Review questions exam 2 patho
Prolonged use of Proton Pump Inhibitors will likely result with the following except: •A. Hypermagnesemia B. Pneumonia C. Fractures D. Low stomach acid
5. Answer: A. Hypermagnesemia Option A: Long term use of PPIs affects intestinal magnesium absorption leading to hypomagnesemia.
The school nurse assesses Brook, a child newly diagnosed with attention deficit hyperactivity disorder (ADHD). Which of the following symptoms are characteristic of the disorder? Select all that apply. A. Constant fidgeting and squirming. B. Excessive fatigue and somatic complaints. C. Difficulty paying attention to details. D. Easily distracted. E. Running away. F. Talking constantly, even when inappropriate.
Answer: A, C, D, and F. Options A, C, D, F: These behaviors are all characteristic of ADHD and indicate that the child is inattentive, hyperactive, and impulsive. Options B & E: B and E are signs of emotional distress in a child and could be associated with a number of different psychiatric diagnoses. .
Patient Gavin is taking antacids, which instruction would be included in the teaching plan? A. "Avoid taking other medications within 2 hours of this one." B. "Continue taking antacids even when pain subsides." C. "Weigh yourself daily when taking this medication." D. "Take the antacids with 8 oz of water."
Answer: A. "Avoid taking other medications within 2 hours of this one." Option A: The client should be instructed to avoid taking other medications within 2 hours of the antacid. Option B: A histamine receptor antagonist should be taken even when the pain subsides. Option C: Daily weights are indicated if the client is taking a diuretic, not an antacid. Option D: Water, which dilutes the antacid, should not be taken with an antacid.
The nurse provides medication instructions to a client with peptic ulcer disease. Which statement, if made by the client, indicates the best understanding of the medication therapy? •A. "The cimetidine (Tagamet) will cause me to produce less stomach acid." B. "Sucralfate (Carafate) will change the fluid in my stomach." C. "Antacids will coat my stomach." D. "Omeprazole (Prilosec) will coat the ulcer and help it heal."
Answer: A. "The cimetidine (Tagamet) will cause me to produce less stomach acid." Option A: Cimetidine (Tagamet), a histamine H2 receptor antagonist, will decrease the secretion of gastric acid. Option B: Sucralfate (Carafate) promotes healing by coating the ulcer. Option C: Antacids neutralize acid in the stomach. Option D: Omeprazole (Prilosec) inhibits gastric acid secretion.
Clinical manifestations of common bile duct obstruction include all of the following except: •A. Amber-colored urine. B. Clay-colored feces. C. Pruritus. D. Jaundice.
Answer: A. Amber-colored urine. A: Amber-colored urine is seen in patients with urinary tract infection. B, C, D: Clay-colored feces, pruritus, and jaundice are clinical manifestations of common bile duct obstruction.
A characteristic associated with peptic ulcer pain is a: •A. Burning sensation localized in the back or mid-epigastrium. B. Feeling of emptiness that precedes meals from 1 to 3 hours. C. Severe gnawing pain that increases in severity as the day progresses. D. Combination of all of the above.
Answer: A. Burning sensation localized in the back or mid-epigastrium. A: As a rule, the patient with an ulcer complains of dull, gnawing pain or a burning sensation in the midepigastrium or the back that is relieved by eating. B: A feeling of emptiness that precedes meals from 1 to 3 hours is not a characteristic associated with peptic ulcer pain. C: A severe gnawing pain that increases in severity as the day progresses is not a characteristic associated with peptic ulcer pain. D: Not all of the options are characteristics associated with peptic ulcer pain.
The following are true about depression, except: A. External causes always play a part in assessment and diagnosis. B. Patients with depression have trouble sleeping and eating. C. Depression can lead to multiple physical problems. D. None of the above.
Answer: A. External causes always play a part in assessment and diagnosis. Depression can have no external causes.
Peptic ulcer disease may be caused by which of the following? •A. Helicobacter pylori B. Clostridium difficile C. Candida albicans D. Staphylococcus aureus
Answer: A. Helicobacter pylori Helicobacter pylori is considered to be the major cause of ulcer formation. Other choices are not related to ulcer formation.
