STUDY

The nurse assesses the client during and after hemodialysis for which symptoms of disequilibrium syndrome?

Headache, deteriorating level of consciousness, and twitching

Which statement best describes the pathophysiology f acute pancreatitis? a. Repeated episodes of acute pancreatitis lead to organ dysfunction b. Chronic alcohol consumption and abuse cause autodigestion of the pancreas c. Inflammation activates enzymes, resulting in autodigestion within the pancreas d. Gallstones become lodged in the common bile duct, causing clay-colored stools

c. Inflammation activates enzymes, resulting in autodigestion within the pancreas

Which teaching will the nurse include for a patient with low platelets from chemotherapy? a. Do not change pet litter boxes b. Do not share personal items c. Use a soft-bristle toothbrush d. Wash dishes between uses

c. Use a soft-bristle toothbrush

Which clinical manifestation is primarily associated with acute pyelonephritis? a. Peripheral and facial edema b. Obstruction and urinary reflux c. Increased urinary retention d. Active bacterial infection

d. Active bacterial infection

The nurse has completed teaching with a client on hemodialysis about self-monitoring between treatments. The nurses determines that the client best understands the information if the client states which of these?

I will monitor my daily intake and output and weight

A client with stage 4 chronic kidney disease asks what type of diet they should follow. The nurse discusses which of the following dietary guidelines?

Low protein, low sodium, low potassium, low phosphate diet

The nurse is caring for a client with acute kidney injury that developed after a severe anaphylactic reaction. What is a primary treatment goal in the initial phase that will help prevent permanent kidney damage?

Maintain a minimal mean arterial pressure of 65 mmHg

The nurse is explaining principles of hemodialysis to a nursing student. Which statement by the student indicates the need for additional information on the topic?

Blood and dialyzing solution mix in the dialyzer to remove molecules of high concentration

The nurse is caring for a client with acute kidney injury and notes a trend of increasingly elevated blood urea nitrogen (BUN) levels. How does the nurse interpret this information?

Breakdown of muscle tissue is occurring which leads to an increase in azotemia

The nurse is assessing a client with kidney injury and notes that the client is having Kussmaul respirations. What condition is the body attempting to compensate for?

Buildup of acidic molecules in the body

Which client with kidney problems is the best candidate for peritoneal dialysis?

Client with a history of difficulty with anticoagulants.

During the admission assessment, a client with suspected chronic kidney disease has all of these findings. For which finding will the nurse notify the provider immediately?

Crackles in both lower and middle lobes

When assessing a 32-year-old male client, which assessment findings lead the nurse to suspect acute glomerulonephritis?

Hypertension, oliguria, fatigue

Priority discharge teaching focused on presentation of acute kidney injury focuses on which of the following?

Dehydration can lead to acute kidney injury even in adults with no kidney problems

The client with acute renal failure has an elevated serum potassium level of 6.2 mEq/L. the nurse would plan which of the following as a priority action?

Place the client on a cardiac monitor

A client is admitted with dark urine, fever, and flank pain and is diagnosed with acute glomerulonephritis. Which risk factor would most likely be found in the client's health history?

Recent sort throat

The client has returned to the medical-surgical unit after a hemodialysis treatment. The nurse notes that an invasive procedure is scheduled on the same day. Which is the best rationale for delaying the invasive procedure for 4 to 6 hours?

The client was heparinized during dialysis

A client with Stage 5 chronic kidney disease is experiencing extreme pruritus and has several areas of discoloration on the skin. The nurse interprets this finding as likely due to excessive amounts of what substance in the blood?

Urea

In acute kidney injury, which of the following diagnostics are used to classify stage of injury?

Urine output and serum creatinine

Heart failure may occur in chronic kidney disease related to which of these factors?

Workload of the heart is increased due to anemia and fluid overload

The nurse is caring for a patient with pancreatitis who just consulted with the dietician. Which menu selection indicates effective patient understanding of the prescribed diet? a. A pancake with syrup and 2% milk b. Vegetable omelet with bacon and potatoes c. Roast turkey, mashed potatoes, and carrots d. Salad with ham, cheese, and hard-boiled egg

a. A pancake with syrup and 2% milk

Which nursing action is most appropriate to address chemotherapy-induced nausea and vomiting? a. Administer antiemetics before nausea or vomiting starts b. Encourage the patient to hold ice chips in the mouth during chemotherapy treatments c. Eat only moist or soft foods d. Assess the oral cavity

