MS Assignment 2

Which statement by the client recovering from an acute case of viral hepatitis indicates understanding of the discharge instructions presented by the nurse? Select all that apply. -"I will avoid alcohol because my liver is scarred and the alcohol causes more damage." -"I will eat four to seven small snacks or meals per day." -"I will take acetaminophen for pain rather than aspirin." -"I will eat foods high in carbohydrates but moderate in fats and proteins." -"I will not have to use condoms during intercourse because I have beaten this."

-"I will avoid alcohol because my liver is scarred and the alcohol causes more damage." -"I will eat four to seven small snacks or meals per day." -"I will eat foods high in carbohydrates but moderate in fats and proteins."

the nurse is giving discharge teaching instructions to a client with diabetes who had a total hypophysectomy. Which statement made by the client indicates that further teaching is necessary? -"There is a risk that i could become permanently sterile." -"My insulin dose will need to be increased from now on." -"I must have cortisone therapy for the rest of my life." -"Lifelong thyroxine replacement therapy will be required."

-"My insulin dose will need to be increased from now on."

Which diagnosis would cause the nurse to assess for signs and symptoms of hypoglycemia? -Liver failure -Anemia -Hyperthyroidism -Stage 3 hypertension

-Liver failure

Which result would the nurse monitor in a client with acetaminophen overdose? -Blood gas level -Liver function tests -Complete blood count -Glycosylated hemoglobin

-Liver function tests

Which response will be given by a nurse caring for a client with chronic hepatitis B who asks "Are there any medications to help me get rid of this problem?"? -"Sedatives can be given to help you relax" -"We can give you immune serum globulin." -"Vitamin supplements are frequently helpful and hasten recovery." -"There are medications to help reduce viral load and liver inflammation."

-"There are medications to help reduce viral load and liver inflammation."

The registered nurse is teaching a student nurse about medications used to treat hyponatremia in hospitalized clients. Which statement made by the student nurse indicates effective learning? -"Tolvaptan is given intravenously." -"Tolvaptan used for more than 30 days causes liver failure." -"These medications promote water retention with no sodium loss." -"Conivaptan use should be stopped when the serum sodium levels increase more than 12mEq/L in 24 hours."

-"Tolvaptan used for more than 30 days causes liver failure."

Which statement indicates the patient understands the origin of hepatitis C? -"You can catch it while you're getting a tattoo." -"You're more likely to get it in crowded living conditions." -"The disease is passed from person to person by casual contact." -"People working at restaurants can give it to you if they don't wash their hands."

-"You can catch it while you're getting a tattoo."

A client with cirrhosis is scheduled for a liver biopsy. The client asks if there are any postprocedural risks. How would the nurse respond? -"The major risk is pneumonia." -"The major risk is site infection." -"The major risk is bleeding." -"The major risk is liver failure."

-"The major risk is bleeding."

Which client problem would the nurse expect to decrease in response to the administration of serum albumin intravenously to a client with ascites? -Confusion -Urinary output -Abdominal girth -Serum ammonia level

-Abdominal girth

A client is hospitalized with a diagnosis of acute pancreatitis. The plan of care is focused on the goals of maintaining nutrition, promoting rest, maintaining fluids and electrolytes, and decreasing anxiety. Which interventions would the nurse implement? Select all that apply. -Provide a low-fat diet -Administer analgesics -Teach relaxation exercises -Encourage walking in the hall -Monitor cardiac rate and rhythm -Observe for signs of hypercalcemia

-Administer analgesics -Teach relaxation exercises -Monitor cardiac rate and rhythm

Which nursing intervention is appropriate when a client is first admitted with hyperglycemic hyperosmolar nonketotic syndrome (HHNS)? -Providing oxygen -Encouraging carbohydrates -Administering fluid replacement -Teaching facts about dietary principles

-Administering fluid replacement

A client with cholelithiasis has a laser laparoscopic cholecystectomy. Which nursing intervention is appropriate for the postoperative plan of care? -Maintain the client's nothing-by-mouth status for the first 24 hours. -Monitor the client's abdominal incision for bleeding. -Offer clear, carbonated beverages to the client. -Ambulate the client when the client is alert and oriented.

-Ambulate the client when the client is alert and oriented.

The nurse reviews the laboratory results of a client with acute pancreatitis. Which test is significant in determining the client's response to treatment? -Platelet count -Amylase level -Red blood cell count -Erythrocyte sedimentation rate

-Amylase level

Which action would the nurse include in the plan of care of a client undergoing a transsphenoidal hypophysectomy? Select all that apply. -Assessing for clear nasal drainage -Maintaining strict intake and output -Increasing daily dietary fiber intake -Elevating the head of the bed 30 degrees -Instructing on the use of an incentive spirometer

-Assessing for clear nasal drainage -Maintaining strict intake and output -Increasing daily dietary fiber intake -Elevating the head of the bed 30 degrees -Instructing on the use of an incentive spirometer

A client is diagnosed with chronic pancreatitis. Which dietary instructions is important for the nurse to share with the client? -Eat a low-fate, low-protein diet. -Avoid foods high in carbohydrates. -Avoid ingesting alcoholic beverages. -Eat a bland diet with no snacks in between.