The most common complication of peptic ulcer disease that occurs in 10% to 20% of patients is: A. Hemorrhage. B. Intractable ulcer. C. Perforation. D. Pyloric obstruction
Answer: A. Hemorrhage. A: Hemorrhage, the most common complication, occurs in 10% to 20% of patients with peptic ulcers in the form of hematemesis or melena. B: Intractable ulcer is not the most common complication of peptic ulcer disease. C: Perforation is not the most common complication of peptic ulcer disease. D: Pyloric obstruction is not the most common complication of peptic ulcer disease.
Which antidepressive drug class is associated with severe food and medication interactions? A. MAOIs B. SSRIs C. SNRIs D. TCAs
Answer: A. MAOIs. This is the reason why this drug class is rarely used.
Nurse Michael recommends that the family of a client with substance-related disorder attend a support group, such as Al-Anon and Alateen. The purpose of these groups is to help family members understand the problem and to: A. Maintain focus on changing their own behaviors B. Learn how to assist the abuser in getting help C. Prevent substance problems in vulnerable family members D. Change the problem behaviors of the abuser
Answer: A. Maintain focus on changing their own behaviors. Option A: Family support groups, such as Al-Anon and Alateen, emphasize the importance of changing one's own behavior rather than trying to change the behavior of the individual with a substance abuse problem. Options B and D: Trying to change the abuser's behavior or learning ways to find help for the abuser would be viewed as codependent behaviors, and thus would not be advocated by family support groups. Option C: Learning about substance abuse may help a vulnerable family member to avoid this problem; however, that is not the purpose of these groups.
Antidote for narcotic overdose. A. Naloxone B. Nubain C. Morphine D. Codeine
Answer: A. Naloxone
An emergency room nurse is assessing a 26 year old female patient who frequently uses opium. What symptoms would indicate that she is experiencing withdrawal? A. Nausea, vomiting, and anxiety B. Fatigue, disorientation, and craving C. Irritability, tremors, and seizures D. Diaphoresis, seizures, and apathy
Answer: A. Nausea, vomiting, and anxiety Explanation: Anxiety, nausea, and vomiting are common symptoms of opium withdrawal.
Patient Clint with agoraphobia has been symptom-free for 4 months. Classic signs and symptoms of phobias include: A. Severe anxiety and fear B. Withdrawal and failure to distinguish reality from fantasy C. Insomnia and an inability to concentrate D. Depression and weight loss
Answer: A. Severe anxiety and fear. Option A: Phobias cause severe anxiety (such as a panic attack) that is out of proportion to the threat of the feared object or situation. Physical signs and symptoms of phobias include profuse sweating, poor motor control, tachycardia, and elevated blood pressure. Option B: Withdrawal and failure to distinguish reality from fantasy occur in schizophrenia. Options C and D: Insomnia, an inability to concentrate, and weight loss are common in depression.
A 42 year old man presents to the ER for alcohol toxicity. While taking the history, the nurse discovers that he drinks on average one fifth of vodka per night, and often must drink an additional 6-12oz to get "a good buzz." When he doesn't drink, he experiences tremors and feels unwell until he is able to drink again. When asked if he would like to quit drinking he states that he has tried unsuccessfully several times over his life. He knows that he needs to get control over his drinking because it is seriously impairing his relationship with his husband and their 13 year old daughter. According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM V), this patient can be considered to have which of the following conditions? A. Substance dependency B. Substance abuse C. Substance addiction D. None of these
Answer: A. Substance dependency Explanation: The symptoms described by this patient put his alcohol use in the category of substance dependency, according to the DSM V, a more severe form of abuse than substance addiction. The criteria for this condition are: Tolerance Withdrawal Unintentional excesses in consumption Persistent desire or unsuccessful efforts to reduce or control substance use A great deal of time is spent to get, use, or recover from the substance Interference with social life The substance use is continued despite knowledge problems caused by use
Nurse Irish is aware that Ritalin is the drug of choice for a child with ADHD. The side effects of the following may be noted by the nurse: A. Increased attention span and concentration. B. Increase in appetite. C. Sleepiness and lethargy. D. Bradycardia and diarrhea
Answer: A. increased attention span and concentration. Option A: The medication has a paradoxical effect that decreases hyperactivity and impulsivity among children with ADHD. Options B, C, and D: Side effects of Ritalin include anorexia, insomnia, diarrhea, and irritability.
