amount 3. Look at weight trends to see if client is losing or maintaining weight 4. Call the nurse who cared for Mr. K yesterday and asked what happened

2. Look at the original prescription to determine frequency and amount

Mr. A (appendectomy) will be discharged with prescriptions for pain medication and antibiotic. What is the most important point that the nurse will emphasize about the medications? 1. "Take the pain medication before the pain becomes severe." 2. "The pain medication may make you feel drowsy or sleepy." 3. "All the antibiotics should be taken, even if you feel good." 4. "The antibiotics should not be shared with any other person."

3. "All the antibiotics should be taken, even if you feel good."

The new RN asks the team leader if it si okay to give Ms. D (bowel obstruction) a dose of psyllium using the HCP's standing orders. Ms. D says, "She feels constipated and take psyllium on a regular basis at home." What is team leader's best response? 1. "Call the HCP to see if the standing orders apply to Ms. D" 2. "Give the psyllium according tot he standing orders." 3. "Laxatives can cause perforation if there is a bowel obstruction." 4. "The client can't be constipated because she is NPO

3. "Laxatives can cause perforation if there is a bowel obstruction."

While the nurse is teaching Mr. A about dressing changes for his appendectomy wound, he says, "When you live on the street, you can't do everything the way you nurses do in the hospital." What is the most important thing to emphasize in helping him to accomplish self-care? 1. "Change the dressing in the AM and the PM." 2. "Use the gauze package to make a sterile field." 3. "Wash your hands before dressing change.: 4. "Discard any opened packages of unused gauze."

3. "Wash your hands before dressing change.:

Ms. T is receiving an oral dose of sulfasalazine 500 mg every 6 hours for treatment of ulcerative colitis. Which assessment finding is cause for greatest concern? 1. Decreased appetite 2. Nausea and vomiting 3. Decreased urine output 4. Headache

3. Decreased urine output

The nurse is caring for a client with a nasogastric (NG) tube. Which task can be delegated to experienced unlicensed assistive personnel (UAP)? 1. Removing the NG tube at the prescribed time 2. Securing the tape if the client accidentally dislodges the tube 3. Disconnecting the suction to allow ambulation to the toilet 4. Reconnecting the suction after the client has ambulated

3. Disconnecting the suction to allow ambulation to the toilet

The health car provider (HCP) told Ms. H (acute cholecystitis) that she would probably need a laparoscopic cholecystectomy; however, the hepatobiliary iminodiacetic acid (HIDA) scan and laboratory results are still pending. Ms. H asks, "What should I expect?" What is the best intervention at this point? 1. Describe the surgical procedure 2. Call the HCP to come and speak with her 3. Provide some written material about gallbladder disease and options 4. Explain general postoperative care, such as coughing and deep breathing exercises

3. Provide some written material about gallbladder disease and options

An 18 year old is admitted with an acute onset of right lower quadrant pain at McBurney's point. Appendicitis is suspected. For which clinical indicator should the nurse assess the client to determine if the pain is secondary to appendicitis? 1. urinary retention 2. Gastric hyperacidity 3. Rebound tenderness 4. Increased lower bowel motility

3. Rebound tenderness

The nurse is providing postoperative care for a client who underwent laparoscopic cholecystectomy. What should be reported immediately to the health care provider? 1. The client cannot void 5 hours postoperatively. 2. The client reports should pain 3. The client reports right upper quadrant pain 5. Output does not equal input for the first few hours

3. The client reports right upper quadrant pain

Ms. T is discouraged and dispirited about her ulcerative colitis. She is resistant to TPN because "i'm being kept alive with tubes." Which explanation will encourage Ms. T to continue with the TPN therapy? 1. "It will help you regain your weight." 2. "It will create a positive nitrogen balance." 3. "Your health care provider has ordered this important therapy for you." 4. "Your bowel can rest, and the diarrhea will decrease."

4. "Your bowel can rest, and the diarrhea will decrease."