-Avoid ingesting alcoholic beverages.

Which clinical indicator would the nurse review before scheduling a client for an endoscopic retrograde cholangiopancreatography (ERCP)? -Urine output -Bilirubin level -Blood pressure -Serum glucose

-Bilirubin level

Which finding would the nurse expect when assessing the nasal passages of a client with thrombocytopenia? -Blood clots -Nasal polyps -Purulent discharge -Pale, swollen turbinates

-Blood clots

During the recovery period for a client treated for a lacerated liver and abdominal hemorrhage, the nurse would monitor the client for which indication of peritonitis? Select all that apply. -Jaundice -Boardlike abdomen -Abdominal tenderness -Decreased bowel sounds -Rapid decrease in coagulation ability

-Boardlike abdomen -Abdominal tenderness -Decreased bowel sounds

Which condition would the nurse anticipate incorporating into the plan of care for a client who reports weight gain and has purplish-blue striae on the abdomen? -Hypothryroidism -Addison disease -Cushing Syndrome -Pheochromocytoma

-Cushing syndrome

For which clinical indicator would the nurse monitor when caring for a client with cholelithiasis and obstructive jaundice? Select all that apply. -Dark urine -Yellow skin -Pain on urination -Clay-colored stool -Coffee-ground vomitus

-Dark urine -Yellow skin -Clay-colored stool

A client who is obese and has a history of alcohol abuse is admitted to the hospital with a diagnosis of acute pancreatitis. Which is an appropriate initial client treatment goal? -Decrease pain -Selection of appropriate food choices -Joining Alcoholics Anonymous -A loss of 4 pounds (1.8 kg) per week

-Decrease pain

Which laboratory test change leads the nurse to determine that the lactulose administered to a client with cirrhosis of the liver is effective? -Decreased amylase -Decreased ammonia -Increased potassium -Increased hemoglobin

-Decreased ammonia

When the nurse is caring for a client who had an open cholecystectomy, which assessment finding most indicates the need for action by the nurse? -Bile-colored drainage from T-tube -Serosanguinous drainage on dressing -Incisional pain rate 5 (0-10 scale) -Decreased breath sounds at lung bases

-Decreased breath sounds at lung bases

Which clinical findings supports the diagnosis of diabetic ketoacidosis (DKA)? -Nervousness and tachycardia -Erythema toxicum rash and pruritus -Diaphoresis and altered mental state -Deep respirations and fruity odor to the breath

-Deep respirations and fruity odor to the breath

Which medical condition could most probably result in clients developing primary diabetes insipidus (DI)? -Meningitis -Brain tumor -Lithium therapy -Defect in hypothalamus

-Defect in hypothalamus

The nurse reviews the medical record of a client with ascites. Which client condition is a contributing factor to the development of ascites? -Portal hypotension -Kidney malfunction -Diminished plasma protein level -Decreased production of potassium

-Diminished plasma protein level

Assessment findings of a client who is admitted to the emergency department include cramping pain in the left lower quadrant, weakness, bloating, malaise, and low-grade fever. The nurse suspects which condition? -Pancreatitis -Appendicitis -Cholecystitis -Diverticulitis

-Diverticulitis

Why would lactulose be prescribed for a client with a history of cirrhosis of the liver? -The desire to drink alcohol is decreased. -Diarrhea is controlled and prevented. -Elevated ammonia levels are lowered. -Abdominal distension secondary to ascites is decreased.

-Elevated ammonia levels are lowered.

Identify the primary causes of adrenal insufficiency. Select all that apply. -Hemorrhage -Tuberculosis -Pituitary tumors -Postpartum pituitary necrosis -Acquired immunodeficiency syndrome (AIDS)

-Hemorrhage -Tuberculosis -Acquired immunodeficiency syndrome (AIDS)

Which type of hepatitis develops into a chronic form of the disease? Select all that apply. -Hepatitis A -Hepatitis B -Hepatitis C -Hepatitis D -Hepatitis E

-Hepatitis B -Hepatitis C -Hepatitis D

With which condition would the nurse associate the response of diaphoresis, weakness, and palor at 3:30 PM in a client with type 1 diabetes who receives 30units of neutral protamine Hagedorn (NPH) insuling at 7:00 AM? -Diabetic coma -Hyperosmolar hyperglycemic nonketotic syndrome -Diabetic ketoacidosis -Hypoglycemic reaction

-Hypoglycemic reaction

Which complication will a nurse monitor for before replacement steroid therapy is regulated fully in a client who has had an adrenalectomy? -Hypotension -Hypokalemia -Hypernatremia -Hyperglycemia

-Hypotension

Which underlying cause would the nurse suspect in a client who has a yellow-orange discoloration in the mucous membranes and sclera with laboratory results revealing red blood cell hemolysis? -Decreased hemoglobin level -Increased serum carotene level -Increased blood flow to the skin -Increased total serum bilirubin level