A 40-year-old, female patient with Crohn's disease is in the emergency room with severe abdominal pain and vomiting. The nurse suspects a total intestinal obstruction. Which assessment findings would confirm the diagnosis? Select all that apply: •Low pitched bowel sounds •Abdominal distention •Polyuria •Hypotension Paralytic ileus
Answer: B & E An intestinal obstruction occurs when the contents of the gastrointestinal tract cannot pass through the intestines. Signs and symptoms of an obstruction include severe abdominal pain, vomiting, abdominal distention, high-pitched or absent bowel sounds, and increased or absent peristalsis (paralytic ileus).
The physician has prescribed Nexium (esomeprazole) for a client with erosive gastritis. The nurse should administer the medication: •A. 30 minutes after meals B. 30 minutes before meals C. With each meal D. In a single dose at bedtime
Answer: B. 30 minutes before meals Option B: Proton pump inhibitors reduce the production of acid in the stomach. Proton pump inhibitors work best when they are taken 30 minutes before the first meal of the day.
How many weeks will the full therapeutic effects of SSRIs be realized? A. 2 weeks B. 4 weeks C. 6 weeks D. 8 weeks
Answer: B. 4 weeks. Therefore, it is important for nurses to instruct patients that effects of the drug will not be instantly feel and experienced
A patient with calculi in the gallbladder is said to have: •A. Cholecystitis. B. Cholelithiasis. C. Choledocholithiasis. D. Choledochotomy.
Answer: B. Cholelithiasis. B: Cholelithiasis is the formation of gallstones in the gallbladder from the solid constituents of bile. A: Cholecystitis is the acute or chronic inflammation of the bladder. C: Choledocholithiasis is the formation gallstones in the common bile duct. D: Choledochotomy involves making an incision in the common duct, usually for removal of stones.
The nurse would be correct in associating paranoid symptoms to increase in which neurotransmitter? •A. Prostaglandin B. Dopamine C. Norepinephrine D. Serotonin
Answer: B. Dopamine. Delusional or paranoid symptoms are associated with increased dopamine activity. Norepinephrine is associated with positive schizophrenic symptoms
The nurse is assessing a client who has just been admitted to the emergency department. Which signs would suggest an overdose of an antianxiety agent? A. Suspiciousness, dilated pupils, and increased blood pressure B. Emotional lability, euphoria, and impaired memory C. Agitation, hyperactivity, and grandiose ideation D. Combativeness, sweating, and confusion
Answer: B. Emotional lability, euphoria, and impaired memory. Option B: Signs of antianxiety agent overdose include emotional lability, euphoria, and impaired memory. Option A: Hallucinogen overdose can produce suspiciousness, dilated pupils, and increased blood pressure. Option C: Amphetamine overdose can result in agitation, hyperactivity, and grandiose ideation. Option D: Phencyclidine overdose can cause combativeness, sweating, and confusion.
What is the top nursing consideration of a nurse who is taking care of an adult client with schizophrenia receiving antipsychotics? •A. Monitor urine output. B. Obtain ECG tracing regularly as ordered. C. Assess bowel sounds. D. Provide comfort measures.
Answer: B. Obtain ECG tracing regularly as ordered. Usage of drugs in this population requires close monitoring for adverse effects. For example, thioridazine and ziprasidone can cause changes in QT interval.
Which of the following best describes the method of action of medications, such as ranitidine (Zantac), which are used in the treatment of peptic ulcer disease?: •A. Neutralize acid B. Reduce acid secretions C. Stimulate gastrin release D. Protect the mucosal barrier
Answer: B. Reduce acid secretions. Option B: Ranitidine is a histamine-2 receptor antagonist that reduces acid secretion by inhibiting gastrin secretion.
A combination of MAOIs and TCAs will precipitate which drug adverse effect? A. Severe hypertensive crisis B. Severe hyperpyretic crisis C. Severe hypnotic crisis D. Severe amnesia
Answer: B. Severe hyper-pyretic crisis. It is accompanied by convulsions, hypertensive episodes, and even death.
