PCC3 Exam 3

Select all the types of viral hepatitis that have preventative vaccine's available in the United States of America? A. Hepatitis A B. Hepatitis B C. Hepatitis A D. Hepatitis D E. Hepatitis E

A. Hepatitis A B. Hepatitis B

You're providing an in-service on viral hepatitis to a group of healthcare workers. You are teaching them about the types of viral hepatitis that can turn into chronic infections. Which types are known to cause acute infections only? Select all that apply A. Hepatitis A B. Hepatitis B C. Hepatitis C D. Hepatitis D E. Hepatitis E

A. Hepatitis A E. Hepatitis E

A patient with acute renal injury has a GFR of 40 mL per minute. Which signs and symptoms below may this patient presents with? Select all that apply A. Hypervolemia B. Hypokalemia C. Increased BUN D. Decreased creatinine

A. Hypervolemia C. Increased BUN

How is hepatitis E transmitted? A fecal oral B. Percutaneous C mucosal D. Body fluids

A fecal-oral

Inside the pancreas are specialized cells that secrete digestive enzymes and hormones. The cells that secrete digestive enzymes are known as __________cells.

Acinar

A Nurses planning care for a client has pre-renal acute kidney injury AKI following abdominal aortic aneurysm repair. Urinary output is 60 ML in the past two hour and blood pressure is 92/50 8 mmHg. The nurse should expect which of the following interventions? A. Prepare the client for a CT scan with contrast dye B. Plan to administer nitroprusside C. Prepare to administer a fluid challenge D. Plan to position the client in Trendelenburg

C. Prepare to administer a fluid challenge

A nurse is caring for a client who has cirrhosis. Which of the following medications can the nurse expect to administer to this client? Select all that apply A. Diuretic B. Beta blocking agent C. Opioid analgesic D. Lactulose E. Sedative

A B D (Diuretics facilitate excretion of excess fluid from the body in a client who has cirrhosis. Beta-blocking agents are prescribed for a client who has cirrhosis to prevent bleeding from varies. Opioid analgesics are metabolized in the liver. They should not be administered to a client who has cirrhosis. Lactulose is prescribed for a client who has cirrhosis to aid in the elimination of ammonia in the stool. Sedatives are metabolized in the liver. They should no be administered to a client who has cirrhosis.)

Select all the signs and symptoms associated with hepatitis A arthralgia B. Bilirubin 1 mg/dL C. Ammonia 15 mcg/dL D. Dark urine E. Vision changes F. Yellowing of the sclera G. Fever H. Loss of appetite

A, D, F, G, and H. The bilirubin and ammonia levels are normal in these options, but they would be abnormal in Hepatitis. A normal bilirubin is 1 or less, and a normal ammonia is 15-45 mcg/dL.

While educating a group of nursing students about the stages of AKI a student asked how long the oliguric stage less. You explain to the student that this stage can last? A. 1 to 2 weeks B. 1 to 3 days C. Few hours to weeks D. 12 months

A. 1 to 2 weeks

Which patient below with AKI is the oliguric stage of AKI? A. A 56-year-old male who has metabolic acidosis, decreased GFR, increased BUN/creatinine, hyperkalemia, edema, and urinary output 350 mL per day B. A 45 year old female with metabolic alkalosis, hypokalemia, normal GFR, increased BUN/creatinine, Edema and urinary output 600 mL per day C. A 39 year old male with metabolic acidosis, hyperkalemia, improving GFR, resolving edema, and urinary output 4 L per day D. A 78-year-old female with respiratory acidosis, increased GFR, decreased BUN/creatinine, hypokalemia and urinary output 550 mL/per day

A. A 56-year-old male who has metabolic acidosis, decreased GFR, increased BUN/creatinine, hyperkalemia, edema, and urinary output 350 mL per day

Which patient below is at most risk for developing acute glomerulonephritis? A. A three-year-old male who has a positive ASO titer. B. A five-year-old male who is recovering from a appendectomy C. An 18-year-old male who is diagnosed with HIV D. Is six-year-old female who is newly diagnosed with measles

A. A three-year-old male who has a positive ASO titer.

A patient with hepatitis is extremely confused. The patient is diagnosed with hepatic encephalopathy which lab result would correlate with this mental status change? A. Ammonia 100mcg/dL B. Bilirubin 7mg/dL C. ALT 56 U/L D. AST 10U/L

