Final Exam Review MEDSURG
The nurse identifies a small amount of bile-colored drainage on the dressing of a client who has had a liver biopsy. What does the nurse conclude?
A biliary vessel has been penetrated.
A paracentesis is prescribed for a client recently admitted to a medical unit. The nurse recalls that the procedure is performed for what reasons? Select all that apply.Extract peritoneal fluid
Extract peritoneal fluid Improve respiratory status Obtain peritoneal fluid for culture
A client who had surgery for a resection of the colon and the formation of a colostomy is to be discharged in several days. What is a primary nursing intervention for this client?
Determine the client's ability to care for the colostomy
A client undergoes an abdominal cholecystectomy with common duct exploration. In the immediate postoperative period, what is the priority nursing action
Encouraging coughing and deep breathing
For which clinical indicator associated with a complication of portal hypertension should the nurse assess the client?
Hemorrhage from esophageal varices
An older client's colonoscopy reveals the presence of extensive diverticulosis. Which type of diet should the nurse encourage the client to follow?
High-fiber
A nurse is assessing two clients. One client has ulcerative colitis, and the other client has Crohn disease. Which is more likely to be identified in the client with ulcerative colitis than in the client with Crohn disease?
Involvement starting distally with rectal bleeding that spreads continuously up the colon
A client with hepatic cirrhosis begins to develop slurred speech, confusion, drowsiness, and a flapping tremor. Which diet can the nurse expect will be prescribed for this client based upon the assessment?
Mod protein
The serum ammonia level of a client with hepatic cirrhosis and ascites is elevated. What nursing intervention is the priority?
Observe the client for increasing confusion.
A client who is obese and has a history of alcohol abuse is admitted to the hospital with the diagnosis of acute pancreatitis. Which is the initial priority expected client outcome in response to therapy at this time?
Report decreased pain
A nurse is teaching a client about prophylactic measures that minimize the risk of contracting hepatitis B. Which actions should be included in this teaching plan? Select all that apply.
Screening of blood donors Maintaining a monogamous sexual relationship
An older client with a history of chronic constipation develops acute appendicitis. Prior to arrival at the hospital, the client attempted self-care at home. Which self-care measures could potentially lead to rupture of the appendix?
Self-administering a small volume enema
A client is admitted to the ambulatory surgery unit for a liver biopsy. The nurse recalls that which assessment finding will be a cause for the biopsy to be postponed?
Signs of bruising
After many years of coping with ulcerative colitis, a client makes the decision to have a colectomy as advised by the primary healthcare provider. Which is most likely the significant factor that impacted on the client's decision?
Surgical treatment cures ulcerative colitis
A nurse is caring for a client who is positive for hepatitis A. Which precautions should the nurse take?
Use gloves when removing the client's bedpan.