Nurse Naomi observes Ashley who is hospitalized on an eating disorder unit during mealtimes and for 1 hour after eating. An explanation for this intervention is: A. To reinforce the behavioral contact B. To prevent purging behaviors C. To develop a trusting relationship D. To maintain focus on the importance of nutrition
Answer: B. To prevent purging behaviors. Option B: Ashley may experience increased anxiety during treatment and, therefore, may resume behaviors designed to prevent weight gain, such as vomiting or excessive exercise
Alcohol abuse-induced thiamine deficiency can cause which of the following? A. Lewy body dementia B. Wernicke-Korsakoff syndrome C. Agnosia D. Wolf-Hirschhorn syndrome
Answer: B. Wernicke-Korsakoff syndrome Explanation: Wernicke-Korsakoff syndrome is caused by a severe deficiency in thiamine, often seen in severe alcohol dependency. It is characterized by visual disturbances, ataxia, and altered consciousness. Wolf-Hirschhorn syndrome is a genetic disorder causing developmental disability and may involve seizures. Lewy body dementia is associated with Parkinson's disease. Agnosia is a neurological disorder causing impaired ability to process sensory information
Nurse Pauline is aware that Dementia, unlike delirium, is characterized by: •A. Slurred speech. B. Insidious onset. C. Clouding of consciousness. D. Sensory perceptual change.
Answer: B. insidious onset. Option B: Dementia has a gradual onset and progressive deterioration. It causes pronounced memory and cognitive disturbances. Options A, C, and D: These are all characteristics of delirium.
Which of the following is not part of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria for autism spectrum disorder (ASD)? A.Stereotyped or repetitive motor movements, use of objects, or speech B. Hyper- or hyporeactivity to sensory input or unusual interests in sensory aspects of the environment C.Hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for the person's developmental level D. Highly restricted, fixated interests that are abnormal in intensity or focus
Answer: C. All of the behaviors listed are part of the diagnostic criteria for autism spectrum disorder except for disruptive hyperactivity-impulsivity present for a period of greater than six months, which is part of the DSM-5's diagnostic criteria for attention deficit hyperactivity disorder (ADHD), not for autism spectrum disorder (ASD). .
How long should a depressive episode last for it to be considered for diagnosis? A. 7 days B. more than 10 days C. 2 weeks D. 3-4 weeks
Answer: C. 2 weeks. Major depression is a syndrome of a persistently sad mood lasting 2 weeks or longer.
Alfred was newly diagnosed with anxiety disorder. The physician prescribed buspirone (BuSpar). The nurse is aware that the teaching instructions for newly prescribed buspirone should include which of the following? A. A reminder of the need to schedule blood work in 1 week to check blood levels of the drug. B. A warning about the incidence of neuroleptic malignant syndrome (NMS). C. A warning about the drugs delayed therapeutic effect, which is from 14 to 30 days. D. A warning that immediate sedation can occur with a resultant drop in
Answer: C. A warning about the drugs delayed therapeutic effect, which is from 14 to 30 days. Option C: The client should be informed that the drug's therapeutic effect might not be reached for 14 to 30 days. The client must be instructed to continue taking the drug as directed. Option A: Blood level checks aren't necessary. Options B and D: NMS hasn't been reported with this drug, but tachycardia is frequently reported.
Nurse Victoria is teaching a group of middle-aged men about peptic ulcers. When discussing risk factors for peptic ulcers, the nurse should mention: •A. A history of hemorrhoids and smoking B. A sedentary lifestyle and smoking C. Alcohol abuse and smoking D. Alcohol abuse and a history of acute renal failure
Answer: C. Alcohol abuse and smoking Option C: Risk factors for peptic (gastric and duodenal) ulcers include alcohol abuse, smoking, and stress. Options A & B: A sedentary lifestyle and a history of hemorrhoids aren't risk factors for peptic ulcers. Option D: Chronic renal failure, not acute renal failure, is associated with duodenal ulcers.