-Increased total serum bilirubin level

Which procedural contraindication would the nurse evaluate in a client suspected of carcinoma of the liver and scheduled for a liver biopsy? -Confusion, disorientation, and jaundice -Presence of any infectious disease process -International normalized ration (INR) greater than 4.5 -Client's food intake is high in vitamins E and phytonadione

-International normalized ratio (INR) greater than 4.5

The nurse is reviewing the electronic health record of a client admitted with syndrome of inappropriate antidiuretic hormone (SIADH). Which medication order would the nurse questions? -Furosemide (Lasix) -Tolvaptan (Aquaretic) -Intravenous (IV) 0.9% sodium chloride -Demeclocycline (Declomycin)

-Intravenous (IV) 0.9% sodium chloride

Which nursing intervention is appropriate to include in the plan of care for client with diabetic ketoacidosis (DKA)? -Intravenous administration of regular insulin -Administer insulin glargine subcutaneously at hour of sleep -Maintain nothing prescribed orally (NPO) status -Intravenous administration of 10% dextrose

-Intravenous administration of regular insulin

Which unique response is associated with diabetic ketoacidosis (DKA) that is not exhibited with hyperglycemic hyperosmolar nonketotic syndrome (HHNS)? -Fluid loss -Glycosuria -Kussmaul respirations -Increased blood glucose level

-Kussmaul respirations

A client who is obese has an abdominal cholecystectomy. How would the nurse plan to alleviate tension on the surgical wound after surgery? -Limiting deep breathing -Maintaining T-tube patency -Maintaining nasogastric tube patency -Encouraging the right side-lying position

-Maintaining nasogastric tube patency

Which assessment finding in a client with acute lymphoblastic leukemia receiving chemotherapy would alert the nurse to the possible development of thrombocytopenia? Select all that apply. -Fever -Diarrhea -Melena -Hematuria -Ecchymosis

-Melena -Hematuria -Ecchymosis

For which sign of hepatic encephalopathy would the nurse assess a client with cirrhosis of the liver? Select all that apply. -Mental confusion -Increased cholesterol -Brown-colored stools -Flapping hand tremors -Musty, sweet breath odor

-Mental confusion -Flapping hand tremors -Musty, sweet breath odor

A client with hepatic cirrhosis begins to exhibit slurred speech, confusion, drowsiness, and a flapping tremor. Based upon this assessment, which prescribed diet would the nurse anticipate? -No protein -Moderate protein -High protein -Strict protein restriction

-Moderate protein

A client with an obstruction of the pancreatic ducts is diagnosed with acute pancreatitis. A subtotal pancreatectomy is performed. The nurse would monitor the client for which postoperative complication? -Constipation -Cholecystitis -Paralytic ileus -Respiratory distress

-Paralytic ileus

Which manifestation in a client who has syndrome of inappropriate antidiuretic hormone (SIADH) would the nurse expect to find upon assessment? -Preservation of salt -Retention of water -Decrease of vasopressin -Presence of pedal edema

-Retention of water

A client is admitted to the hospital with suspected liver disease, and a needle biopsy of the liver is performed. After the procedure, the nurse would maintain the client in which position? -Supine -Semi-Fowler's -Right side-lying -Dorsal recumbent

-Right side-lying

The nurse is caring for a client with acute pancreatitis. Which elevated laboratory test result is most indicative of acute pancreatitis? -Blood glucose -Serum lipase -Serum bilirubin level -White blood cell count

-Serum lipase

Which complication would the nurse expect if a client with Addison's disease receiving cortisone therapy abruptly stops the medication? Select all that apply. -Hypokalemia -Generalized edema -Shock -Alkalosis -Circulatory collapse

-Shock -Circulatory collapse

The nurse is caring for a client who is prescribed desmopressin acetate. Which is the expected outcome in the client? -Sodium: 136 mEq/L -Specific gravity: 1.005 -Urine output: 3 L/day -Osmolarity: 100 mOsm/kg

-Sodium: 136 mEq/L

A client who has a history of alcohol abuse now has recurrent exacerbations of chronic pancreatitis. The nurse asks the client to obtain a stool specimen. When assessing the client's stool, which would the nurse expect to observe? -Melena -Steatorrhea -Hard, dry stool -Ribbon-shaped stool

-Steatorrhea

A client has laparoscopic surgery to remove a calculus from the common bile duct. Which postoperative client response indicates to the nurse that bile flow into the duodenum is reestablished? -Stools become brown. -Liver tenderness is relieved. -Colic is absent after ingestion of fats. -Serum bilirubin level returns to the expected range.

-Stools become brown.

Which clinical manifestation would the nurse expect to find upon assessment of a client with Cushing syndrome? Select all that apply. -Polyuria -Truncal obesity -Hypotension -Sleep Disturbance -Thin arms and legs

-Truncal obesity -Sleep disturbance -Thin arms and legs