A nurse is caring for a client with diagnosis of acute pancreatitis and alcoholism. The client asks, "What does my drinking have to do with my diagnosis?" What effect of alcohol should the nurse include when responding? 1. promotes the formation of calculi in the cystic duct 2. stimulates the pancreas to secrete more insulin that it can immediately produce 3. alters the composition of enzymes so they are capable of damaging the pancreas 4. Increases enzyme secretion and pancreatic duct pressure that causes backflow of enzymes into the pancreas

4. Increases enzyme secretion and pancreatic duct pressure that causes backflow of enzymes into the pancreas

All of these clients must receive their routine morning medications. Which client should receive his or her medication last? 1. Ms. H (acute cholecystitis) 2. Ms. D (bowel obstruction) 3. Ms. T (ulcerative colitis) 4. Mr. K (PEG-tube)

4. Mr. K (PEG-tube)

A client is discharged the same day after ambulatory surgery for a laparoscopic cholecystectomy. The nurse is providing discharge teaching about how many days the client should wait to engage in certain activities. Place in order the activities from the first to the last in which the client may engage. 1. showering 2. driving a car 3. performing light exercise 4. getting out of bed in a chair 5. lifting objectives of more than ten pounds

4. getting out of bed in a chair 3. performing light exercise 1. showering 2. driving a car 5. lifting objectives of more than ten pounds

The night shift nurse has just finished giving the RN team leader a report on the six clients. Which client has the highest acuity level and is at greatest risk for shock during the shift? 1. Ms. H (acute cholecystitis) 2. Ms. D (bowel obstruction) 3. Ms. T (ulcerative colitis) 4. Mr. A (appendectomy) 5. Mr. K (PEG-tube) 6. Mr. R (acute pancreatitis)

6. Mr. R (acute pancreatitis)

A nurse is assessing a client who has possible appendicitis. The nurse assesses the client for rebound tenderness. Place an X on the illustration where the client is expected to report pain.

Look on page 351 in NCLEX book, #289 (answer page) (lower right quadrant)

Which are advantages of minimally invasive surgery (MIS) laparoscopic cholecystectomy? SATA a. complications are uncommon b. the mortality is similar to traditional cholecystectomy c. patients recovery more rapidly d. postoperative pain is less severe e. bile duct injuries are rare f. IV antibiotics are never needed because of decreased infection rates

a. complications are uncommon c. patients recovery more rapidly d. postoperative pain is less severe e. bile duct injuries are rare

The patient with acute pancreatitis experiences abdominal pain. What is the best intervention to begin managing this pain? a. IV opioids by means of patient-controlled analgesia (PCA) b. oral opioids such as morphine sulfate given as needed d. intramuscular opioids given every 6 hours d. oral hydromorphone (Dilaudid) given twice daily

a. IV opioids by means of patient-controlled analgesia (PCA)

Which statement are true regarding laparopscopic cholecystectomy? SATA a. Laparoscopic cholecystectomy is considered the "gold standard" and is performed far more often than the traditional open approach b. Patients with chronic lung disease or heart failure who are unable to tolerate the oxygen used in the laparoscopic procedure are examples of patients who have the open surgical approach (abdominal laparotomy). c. Removing the gallbladder technique reduces the risk of wound complications d. Patients who have their gallbladders removed by the laparoscopic technique should be taught the importance of early ambulation to promote absorption of carbon dioxide e. use of laparoscopic cholecystectomy puts the patient at increased risk for bile duct injuries f. after a laparoscopic cholecystectomy, assess the patient's oxygen saturation level frequently until the effects of the anesthesia have passed

a. Laparoscopic cholecystectomy is considered the "gold standard" and is performed far more often than the traditional open approach c. Removing the gallbladder technique reduces the risk of wound complications d. Patients who have their gallbladders removed by the laparoscopic technique should be taught the importance of early ambulation to promote absorption of carbon dioxide f. after a laparoscopic cholecystectomy, assess the patient's oxygen saturation level frequently until the effects of the anesthesia have passed

The nurse is caring for a patient with pancreatic cancer who had Whipple procedure. Which interventions and assessments does the nurse implement? SATA a. Place the patient in Semi-Fowler's position b. Place the NG tube on intermittent suction c. monitor NG drainage, which should be bile-tinged and contain blood d. keep the patient NPO e. check blood glucose often f. monitor for signs and hypovolemia to prevent shock

a. Place the patient in Semi-Fowler's position b. Place the NG tube on intermittent suction d. keep the patient NPO e. check blood glucose often f. monitor for signs and hypovolemia to prevent shock