A patient is prescribed with esomeprazole for the treatment of GERD. Upon review of current medication use, the nurse noted that the patient is taking clopidogrel. The nurse warned the patient that esomeprazole: •A. Have no evidence of potential interaction with clopidogrel B. Increase the effectiveness of clopidogrel C. Decrease the effectiveness of clopidogrel D. Increase acid production
Answer: C. Decrease the effectiveness of clopidogrel Option C: Esomeprazole inhibits CYP2C19 enzyme which serves as a pathway for certain medication. One of which is clopidogrel, so taking it with esomeprazole will potentially decrease the effectiveness of clopidogrel.
Ralph is admitted at Nurseslabs Medical Center with the diagnosis of bipolar disorder, single manic episode. Which of the following behaviors would the nurse expect to assess? A. Apathy, poor insight, and poverty of ideas. B. Anxiety, somatic complaints, and insomnia. C. Elation, hyperactivity, and impaired judgment. D. Social isolation, delusional thinking, and clang associations.
Answer: C. Elation, hyperactivity, and impaired judgment. Option C: A client with bipolar disorder, manic episode, would demonstrate flight of ideas and hyperactivity as part of the increased psychomotor activity. The mood is one of elation, and the feeling is that one is invincible; therefore, judgment may be quite impaired. Option A: The symptoms in option A would be more characteristic of an individual with long-term schizophrenia. Option B: The symptoms in option B would be more characteristic of someone with an anxiety disorder, although a manic individual may also not sleep because of excessive energy. Option D: The symptoms in option D are more characteristic of schizophrenia.
Which of the following tests can be used to diagnose ulcers? •A. Barium swallow B. Abdominal x-ray C. Esophagogastroduodenoscopy (EGD) D. Computed tomography (CT) scan
Answer: C. Esophagogastroduodenoscopy (EGD) Option C: The EGD can visualize the entire upper GI tract as well as allow for tissue specimens and electrocautery if needed. Option A: The barium swallow could locate a gastric ulcer. Options B and D: A CT scan and an abdominal x-ray aren't useful in the diagnosis of an ulcer.
The nurse assesses a client with the admitting diagnosis of bipolar affective disorder, mania. The symptom presented by the client that requires the nurse's immediate intervention is the client's: A. Outlandish behaviors and inappropriate dress. B. Grandiose delusions of being a royal descendant of King Arthur. C. Nonstop physical activity and poor nutritional intake. D. Constant, incessant talking that includes sexual innuendoes and teasing the staff.
Answer: C. Nonstop physical activity and poor nutritional intake. Option C: Mania is a mood characterized by excitement, euphoria, hyperactivity, excessive energy, decreased need for sleep, and impaired ability to concentrate or complete a single train of thought. Mania is a period when the mood is predominately elevated, expansive, or irritable. All options reflect a client's possible symptomatology. Option C, however, clearly presents a problem that compromises one's physiological integrity and needs to be addressed immediately.
Nurse Nadine is assessing James who is diagnosed with bipolar disorder. The nurse would expect to find a history of: A. A depressive episode followed by prolonged sadness. B. A series of depressive episodes that recur periodically. C. Symptoms of mania that may or may not be followed by depression. D. Symptoms of mania that include delusional thoughts.
Answer: C. Symptoms of mania that may or may not be followed by depression. Option C: The definition of bipolar disorder is a mood disturbance in which the symptoms of mania have occurred at least one time. Depression may or may not occur as a separate episode in bipolar disorder. Options A, B, D: None of the other options indicate a correct understanding of bipolar disorder.
During assessment, the nurse is looking for positive indicators of appendicitis, which include all of the following except: •A. A low-grade fever. B. Abdominal tenderness on palpation. C. Thrombocytopenia. D. Vomiting.
Answer: C. Thrombocytopenia. C: Thrombocytopenia could not be found in a patient with appendicitis. A: A low-grade fever is a symptom of appendicitis. B: Abdominal tenderness on palpation is a symptom of appendicitis. D: Vomiting is a symptom of appendicitis.
Which of the following statements describes the action of antacids? A. Antacids block the production of gastric acid B. Antacids enhance the action of acetylcholine C. Antacids block dopamine D. Antacids neutralize gastric acid
Answer: D. Antacids neutralize gastric acid Option D: Antacids act to bring the pH above 3. Options A, B, and C: Other choices are incorrect because they describe actions of antiacid drugs.
