Inflammation & tissue integrity 39/39
A nurse is caring for a client newly diagnosed with hepatitis A. Which statement by the client indicates the need for further teaching? "I'll take all my medications as ordered." "I'll wash my hands often." "I'll be very careful when preparing food for my family." "How did this happen? I've been faithful my entire marriage."
"How did this happen? I've been faithful my entire marriage."
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? "Does your work expose you to chemicals?" "How often do you drink alcohol?" "Have you had an infection recently?" "What type of over-the-counter pain reliever do you use?"
"How often do you drink alcohol?"
A nurse is providing dietary instructions to a client with a history of pancreatitis. Which instruction is correct? "Maintain a high-fat, high-carbohydrate diet." "Maintain a high-fat diet and drink at least 3 L of fluid a day." "Maintain a high-carbohydrate, low-fat diet." "Maintain a high-sodium, high-calorie diet."
"Maintain a high-carbohydrate, low-fat diet."
A client who has just been diagnosed with hepatitis A asks, "How did I get this disease?" What is the nurse's best response? "You could have gotten it by using I.V. drugs." "You probably got it by engaging in unprotected sex." "You may have eaten contaminated restaurant food." "You must have received an infected blood transfusion."
"You may have eaten contaminated restaurant food."
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? A liver biopsy A CT scan A prothrombin time Platelet count
A liver biopsy
A client with cirrhosis is at risk for developing esophageal varices. Which of the following instructions should a nurse provide the client to minimize such risk? Avoid intake of sodium-rich food. Use aspirin at least once a day. Abstain from drinking alcohol. Increase intake of potassium-rich food.
Abstain from drinking alcohol.
Which term is used to describe a chronic liver disease in which scar tissue surrounds the portal areas? Alcoholic cirrhosis Biliary cirrhosis Postnecrotic cirrhosis Compensated cirrhosis
Alcoholic cirrhosis
Lactulose (Cephulac) is administered to a patient diagnosed with hepatic encephalopathy to reduce which of the following? Ammonia Bicarbonate Calcium Alcohol
Ammonia
When caring for a client with cirrhosis, which symptom(s) should the nurse report immediately? Change in mental status Diarrhea or constipation Anorexia and dyspepsia Fatigue and weight loss
Change in mental status
A client comes to the clinic and informs the nurse that he is there to see the physician for right upper abdominal discomfort, nausea, and frequent belching especially after eating a meal high in fat. What disorder do these symptoms correlate with? Cholecystitis Biliary colic Cholelithiasis Hepatitis
Cholelithiasis
Increased appetite and thirst may indicate that a client with chronic pancreatitis has developed diabetes melitus. Which of the following explains the cause of this secondary diabetes? Dysfunction of the pancreatic islet cells Renal failure Ingestion of foods high in sugar Inability for the liver to reabsorb serum glucose
Dysfunction of the pancreatic islet cells
The mode of transmission of hepatitis A virus (HAV) includes which of the following? Semen Saliva Fecal-oral Blood
Fecal-oral
A nurse is preparing a client for surgery. During preoperative teaching, the client asks where is bile stored. The nurse knows that bile is stored in the: Common bile duct Duodenum Gallbladder Cystic duct
Gallbladder
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? Vanilla pudding Mashed potatoes Hot roast beef sandwich with gravy White rice
Hot roast beef sandwich with gravy
A critical care nurse is caring for a client with acute pancreatitis. One potentially severe complication involves the respiratory system. Which of the following would be an appropriate intervention to prevent complications associated with the respiratory system? Withhold oral feedings. Administer enteral or parenteral nutrition. Maintain the client in a semi-Fowler's position. Carry out wound care as prescribed.
Maintain the client in a semi-Fowler's position.
From the following profiles of clients, which client would be most likely to undergo the diagnostic test of cholecystography? Steven, suspected of having a tumor in the colon Sandra, suspected of having lesions in the liver Andrew, suspected of having esophageal abnormalities Mark, suspected of having stones in the gallbladder
Mark, suspected of having stones in the gallbladder
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? Hemolytic jaundice Obstructive jaundice Hepatocellular jaundice Cirrhosis of the liver
Obstructive jaundice
A nurse is gathering equipment and preparing to assist with a sterile bedside procedure to withdraw fluid from a client's abdomen. The procedure tray contains the following equipment: trocar, syringe, needles, and drainage tube. The client is placed in he high Fowler position and a blood pressure cuff is secured around the arm in preparation for which procedure? Abdominal ultrasound Dialysis Liver biopsy Paracentesis
Paracentesis
The nurse is admitting a patient to the intensive care unit with a diagnosis of acute pancreatitis. What does the nurse expect was the reason the patient came to the hospital? Fever Jaundice Mental agitation Severe abdominal pain
Severe abdominal pain
Which is the most common report by clients with pancreatitis? Severe, radiating abdominal pain Tarry, black stools and dark urine Increased and painful urination Increased appetite and weight gain
Severe, radiating 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? Use incentive spirometry every hour. Withhold analgesics unless necessary. Instruct the client to cough only when necessary. Monitor pulse oximetry every hour.