Which are potential cardiovascular complications for a patient after surgery for a Whipple procedure? SATA a. Thrombophlebitis b. pulmonary embolism c. myocardial infarction d. heart failure e. renal failure f. hemorrhage at anastomosis sites with hypovolemia

a. Thrombophlebitis c. myocardial infarction d. heart failure f. hemorrhage at anastomosis sites with hypovolemia

Which is a key feature of pancreatic cancer? a. anorexia b. weight gain c. pale urine d. dark-colored stools

a. anorexia

Which are common manifestations of a cute cholecystitis? SATA a. anorexia b. ascites c. eructation d. steatorrhea e. jaundice f. rebound tenderness

a. anorexia c. eructation e. jaundice f. rebound tenderness

Which abnormal laboratory findings are cardinal findings in acute pancreatitis? SATA a. elevated serum lipase b. increased serum amylase c. decreased serum trypsin d. elevates serum elastase e. decreased serum glucose f. elevated bilrubin

a. elevated serum lipase b. increased serum amylase d. elevates serum elastase f. elevated bilrubin

The nurse is administering ketorolac to a 78 year old patient for mild to moderate biliary pain management. Which assessment finding indicates the patient is experiencing a side effect of this drug? a. gastrointestinal upset b. ventricular cardiac dysrhythmias c. decreased urinary output d. jaundice

a. gastrointestinal upset

The nurse on a medical-surgical unit is caring for several patients with acute cholecystitis. Which task is best to delegate to the unlicensed assistive personnel (UAP)? a. obtain the patients' vital signs b. Determine if any foods are not tolerated c. Assess what measures relieve the abdominal pain d. Asks the patients to describe their daily activity or exercise routines

a. obtain the patients' vital signs

The patient is to continue pancreatic enzyme replacement therapy (PERT) after discharge. Which statement indicates that the patient understands teaching about this therapy? a. "I will take the enzymes before meals with a full glass of water." b. "I will take the enzymes after I take my ranitidine." c. "I will mix the enzymes with chopped meat." d. "I will chew the capsules before swallowing the enzymes."

b. "I will take the enzymes after I take my ranitidine."

The patient with acute cholecystitis has a pacemaker. Which diagnostic test is contraindicated? a. Extracorporeal shock wave lithotripsy (ERCP) b. Magnetic resonance cholangiopancreatography (MRCP) c. Ultrasonography of the right upper quadrant d. Hepatobiliary (HIDA) scan

b. Magnetic resonance cholangiopancreatography (MRCP)

A patient is scheduled for tests to verify the medical diagnosis of cholecystitis. For which diagnostic test doest eh nurse provide patient teaching? a. Extracorporeal shock wave lithotripsy (ESWL) b. Ultrasonography of the right upper quadrant c. Endoscopic retrograde cholangiopancreatography (ERCP) d. serum level aspartate aminotransferase (AST)

b. Ultrasonography of the right upper quadrant

The nurse has instructed a patient in the recovery phase of acute pancreatitis about diet therapy. Which statement by the patient indicates that teaching has been successful? a. "i will eat the usual three meals a day that I am used to." b. "I am eating tacos for my first meal back home." c. "I will avoid eating chocolate and drinking coffee." d. "I will limit the amount of protein in my diet?"

c. "I will avoid eating chocolate and drinking coffee."

The nursing student is caring for a patient with chronic pancreatitis who is receiving pancreatic enzyme replacement therapy. Which statement by the student indicates the ned for further study concerning this therapy? a. "The enzymes will be administered with meals." b. "The patient will take the drugs with a glass of water." c. "If the patient has difficulty swallowing the enzyme preparation, I will crush it and mix it with foods." d. "The effectiveness of pancreatic enzyme treatment is monitored by the frequency and fat content of stools."

c. "If the patient has difficulty swallowing the enzyme preparation, I will crush it and mix it with foods."