Which medications have been found to help reduce or eliminate panic attacks? A. Anticholinergics B. Mood stabilizers C. Antipsychotics D. Antidepressants
Answer: D. Antidepressants. Option D: Tricyclic and monoamine oxidase (MAO) inhibitor antidepressants have been found to be effective in treating clients with panic attacks. Why these drugs help control panic attacks isn't clearly understood. Option A: Anticholinergic agents, which are smooth-muscle relaxants, relieve physical symptoms of anxiety but don't relieve the anxiety itself. Option B: Mood stabilizers aren't indicated because panic attacks are rarely associated with mood changes. Option C: Antipsychotic drugs are inappropriate because clients who experience panic attacks aren't psychotic.
Statistics show that there is a greater incidence of gallbladder disease for women who are: •A. Multiparous. B. Obese. C. Older than 40 years of age. D. Characterized by all of the above.
Answer: D. Characterized by all of the above. D: All of the options above are risk factors for gallbladder disease. A, B, C: Multiparity, obesity, and women older than 40 years have greater risk factors for gallbladder disease.
Nurse Christine is teaching a client about disulfiram (Antabuse), which the client is taking to deter his use of alcohol. She explains that using alcohol when taking this medication can result in: A. Increased pulse and blood pressure B. Abdominal cramps and diarrhea C. Drowsiness and decreased respiration D. Flushing, vomiting, and dizziness
Answer: D. Flushing, vomiting, and dizziness. Option D: Disulfiram (Antabuse) prevents complete alcohol metabolism in the body. Therefore when alcohol is consumed, the client has a hypersensitivity reaction. Flushing, vomiting, and dizziness are associated with the incomplete breakdown of alcohol metabolites. Options A, B, and C: Other choices are not associated with the use of disulfiram along with alcohol.
Methylphenidate (Ritalin) is prescribed to an 8-year-old child for the treatment of attention deficit hyperactivity disorder (ADHD). The nurse will most likely monitor which of the following during the medication therapy? A. Deep tendon reflex B. Intake and output C. Temperature and breath sound D. Height and weight
Answer: D. Height and weight. Option D: Methylphenidate (Ritalin) may cause slow growth. The nurse will need to keep track of the client's height and weight to make sure that there is a normal growth and development.
Nurse Josefina is caring for a client who has been diagnosed with delirium. Which statement about delirium is true? •A. It's characterized by an acute onset and lasts about 1 month. B. It's characterized by a slowly evolving onset and lasts about 1 week. C. It's characterized by a slowly evolving onset and lasts about 1 month. D. It's characterized by an acute onset and lasts hours to a number of days.
Answer: D. It's characterized by an acute onset and lasts hours to a number of days D: Delirium has an acute onset and typically can last from several hours to several days
Nurse Nancy is assessing a child with pyloric stenosis; she is likely to note which of the following? •A. "Currant jelly" stools. B. Regurgitation. C. Steatorrhea. D. Projectile vomiting.
Answer: D. Projectile vomiting. Option D: Projectile vomiting is a key sign of pyloric stenosis. Option B: Regurgitation is seen more commonly with gastroesophageal reflux. Option C: Steatorrhea occurs in malabsorption disorders such as celiac disease. Option A: "Currant jelly" stools are characteristic of intussusception.
The diagnostic procedure of choice for choledocholithiasis is: •A. Xray. B. Oral cholecystography. C. Cholecystography. D. Ultrasonography.
Answer: D. Ultrasonography. D: Ultrasonography has replaced cholecystography as the diagnostic procedure of choice because it is rapid and accurate and can be used in patients with liver dysfunction and jaundice. A: If gallbladder disease is suspected, an abdominal x-ray may be obtained to exclude other causes of symptoms. B&C: Oral cholangiography may be performed to detect gallstones and to assess the ability of the gallbladder to fill, concentrate its contents, contract and empty.
Which of the following symptoms is most worrisome in a patient undergoing alcohol withdrawal A.Agitation B.Tachycardia C.Bradycardia D.Delirium Tremors
Answer: D: Delirium tremors Explanation: Delirium tremens (DT) is a rapid onset of confusion seen during alcohol withdrawal. The symptoms of DT include altered mental status, autonomic instability, and even seizures. DT is also characterized by hallucinations such as the sensation of something "crawling" on the patient. DT is the most severe consequence of withdrawal and can be fatal if untreated.