A. Ammonia 100mcg/dL

A nurse is planning care for a client who has stage 4 chronic kidney disease. Which of the following actions should the nurse include in the plan of care? Select all that apply A. Assess for jugular vein distention B. Provide frequent mouth rinses C. Auscultate for a pleural friction rub D. Provide a high sodium diet E. Monitor for dysrhythmias

A. Assess for jugular vein distention B. Provide frequent mouth rinses C. Auscultate for a pleural friction rub E. Monitor for dysrhythmias

The nurse is carrying for a client in end-stage liver failure. What interventions should be implemented when observing for hepatic encephalopathy? Select all that apply A. Assess the clients neurological status as prescribed B. Monitor the clients hemoglobin and hematocrit levels C. Monitor the client serum ammonia levels D. Monitor the clients electrolyte values daily E. Prepare to insert an esophageal balloon tamponade tube F. Make sure the clients fingernails are short

A. Assess the clients neurological status as prescribed C. Monitor the client serum ammonia levels

A patient has lab work drawn and it's shows a positive HBsAg. What education will you provide to the patient? A. Avoid sexual intercourse or intimacy such as kissing until blood work is negative B. The patient is now recovered from a previous hepatitis B infection and is now immune C. The patient is not a candidate from antiviral or interferon medications D. The patient is less likely to develop a chronic infection

A. Avoid sexual intercourse or intimacy such as kissing until blood work is negative

A nurse is completing nutrition teaching for a client who has pancreatitis. Which of the following statements by the client indicates an understanding of the teaching? Select all that apply A. I plan to eat small frequent meals B. I will eat easy tight to digest meals with limited spice C. I will use skim milk when cooking D. I plan to drink regular cola E. I will limit alcohol intake to two drinks per day

A. I plan to eat small frequent meals B. I will eat easy tight to digest meals with limited spice C. I will use skim milk when cooking

A patient with viral hepatitis states their flu like symptoms have subsided. However they now have yellowing of the skin and sclera along with dark urine. Based on this finding this is what phase of hepatitis? A. Icteric B. Posticteric C. Pricteric D. Convalescent

A. Icteric

A nurse is teaching a client who has hepatitis B about home care. Which of the following instructions should the nursing include in the teaching? Select all that apply A. Limit physical activity B. Avoid alcohol C. Take acetaminophen for comfort D. Wearing mask in public places E. Eat small frequent meals

A. Limit physical activity B. Avoid alcohol E. Eat small frequent meals A nurse is teaching

The nurse is caring for a client who is diagnosed with cirrhosis. Which serum laboratory values will the nurse expect to be abnormal? Select all that apply A. Prothrombin time B. Serum bilirubin C. Albumin D. Asparte amniotransferase AST E. Lactate dehydrogenase LDH F. Acid phosphate

A. Prothrombin time B. Serum bilirubin C. Albumin D. Asparte amniotransferase AST E. Lactate dehydrogenase LDH

A nurse is planning care for a client who has post renal AKI due to metastatic cancer. The client has a blood creatine of 5 mg/DL. Which of the following intervention should the nurse include in the plan? Select all that apply A. Provide a high-protein diet B. Assess the urine for blood C. Monitor for intermittent anuria D. Weigh the client once per week E. Provide NSAIDS for pain

A. Provide a high-protein diet B. Assess the urine for blood C. Monitor for intermittent anuria

While assisting a patient with chronic pancreatitis in the bathroom, you notice the patient still to be greasy and oily and appearance. In your documentation you notice as: A. Steatorrhea B. Melena C. Currant D. Hematochezia

A. Steatorrhea

Which statements are correct regarding the anatomy and physiology of the liver? Select all that apply A. The liver has three lobes and eight segments B. The liver produces bile which is released into the small intestine to help digest fats C. The liver turns urea a byproduct of protein breakdown into ammonia D. The liver plays an important role in the coagulation process

A. The liver has three lobes and eight segments B. The liver produces bile which is released into the small intestine to help digest fats

A patient is diagnosed with hepatitis D. What statement is true about the type of viral hepatitis? Select all that apply A. The patient will also have hepatitis B virus B. Hepatitis D is most common in southern and eastern Europe, Mediterranean, and Middle East C. Prevention of hepatitis D includes handwashing and the hepatitis D vaccine Hepatitis D is most commonly transmitted via the fecal oral route