A female patient is to have her gallbladder removed by natural orifice transluminal endoscopic surgery. What does the nurse teach about this surgery? a. The surgeon will use powerful shock waves to break up the gallstones b. The surgeon will insert a transhepatic biliary catheter to open blocked bile ducts c. the surgeon will use a vaginal approach to remove the gallbladder d. the surgeon will inject ursodeoxycholic acid to dissolve any remaining gallstone fragments

c. the surgeon will use a vaginal approach to remove the gallbladder

Which statement about the care of patient with Jackson-Pratt (JP) drain after a traditional cholecystectomy is true? a. The patient is maintained in the prone position b. When the patient is allowed to eat, the JP drain is clamped continuously c. The JP drain is irrigated every hour for the first 24 hours d. Serosanguineous drainage stained with bile is expected for 24 hours

d. Serosanguineous drainage stained with bile is expected for 24 hours

Which condition is most likely to be treated with antibiotics? a. cancer of the gallbladder b. acute cholelithiasis c. chronic pancreatitis d. acute necrotizing pancreatitis

d. acute necrotizing pancreatitis

After removal of the gallbladder, a patient experiences abdominal pain with vomiting for several weeks. What does the nurse recognize? a. chronic cholecystitis b. Recurrence of acute cholecystitis c. unremoved gallstone d. postcholecystectomy syndrome

d. postcholecystectomy syndrome

The RN is observing the nursing student perform an abdominal assessment on Ms. D, who was admitted for a bowel obstruction. For which actions will the supervising nurse intervene? SATA 1. Palpating for abdominal distention with index fingertip 2. Auscultating for bowel sounds with NG tube attached to low wall suction 3. Performing the physical assessment before asking about pain 4. Checking the NG collection canister for quantity and quality of drainage 5. Inspecting for visible signs of peristaltic waves or abdominal distention 6. Checking for skin turgor over the lower abdominal area

1. Palpating for abdominal distention with index fingertip 2. Auscultating for bowel sounds with NG tube attached to low wall suction 3. Performing the physical assessment before asking about pain 6. Checking for skin turgor over the lower abdominal area

The nurse is reviewing the medication administration record for Ms. T (ulcerative colitis). Which situation needs immediate investigation? 1. Two tablets of senna were given yesterday morning 2. One dose of atropine sulfate was given yesterday morning 3. IV infusion of infliximab 5 mg/kg was given last evening 4. IV hydrocortisone 100 mg was given last evening

1. Two tablets of senna were given yesterday morning

A nurse is caring for a client with colelithiasis and obstructive jaundice. When assessing this client, the nurse should be alert for which common clinical indicators associated with these conditions? SATA 1. ecchymosis 2. yellow sclera 3. dark brown stool 4. straw colored stool 5. pain in right upper quadrant

1. ecchymosis 2. yellow sclera 5. pain in right upper quadrant

The nurse is caring for an obese postoperative client who underwent surgery for bowel resection. As the client is moving in bed, he comments, "something popped open." Upon examination, the nurse notes wound evisceration. Place the steps in order for handling this complication. 1. Cover the intestine with sterile moistened gauze 2. Stay calm and stay with the client 3. Check the vital signs, especially blood pressure and pulse 4. Have a colleague gather sterile supplies and contact the health care provider (HCP) 5. Put the client into semi-Fowler position with knees slightly flexed 6. Prepare the client for surgery as ordered

2, 5, 3, 4, 1, 6

The home health nurse sees that the client is taking cimetidine. What question is the nurse most likely to ask to evaluate the efficacy of the therapy? 1. "Are you still having problems with constipation?" 2. " Has the medication helped to relieve the acid indigestion?" 3. "Did the medication relieve the nausea and vomiting?" 4. "Do you feel like your appetite has improved?"

2. " Has the medication helped to relieve the acid indigestion?"

The night nurse gives a brief and incomplete report. Which question should the oncoming RN team leader pose to the night shift nurse to help determine the priority actions for Ms. H who was admitted for acute cholecystitis? 1. "What are her vital signs?" 2. "Is she going to surgery or radiology this morning?" 3. "Is she still having pain?" 4. "Does she need any morning medications?"

2. "Is she going to surgery or radiology this morning?"