Symptoms suggestive of ulcerative colitis include all of the following except? •Bloody diarrhea mixed with mucus •Nausea and vomiting •Weight gain Abdominal pain
Answer: c. Weight gain. Symptoms of ulcerative colitis include bloody diarrhea mixed with mucus, nausea/vomiting, abdominal pain, and possible weight loss with long-term diarrhea
Which of the following are negative symptoms of schizophrenia? •A. apathy and delusion B. lack of motivation, blunted affect, and apathy C. bizarre behavior and delusions D. a sociality, anhedonia, and periodic excitability
B. lack of motivation, blunted affect, and apathy. Negative symptoms are also called as deficit symptoms.
A child diagnosed with autism will demonstrate impaired development in •a. adhering to routines. b. playing with other children. c. swallowing and chewing. d. eye-hand coordination.
B. playing with other children. Autism affects the normal development of the brain in social interaction and communication skills. Symptoms associated with autism spectrum disorders include significant deficits in social relatedness, including communication, nonverbal behavior, and age-appropriate interaction.
For a client in hepatic coma, which outcome would be the most appropriate? •The client is oriented to time, place, and person. •The client exhibits no ecchymotic areas. •The client increases oral intake to 2,000 calories/day. •The client exhibits increased serum albumin level.
Correct A. The client is oriented to time, place, and person. Option A: Hepatic coma is the most advanced stage of hepatic encephalopathy. As hepatic coma resolves, improvement in the client's level of consciousness occurs. The client should be able to express orientation to time, place, and person. Option B: Ecchymotic areas are related to decreased synthesis of clotting factors. Option C: Although oral intake may be related to level of consciousness, it is more closely related to anorexia. Option D: The serum albumin level reflects hepatic synthetic ability, not level of consciousness.
Dr. Smith has determined that the client with hepatitis has contracted the infection from contaminated food. The nurse understands that this client is most likely experiencing what type of hepatitis? •Hepatitis A •Hepatitis B •Hepatitis C Hepatitis D
Correct Answer: A. Hepatitis A Option A: Hepatitis A is transmitted by the fecal-oral route via contaminated food or infected food handlers. Options B, C, & D: Hepatitis B, C, and D are transmitted most commonly via infected blood or body fluids.
Which assessment finding indicates that lactulose is effective in decreasing the ammonia level in the client with hepatic encephalopathy? •Passage of two or three soft stools daily •Evidence of watery diarrhea •Daily deterioration in the client's handwriting •Appearance of frothy, foul-smelling stools
Correct Answer: A. Passage of two or three soft stools daily Option A: Lactulose reduces serum ammonia levels by inducing catharsis, subsequently decreasing colonic pH and inhibiting fecal flora from producing ammonia from urea. Ammonia is removed with the stool. Two or three soft stools daily indicate effectiveness of the drug. Option B: Watery diarrhea indicates overdose. Option C: Daily deterioration in the client's handwriting indicates an increase in the ammonia level and worsening of hepatic encephalopathy. Option D: Frothy, foul-smelling stools indicate steatorrhea, caused by impaired fat digestion.
Which of the following will the nurse include in the care plan for a client hospitalized with viral hepatitis? •Increase fluid intake to 3000 ml per day •Adequate bed rest •Bland diet • Administer antibiotics as ordered
Correct Answer: B. Adequate bed rest Option B: Treatment of hepatitis consists of bed rest during the acute phase to reduce metabolic demands on the liver, thus increasing blood supply and cell regeneration. Options A, C, & D: Forcing fluids, antibiotics, and bland diets are not part of the treatment plan for viral hepatitis.