Use incentive spirometry every hour.
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: Riboflavin Vitamin C. Thiamine Vitamin K
Vitamin K
Which condition indicates an overdose of lactulose? Fecal impaction Watery diarrhea Constipation Hypoactive bowel sounds
Watery diarrhea
The digestion of carbohydrates is aided by trypsin. lipase. amylase. secretin.
amylase.
Total parental nutrition (TPN) should be used cautiously in clients with pancreatitis because they are at risk for hepatic encephalopathy. are at risk for gallbladder contraction. can digest high-fat foods. cannot tolerate a high glucose concentration.
cannot tolerate a high glucose concentration.
A client with a lengthy history of alcohol addiction is being seen for jaundice. The appearance of jaundice would most likely indicate: glucose underproduction. bile overproduction. liver disorder. gallbladder disease.
liver disorder.
Ac client with a lengthy history of alcohol addiction is diagnosed with cirrhosis. The nurse emphasizes that the principal goal of cirrhosis therapy is: preserving liver function. curing the illness. restoring fat-soluble vitamin absorption. increasing alcohol tolerance
preserving liver function
Which nursing assessment is most important in a client diagnosed with ascites? Assessment of the oral cavity for foul-smelling breath Auscultation of abdomen Palpation of abdomen for a fluid shift Daily measurement of weight and abdominal girth
Daily measurement of weight and abdominal girth
A nurse has admitted a client suspected of having acute pancreatitis. The nurse knows that mild acute pancreatitis is characterized by: Disseminated intravascular coagulopathy Sepsis Pleural effusion Edema and inflammation
Edema and inflammation
A client has developed drug-induced hepatitis from a drug reaction to antidepressants. What treatment does the nurse anticipate the client will receive to treat the reaction? Azathioprine High-dose corticosteroids Liver transplantation Paracentesis
High-dose corticosteroids
When reviewing the history of a client with pancreatic cancer, the nurse would identify which of the following as a possible risk factor? One-time exposure to petrochemicals Ingestion of a low-fat diet Ingestion of caffeinated coffee History of pancreatitis
History of pancreatitis
A student nurse is preparing a plan of care for a client with chronic pancreatitis. What nursing diagnosis related to the care of a client with chronic pancreatitis is the priority? Nausea Impaired nutrition: less than body requirements Anxiety Disturbed body image
Impaired nutrition: less than body requirements
Which of the following symptoms would indicate that a client with chronic pancreatitis has developed secondary diabetes? Low blood pressure and pulse Vomiting and diarrhea Increased appetite and thirst Decreased urination and constipation
Increased appetite and thirst
A client is scheduled for a cholecystogram for later in the day. What is the nurse's understanding on the diagnostic use of this exam? It visualizes the gallbladder and bile duct. It visualizes the liver and pancreas. It visualizes the biliary structures and pancreas via endoscopy. It shows the sizes of the abdominal organs and detects any masses.
It visualizes the gallbladder and bile duct.
Which enzyme aids in the digestion of fats? Lipase Secretin Trypsin Amylase
Lipase
A client with acute pancreatitis has been started on total parenteral nutrition (TPN). Which action should the nurse perform after administration of the TPN? Auscultate the abdomen for bowel sounds every 4 hours Measure blood glucose concentration every 4 to 6 hours Monitor for reports of nausea and vomiting Measure abdominal girth every shift
Measure blood glucose concentration every 4 to 6 hours
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? To aid opening up of pancreatic duct To drain the pancreatic bed To prevent the occurrence of fibrosis To avoid inflammation of the pancreas
To avoid inflammation of the pancreas
The nurse is educating a patient with cirrhosis about the importance of maintaining a low-sodium diet. What food item would be permitted on a low-sodium diet? Hot dog A pear Sliced ham Peanut butter
a pear
A client with viral hepatitis A is being treated in an acute care facility. Because the client requires enteric precautions, the nurse should: wear a mask when handling the client's bedpan. wear a gown when providing personal care for the client. place the client in a private room. wash her hands after touching the client.
wash her hands after touching the client.