A nurse is preparing a teaching plan for a client with a history of cholelithiasis. Which information about why the ingestion of fatty foods will cause discomfort should the nurse include in the teaching plan? 1. fatty foods are hard to digest 2. bile flow into the intestine is obstructed 3. the liver is manufacturing inadequate bile 4. there is inadequate closure of the ampulla of Vater

2. bile flow into the intestine is obstructed

Which clinical indicator should the nurse identify before scheduling a client for an endoscopic retrograde cholangiopancreatography (ERCP)? 1. urine output 2. bilirubin level 3. blood pressure 4. serum glucose

2. bilirubin level

A client is returned to the surgical unit after abdominal cholecystectomy. What is the main reason why the nurse should assess for clinical indicators of respiratory complications? 1. Length of time required for surgery is prolonged 2. incision is in close proximity to the client's diaphragm 3. Client's resistance is lowered because of bile in the blood 4. Bloodstream is invaded by microorganisms from the biliary tract

2. incision is in close proximity to the client's diaphragm

Before a cholecystectomy vitamin K is prescribed. Which element, formed in the presence of vitamin K, should the nurse determine is the purpose of administering this medication? 1. bilirubin 2. prothrombin 3. thromboplastin 4. cholecystokinin

2. prothrombin

A client had surgery for a perforated appendix with localized peritonitis. In which position should the nurse place this client? 1. sims 2. semi-fowler 3. Trendelenburg 4. dorsal recumbent

2. semi-fowler

Which reporting tasks are appropriate to delegate to the UAP? SATA 1. Reporting on the condition of Ms. T's perineal area after application of ointment 2. Reporting the quality and color of NG drainage for Ms. D 3. Reporting whether Mr. R's blood pressure is below 100/60 mm Hg 4. Reporting if any of the clients indicate pain 5. Reporting if Mr. A is seen leaving the unit to smoke a cigarette 6. Reporting that Mr. K's family has questions

3. Reporting whether Mr. R's blood pressure is below 100/60 mm Hg 4. Reporting if any of the clients indicate pain 5. Reporting if Mr. A is seen leaving the unit to smoke a cigarette 6. Reporting that Mr. K's family has questions

Ms. D (bowel obstruction) reports feeling weak. She seems more confused compared with her baseline. The NG drainage container has a large amount of watery bile-colored fluid. Which laboratory values should be checked first? 1. Blood urea nitrogen and creatinine levels 2. Platelet count and WBC count 3. Sodium level, potassium level, and pH of blood 4. Bilirubin level, hematocrit, and hemoglobin level

3. Sodium level, potassium level, and pH of blood

A client with a history of pancreatitis is scheduled for surgery to excise a pseudocyst of pancreas. The client asks, "what is a pseudocyst?" What information should the nurse include in a response to this question? 1. malignant growth 2. pocket of undigested food particles 3. dilated space of necrotic tissue and blood 4. sack filled with fluid and pancreatic enzymes

3. dilated space of necrotic tissue and blood

Ms. H's (acute cholecystitis) HIDA scan shows a decreased bile flow with gallbladder disease and obstruction. Because of the obstruction, the nurse is vigilant for the complication of biliary colic. What are the key signs and symptoms that the nurse will watch for? 1. Rebound tenderness and a sausage-shaped mass in the right upper quadrant 2. Flatulence, dyspepsia, and eructation after eating or drinking 3. Right upper quadrant abdominal pain that radiates to the right should or scapula 4. Severe abdominal pain and tachycardia, pallor, diaphoresis, and prostration

4. Severe abdominal pain and tachycardia, pallor, diaphoresis, and prostration

Because of Ms. T's (ulcerative colitis) severe diarrhea, the nurse is reviewing the laboratory results. Which laboratory results are cause for greatest concern? 1. The WBC count is slightly increased 2. The hemoglobin and hematocrit are slightly decreased 3. The erythrocyte sedimentation (ESR) rate is increased 4. The serum sodium and potassium levels are decreased