A. The patient will also have hepatitis B virus B. Hepatitis D is most common in southern and eastern Europe, Mediterranean, and Middle East

Which of the following are not a sign and symptom of AG poststreptococcal? Select all that apply A. hypotension B. Increase glomerular filtration rate C. Coke colored urine D. Massive protinuria E. Elevated BUN and creatinine F. Mild swelling of the face or eyes

A. hypotension B. Increase glomerular filtration rate D. Massive protinuria

The acinar cells in the pancreas release what select all that apply A.Amylase B. Somatostatin C. Lipase D. Protease

A.Amylase C. Lipase D. Protease

A patient is prescribed Peginterferon Alfa 2a. The nurse will prepare to administer this medication what route? A. Oral B intramuscular C. Subcutaneous D. Intravenous

B intramuscular

A patient was exposed to hepatitis B recently. Post exposure precautions include vaccination and administration of HBIg. HBIg needs to be given ASAP, preferably ______ after exposure to be effective A. Two weeks B. 24 hours C. One month D. Seven days

B. 24 hours

Which patient below is at most risk for developing a complication related to hepatitis E infection? A. A 45-year-old male with diabetes B. A 26-year-old female and the third trimester of pregnancy C. A 12-year-old female with ventricular septal defect D. Is 63-year-old male with cardiovascular disease

B. A 26-year-old female and the third trimester of pregnancy

Which patients below are at risk for developing complications related to chronic hepatitis infection, such as cirrhosis, liver cancer, and liver failure? Select all that apply A. A 55-year-old male with hepatitis A B. An infant who contracted hepatitis B at birth C. A 32-year-old female with hepatitis C who reports using IV drugs D. A 50-year-old male with alcoholism and hepatitis D E. A 30-year-old who contracted hepatitis E

B. An infant who contracted hepatitis B at birth C. A 32-year-old female with hepatitis C who reports using IV drugs D. A 50-year-old male with alcoholism and hepatitis D

A nurse is caring for a client who has cirrhosis. The nurse should identify which of the following findings as indicators of hepatic encephalopathy? SATA A. Anorexia B. Change in orientation C. Asterixis D. Ascitites E. Fetor hepaticus

B. Change in orientation C. Asterixis E. Fetor hepaticus

A patient with a cute pancreatitis is reporting excessive thirst, excessive voiding and blurred vision. As the nurse, your priority is? A. Reassure the patient this is normal with pancreatitis B. Check the patient's blood glucose C. Assist the patient with drinking a simple sugar drink like orange juice D. Provide a dark calm environment

B. Check the patient's blood glucose

What is solely filtered from the bloodstream via the glmarless and is not reabsorbed back into the bloodstream but exc created through the urine? A. Urea B. Creatinine C. Potassium D. Magnesium

B. Creatinine

You're assessing morning lab values on a female patient who is recovering from a MI. Which lab value below requires you to notify the physician? A. Potassium 4.2 mEq/L B. Creatinine 35 ML/min C. BUN 20mg/dL D. Blood pH 7.40

B. Creatinine 35 ML/min

During the posticteric phase of Hepatitis the nurse would expect to find? Select all that apply: A. Increased ALT and AST levels along with an increased bilirubin level B. Decreased liver enzymes and bilirubin level C. Flu-like symptoms D. Resolved jaundice and dark urine

B. Decreased liver enzymes and bilirubin level D. Resolved jaundice and dark urine

Select all the ways a person can become infected with Hepatitis B: A. Contaminated food/water B. During the birth process C. IV drug use D. Undercooked pork or wild game E. Hemodialysis F. Sexual intercourse

B. During the birth process C. IV drug use E. Hemodialysis F. Sexual intercourse

Your patient with acute pancreatitis is scheduled for a test that will use a scope to assess the pancreas, bile ducts, and gallbladder. The patient asks you, what is the name of the test I'm going for later? You tell the patient it is called: A. MRCP B. ERCP C. CT scan of the abdomen D. EGD

B. ERCP

A nurse is reviewing client laboratory data. Which of the following findings is expected for a client who has stage 4 chronic kidney disease? A. Blood urea nitrogen BUN 15 mg/dL B. Glomerular filtration rate GFR 20 mL/min C. Blood creatinine 1.1 mg/ dL D. Blood potassium 5.0 mEq/L