For a client with hepatic cirrhosis who has altered clotting mechanisms, which intervention would be most important? •Allowing complete independence of mobility •Applying pressure to injection sites •Administering antibiotics as prescribed • Increasing nutritional intake
Correct Answer: B. Applying pressure to injection sites Option B: The client with cirrhosis who has altered clotting is at high risk for hemorrhage. Prolonged application of pressure to injection or bleeding sites is important. Option A: Complete independence may increase the client's potential for injury, because an unsupervised client may injure himself and bleed excessively. Options C & D: Antibiotics and good nutrition are important to promote liver regeneration. However, they are not most important for a client at high risk for hemorrhage
Spironolactone (Aldactone) is prescribed for a client with chronic cirrhosis and ascites. The nurse should monitor the client for which of the following medication-related side effects? •Jaundice •Hyperkalemia •Tachycardia Constipation
Correct Answer: B. Hyperkalemia Option B: This is a potassium-sparing diuretic so clients should be monitored closely for hyperkalemia. Diarrhea, dizziness, and headaches are other more common side effects. Options A, C, & D: Tachycardia, jaundice, and constipation are not expected side effects of spironolactone (Aldactone).
Nurse Farrah is providing care for Kristoff who has jaundice. Which statement indicates that the nurse understands the rationale for instituting skin care measures for the client? •"Jaundice is associated with pressure ulcer formation." • "Jaundice impairs urea production, which produces pruritus." •"Jaundice produces pruritus due to impaired bile acid excretion." • "Jaundice leads to decreased tissue perfusion and subsequent breakdown."
Correct Answer: C. "Jaundice produces pruritus due to impaired bile acid excretion." Option C: Jaundice is a symptom characterized by increased bilirubin concentration in the blood. Bile acid excretion is impaired, increasing the bile acids in the skin and causing pruritus. Option A: Jaundice is not associated with pressure ulcer formation. However, edema and hypoalbuminemia are. Options B & D: Jaundice itself does not impair urea production or lead to decreased tissue perfusion.
The nurse is performing an abdominal assessment and inspects the skin of the abdomen. The nurse performs which assessment technique next? A. Palpates the abdomen for sizeB. Palpates the liver at the right rib margin C. Listens to bowel sounds in all four quadrants D. Percusses the right lower abdominal quadrant
Correct Answer: C. Listens to bowel sounds in all four quadrants Option C: The appropriate sequence for abdominal examination is inspection, auscultation, percussion, and palpation. Auscultation is performed after inspection to ensure that the motility of the bowel and bowel sounds are not altered by percussion or palpation. Therefore, after inspecting the skin on the abdomen, the nurse should listen for bowel sounds.
A 52-year-old man was referred to the clinic due to increased abdominal girth. He is diagnosed with ascites by the presence of a fluid thrill and shifting dullness on percussion. After administering diuretic therapy, which nursing action would be most effective in ensuring safe care? •Measuring serum potassium for hyperkalemia •Assessing the client for hypervolemia •Measuring the client's weight weekly •Documenting precise intake and output
Correct Answer: D. Documenting precise intake and output Option D: For the client with ascites receiving diuretic therapy, careful intake and output measurement is essential for safe diuretic therapy. Diuretics lead to fluid losses, which if not monitored closely and documented, could place the client at risk for serious fluid and electrolyte imbalances. Option A: Hypokalemia, not hyperkalemia, commonly occurs with diuretic therapy. Option B: Because urine output increases, a client should be assessed for hypovolemia, not hypervolemia. Option C: Weights are also an accurate indicator of fluid balance. However, for this client, weights should be obtained daily, not weekly.
Jordin is a client with jaundice who is experiencing pruritus. Which nursing intervention would be included in the care plan for the client? •Administering vitamin K subcutaneously •Applying pressure when giving I.M. injections •Decreasing the client's dietary protein intake •Keeping the client's fingernails short and smooth
Correct Answer: D. Keeping the client's fingernails short and smooth Option D: The client with pruritus experiences itching, which may lead to skin breakdown and possibly infection from scratching. Keeping his fingernails short and smooth helps prevent skin breakdown and infection from scratching. Options A & B: Applying pressure when giving I.M. injections and administering vitamin K subcutaneously are important if the client develops bleeding problems. Option C: Decreasing the client's dietary intake is appropriate if the client's ammonia levels are increased.
When preparing to assess a 4-year-old child to help rule out a neurodevelopmental disorder, the nurse bases interventions on the understanding that a. children of that age are very resilient. b. age make these children poor interviewees. c. poor cooperation is typical at that age. d. language skills are limited at that age
d. language skills are limited at that age. Younger children are more difficult to diagnose than older children because of their limited language skills and cognitive and emotional development.