4. The serum sodium and potassium levels are decreased

The RN is supervising the nurse student in administering Ms. D's (bowel obstruction) medications through the NG tube. When would the nurse intervene? 1. The student compares medication administration record with the original prescription 2. The student draws up 30 mL of sterile water for flush in a large-bore syringe 3. The student performs three checks of the medication names and dosages 4. The student crushes tablets and puts all medications in the same cup

4. The student crushes tablets and puts all medications in the same cup

The nurse is collaborating with the dietitian to provide diet teaching for a patient with chronic pancreatitis and his family. Which are important teaching points for this teaching plan? SATA a. the patient will need increased calorie intake (4000-6000) per day to maintain weight b. be sure to include foods that are high in fat because they are essential for healing c. alcohol intake should be avoid d. provide a bland diet with frequent meals e. avoid irritating substances such as caffeinated beverages which stimulate the GI system f. add rich foods to the diet to help meet the caloric requirements

a. the patient will need increased calorie intake (4000-6000) per day to maintain weight c. alcohol intake should be avoid d. provide a bland diet with frequent meals e. avoid irritating substances such as caffeinated beverages which stimulate the GI system

Which statement about pancreatic cancer are accurate? SATA a. venous thromboembolism (VTE) is common complication of pancreatic cancer b. Pancreatic cancer often presents in a slow and vague manner c. severe pain is an early feature of this disease d. there are no specific blood tests to diagnose pancreatic cancer e. chemotherapy is the treatment of choice for pancreatic cancer f. chronic pancreatitis predisposes a patient to pancreatic cancer

a. venous thromboembolism (VTE) is common complication of pancreatic cancer b. Pancreatic cancer often presents in a slow and vague d. there are no specific blood tests to diagnose pancreatic cancer f. chronic pancreatitis predisposes a patient to pancreatic cancer

Which diagnostic test is the most accurate in verifying a diagnosis of acute pancreatitis? a. Trypsin b. lipase c. alkaline phosphatase d. alanine aminotransferase

b. lipase

A patient with acute pancreatitis is at risk for the development of paralytic (adynamic) ileus. Which action provides the nurse with the best indication of bowel function? a. observing contents of the nasogastric drainage b. weighing the patient every day at the same time c. asking the patient if he or she has passed flatus or had a stool d. Obtaining a computed tomography (CT) scan of the abdomen with contrast medium.

c. asking the patient if he or she has passed flatus or had a stool

What is one of the main advantages of cholecystectomy by the natural orifice transluminal endoscopic surgery (NOTES) procedure? a. very small visible incisions b. Jackson-Pratt drain removes excess fluid c. no visible incision lines d. resumption of normal activities the day of surgery

c. no visible incision lines

Disseminated intravascular coagulation (DIC) is a complication of pancreatitis. What pathophysiology leads to this complication? a. hypovolemia b. peritoneal irritation and seepage of pancreatic enzymes c. disruption of alveolar-capillary membrane d. consumption of clotting factors and formation of microthrombi

d. consumption of clotting factors and formation of microthrombi

Which type of drug is used to treat acute severe biliary pain? a. acetaminophen b. nonsteroidal antiinflammatory drugs (NSAIDS) c. antiemetics d. opioids

d. opioids

A client who had surgery for ruptured appendix develops peritonitis. What clinical findings related to peritonitis should the nurse expect the client to exhibit? SATA 1. fever 2. hyperactivity 3. extreme hunger 4. urinary retention 5. abdominal muscle rigidity

1. fever 5. abdominal muscle rigidity

The RN is teaching the nursing student about enteral feedings for clients such as Mr. K, who has a PEG tube. In the postoperative period, when can enteral feedings be started? 1. Within 6 to 8 hours after the procedure 2. When bowel sounds occur, usually within 24 hours 3. When the client reports feeling hungry 4. On a schedule determined by the pharmacy

2. When bowel sounds occur, usually within 24 hours

The nurse is evaluating electrolyte values for a patient with acute pancreatitis and notes that the serum calcium is 6.8 mEq/L. How does the nurse interpret this finding? a. within normal limits considering the diagnosis of acute pancreatitis b. a result of the body not being able to use bound calcium c. a protective measure that will reduce the risk of complications d. full compensation of the parathyroid gland

b. a result of the body not being able to use bound calcium