B. Glomerular filtration rate GFR 20 mL/min Stage 4 CKD BUN is 10-15 times above range, creatinine is as high as 15-30 mg/dL, potassium greater than 5.0 mEq/L

The liver receives blood from two sources. The ________ is responsible for pumping blood rich in nutrients into the liver A. Hepatic artery B. Hepatic portal vein C. Mesenteric artery D. Hepatic iliac vein

B. Hepatic portal vein

836-year-old male patient is diagnosed with a KI. The patient is voiding 4 L per day of urine. What complication can arise based on the stage of AKI this patient is in? Select all that apply A. Water in Toxification B. Hypotension C. Low urine specific gravity D. Hypokalemia E. Normal GFR

B. Hypotension C. Low urine specific gravity D. Hypokalemia

A patient who received treatment for pancreatitis is being discharged home. You're providing diet teaching to the patient. Which statement by the patient requires immediate reeducation about the diet restrictions? A. It will be hard but I will eat a diet low in fat and avoid greasy foods B. It's very important I limit my alcohol to no more than 2 to 3 glasses of wine a week C. I will concentrate on eating complex carbs rather than refined carbs D. I will purchase foods that are high in protein

B. It's very important I limit my alcohol to no more than 2 to 3 glasses of wine a week

A five-year-old male is admitted with acute glomerial nephitis. On assessment, you note mild Edema predominantly in the face and tea colored urine. The patient's blood pressure is 165/110, heart rate 95, O2 levels 98% on room air, and temperature 98.9°F. In your nursing care plan, what nursing interventions will you include in this patient's plan of care? A. Initiate and maintain a high sodium diet daily B. Monitor intake and output hourly C. Assess color of urine after every void D. Encourage patient to ambulate every two hours while awake E. Weigh patient every day on a standing scale F. Encourage the patient to consume 4 L of fluid per day

B. Monitor intake and output hourly D. Encourage patient to ambulate every two hours while awake E. Way patient every day on a standing scale

A nurse is preparing to administer pancrelipase to a client who has pancreatitis. Which of the following action should the nurse take? A. Instruct the client to chew the medication before swallowing B. Offer a glass of water following medication administration C. Administer the medication 30 minutes before meals D. Sprinkle the contents on peanut butter

B. Offer a glass of water following medication administration

A nurse is caring for a client who has a new diagnosis of hepatitis C .Which of the following laboratory findings should the nurse expect? A. Presence of immunoglobulin G antibodies IgG B. Positive EIA test C. Aspartate amnio transferase AST 35 units/L D. Alanine aminotransferase ALT 15 IU/L

B. Positive EIA test

While providing care to a pediatric patient with acute glomerulonephritis, you note the urine output is 10 mL per hour. The patient weighs 30 pounds. As a nurse you want to limit what type of food from the patient's diet? A. Calcium rich foods B. Potassium rich foods C. Purine rich foods D. None of the above because the patient's urinary output is normal based on the patient's weight.

B. Potassium rich foods

You're developing a nursing care plan for a patient in the diaries of stage of AKI What nursing diagnosis would you include in the care plan? A. Excess fluid volume B. Risk for electrolyte imbalance C. Urinary retention D. Acute pain

B. Risk for electrolyte imbalance

A 36-year-old patient lab work shows anti-hepatitis a virus and IgG present in the blood. As the nurse she would interpret this blood work as? A. The patient has an active infection of hepatitis A B. The patient has recovered from a previous hepatitis A infection and is now immune to it C. The patient is in the preicteric phase of viral hepatitis D. The patient is in the icteric phase of viral hepatitis

B. The patient has recovered from a previous hepatitis A infection and is now immune to it

Which patient below is at most risk for developing chronic pancreatitis? A. A 25-year-old female with a history of gallstones B. A 35-year-old male who reports social drinking of alcohol C. A 15-year-old female with cystic fibrosis D. A 66-year-old female stomach cancer

C. A 15-year-old female with cystic fibrosis

Select all the patients below that are at risk for an acute intrarenal injury A. A 45 year old male with a renal calculus B. A 65-year-old male with BPH C. A 25 year old male receiving chemotherapy D. A 36-year-old female with renal artereri stenosis E. A six-year-old male with acute glomerulonephritis F. 87-year-old male who is taking aminoglycoside medication for an infection

C. A 25 year old male receiving chemotherapy E. A six-year-old male with acute glomerulonephritis F. 87-year-old male who is taking aminoglycoside medication for an infection

The physician writes an order for administration of lactulose. Which lab result indicates this medication was successful? A. Bilirubin <1mg B. ALT 8 U/L C. Ammonia 16 mcg/dL D. AST 10 U/L

C. Ammonia 16 mcg/dL

A patient with hepatitis has a bilirubin of 6 mg. What findings would correlate with this lab result? Select all that apply A. None because this bilirubin level is normal B. Yellowing of the skin and Scalera C. Clay colored stools D. Bluish discoloration on the flanks of the abdomen E. Dark urine E. Mental status changes

C. Clay colored stools D. Bluish discoloration on the flanks of

You are providing education to a patient with an active hepatitis B infection. What will you include in there discharge instructions? Select all that apply A. Take acetaminophen as needed for pain B. A large meals spread out through the day C. Follow a diet low in fat and high in carbs D do not share toothbrushes razors utensils drinking cups or any other type of personal hygiene products E. Perform aerobic exercises daily to maintain strength

C. Follow a diet low in fat and high in carbs D do not share toothbrushes razors utensils drinking cups or any other type of personal hygiene products

A nurse is assessing a client who has pancreatitis. Which of the following findings should the nurse identify as a manifestation of pancreatitis? A. Generalized cyanosis B. Hyperactive bowel sounds C. Gray blue discoloration of the skin around the umbilicus D. Wheezing in the lower lung fields

C. Gray-blue discoloration of the skin around the umbilicus

Which is the best preventative measure to help prevent all types of viral hepatitis? A. Vaccination B. Proper disposal of needles C. Hand hygiene D. Blood an organ donation screening

C. Hand hygiene

A patient with AKI has a urinary output of 350 mL per day. In addition, morning labs showed an increase BUN and creatinine level along with potassium level of 6 mEq/L. What type of diet ordered by the physician is most appropriate for this patient? A. Low sodium, high protein, low potassium B. High protein, low potassium, and low sodium C. Low protein, low potassium and low sodium D. High protein and high potassium

C. Low protein, low potassium and low sodium

A patient who is experiencing poststreptococcal glomerulonephritis has edema mainly in the face around the eyes. As a nurse you know to expect the Edema to be most prominent during the ? A. Evening B. Afternoon C. Morning D. Bedtime

C. Morning

A nurse is assessing a client who has prerenal AKD. Which of the following findings should the nurse expect? Select all that apply A. Reduced BUN B. Elevated cardiac enzymes C. Reduced urine output D. Elevated blood creatinine E. Elevated blood calcium

C. Reduced urine output D. Elevated blood creatinine

Which of the following is not a common source of transmission for hepatitis A? Select all that apply A. Water B. Food C. Semen D. Blood

C. Semen D. Blood

You patient with hepatitis A asks you about the treatment options for his condition. Your response is? A. Antiviral medications B. Interferon C. Supportive care D. Hepatitis a vaccine

C. Supportive care

A patient has completed the hepatitis B vaccine series. What blood results below would demonstrate the vaccine was successful at providing immunity to hepatitis b? A. Positive IgG B. Positive HBSAG C. Positive IGM D. Positive anti-HBS

D Positive Anti-HBs

During a home health visit, you are assessing how a patient takes prescribed pancreatic enzyme. The patient is unable to swallow the capsule whole so they open the capsule and mix the beads inside the capsule with food/drink. Which food or drink it safe for the patient to mix the beads with? A. Pudding B. Ice cream C. Milk D. Applesauce

D. Applesauce

A patient is admitted to the ER with the following signs and symptoms: very painful mid epigastric pain felt in the back, elevated glucose, fever, and vomiting. During the head to toe assessment you noticed blue discoloration around the belly button. As a Nurse, you know this is called? A. Grey Turner's sign B. McBurney's sign C. Homans sign D. Cullens sign

D. Cullens sign

A nurse is completing an admission assessment of a client who has pancreatitis. Which of the following findings should the nurse expect? A. Pain and right upper quadrant radiating to right shoulder B. Report of pain being worse when sitting upright C. Pain relieved with defecation D. Epigastric pain radiating to left shoulder

D. Epigastric pain radiating to left shoulder

A patient is diagnosed with hepatitis A. The patient asks how a person can become infected with this condition. Do you know the most common route of transmission is? A. Blood B. Percutaneous C. Mucosal D. Fecal oral

D. Fecal oral

You are caring for a 45 year old patient who is admitted with suspected acute pancreatitis. The patient reports having extreme mid epigastric pain that radiates to the back. The patient states the pain started last night after eating fast food. As the nurse, you know the two most common causes of acute pancreatitis are: A. High cholesterol and alcohol abuse B. History of diabetes in smoking C. Pancreatic cancer and obesity D. Gall stones and alcohol abuse

D. Gall stones and alcohol abuse

What is the most common transmission route of hepatitis C? A. Blood transfusion B. Sharps injury C. Long-term dialysis D. IV drug use

D. IV drug use

A nurse is reviewing the admission laboratory results of a client who has acute pancreatitis. Which of the following findings should the nurse expect? A. Decrease blood lipase level B. Decreased blood amylase level C. Increased blood calcium levels D. Increased blood glucose levels

D. Increased blood glucose levels

A 25 year old patient was exposed to hepatitis A virus at a local restaurant one week ago. What education is important to provide to this patient? A. Inform the patient to notify the physician when signs and symptoms of viral hepatitis start to appear B. Reassure the patient the chance of acquiring the virus is very low C. Inform the patient is very important to obtain the hepatitis A vaccine immediately to prevent infection D. Inform the patient to promptly go to the local health department to receive immune globulin

D. Inform the patient to promptly go to the local health department to receive immune globulin

A nurse on a medical surgical unit is admitting a client who has hepatitis B with ascites. Which of the following actions should the nurse include in the plan of care? A. Initiate contact precautions B. Weigh the client weekly C. Measure abdominal girth at the base of the rib cage D. Provide a high calorie high carbohydrate diet

D. Provide a high calorie high carbohydrate diet

A patient with AKI has the following labs: GFR 92 mL per minute, BUN 17 mg /DL, potassium 4.9 mEq/L, And creatinine 1 mg / DL. The patients 24 hour urinary output is one. 75 L. Based on these findings what stage of AKI is the patient in? A. Initiation B. Diuresis C. Oliguric D. Recovery

D. Recovery

A physician orders a patient with pancreatitis to take pancreatiti enzymes. What assessment finding demonstrates they are working properly? A abdominal girth is decreased B. Skin turgor is less than two seconds C. Blood glucose is 250 D. Stools appear formed and solid

D. Stools appear formed and solid

Within the past month the admission rate of patients with poststreptococcal glomerulonephritis has doubled on your unit. You are providing an in-service to your colleagues about this condition. Which statement is correct about this condition? A. This condition tends to present six months after a strep throat infection B. It is important the patient consumes a diet rich in potassium-based foods due to the risk of hypokalemia C. Patients are less likely to experience hematuria with this condition D. This condition is not caused by the streptococcal bacteria attacking the glomerulus, but the immune system response to the bacteria by creating an antigen antibody complex which inflames a glomerulus

D. This condition is not caused by the streptococcal bacteria attacking the glomerulus, but the immune system response to the bacteria by creating an antigen antibody complex which inflames a glomerulus

True or false: all patients with AKI will progress through the oliguric stage of AKI but not all patients will progress through the diuresis stage.

False

True or false: poststreptococcal glomerulonephritis is a type of nephrotic syndrome, which means there's a leakage of both red blood cells and proteins from the inflamed glomerulus into the filtrate

False

A 55-year-old male patient is admitted with a massive G.I. bleed. The patient is at risk for what type of acute kidney injury? A. Post renal B. Intra-renal C. Pre-Renal D. Intrinsic Renal

The answer is C. Pre-renal injury is due to decreased perfusion to the kidneys secondary to a cause (massive GI bleeding...patient is losing blood volume). This leads to a major decrease in kidney function because the kidneys are deprived of nutrients to function and the amount of blood it can filter. Pre-renal injury can eventually lead to intrarenal damage where the nephrons become damaged.

True or false: a patient with hepatitis A is contagious about two weeks before signs and symptoms appear and 1 to 3 weeks after the symptoms appear

True