a. Administer antiemetics before nausea or vomiting starts

The nurse is completing an assessment on a patient being treated for pancreatitis and notes a blood pressure that has remained around 80/60 mmHg for a few days despite fluid resuscitation. The patient has pale, clammy skin; a heart rate of 100 bpm; and reports dizziness. Which order from the primary care provider does the nurse anticipate receiving? a. Administer dopamine b. Insert nasogastric tube c. Administer morphine sulfate d. Give intravenous fluids LR 150 mL/hour

a. Administer dopamine

Which laboratory values will the nurse expect to be decreased in the patient with cirrhosis? (Select all that apply) a. Albumin b. Calcium c. Potassium d. Ammoniae e. Alkaline phosphatase

a. Albumin b. Calcium c. Potassium

An elevation in which laboratory value can lead to increased confusion and lethargy in the patient with cirrhosis? a. Ammonia b. Potassium c. Total bilirubin d. PT/INR

a. Ammonia

Which dietary selection is most appropriate for the patient with cancer? a. An omelet with bacon, ham, and spinach b. Chips and salsa with avocado c. Spaghetti with marinara sauce d. Grilled cheese with French fries

a. An omelet with bacon, ham, and spinach

What should the nurse include in a focused assessment when caring for a patient admitted to the hospital with a diagnosis of cirrhosis? (Select all that apply) a. Assess the lower extremities b. Assess skin integrity and color c. Measure abdominal circumference d. Auscultate the abdomen for bowel sounds e. Assess for pupil reaction and accommodation

a. Assess the lower extremities b. Assess skin integrity and color c. Measure abdominal circumference

The client's care plan includes the nurse diagnosis "Excess Fluid Volume". Which interventions are appropriate for this nursing diagnosis?

a. Auscultate breath sounds every shift b. Monitor intake and output c. Measure weight daily

Which information will the nurse include in discharge teaching for a patient with cancer? (Select all that apply) a. Avoid large crowds b. Take aspirin to prevent blood clots c. You may continue to play soccer d. Protein shakes can be used to increase protein intake e. Inspect your mouth daily f. Do not reuse cups or dishes without washing them

a. Avoid large crowds d. Protein shakes can be used to increase protein intake e. Inspect your mouth daily f. Do not reuse cups or dishes without washing them

Which item should the nurse remove from the dinner tray of a patient with cirrhosis? a. Bacon b. Broccoli c. Potatoes d. Ice cream

a. Bacon

Following assessment of a patient, the nurse notes a bluish discoloration in the periumbilical area. How would the nurse correctly document this finding?a. Cullen's sign b. Grey-Turner's spots c. Rebound tenderness d. Costovertebral angle pain

a. Cullen's sign

1.A nurse is caring for a patient who has been diagnosed with cirrhosis; the disease is in the early stages. Which clinical manifestation would the nurse expect the patient to exhibit? a. Fatigue b. Jaundice c. Skin lesions d. Peripheral neuropathy

a. Fatigue

The nurse is evaluating a patient in the emergency department for suspected pancreatitis. Which factors, if present in the patient history or current assessment, would increase the risk for pancreatitis? (Select all that apply) a. History of gallstones b. Type 1 diabetes c. Presence of biliary sludge d. African American ethnicity e. 30 pack year history of smoking

a. History of gallstones c. Presence of biliary sludge d. African American ethnicity e. 30 pack year history of smoking

The nurse is preparing to administer spironolactone to a patient with cirrhosis. Which finding would lead the nurse to withhold the dose of spironolactone?a. Hyperkalemia b. Confusion and lethargy c. Decreased bowel sounds d. Petechiae and ecchymosis

a. Hyperkalemia

The nurse is providing discharge teaching to a male patient with cirrhosis about managing his care at home. Which statement made by the patient indicates a need for further teaching? a. I will weigh myself every other day b. I will stay away from drinking alcohol c. I can use lotion to decrease any itching d. I should get out of bed and move slowly

a. I will weigh myself every other day

Which assessment finding would demonstrate the efficacy of pancreatic enzyme replacement? a. No evidence of steatorrhea b. Green-colored bowel movements c. Amylase and lipase within normal range d. Fasting blood glucose levels less than 100 mg/dL

a. No evidence of steatorrhea

The nurse is caring for a patient with diagnosed acute pancreatitis and notes a recent elevation in temperature, a respiratory rate of 28 breaths/min, and a few crackles in the bases of the lungs. Which actions by the nurse would best address the patient's current situation? (Select all that apply) a. Obtain O2 saturation level b. Obtain STAT ABGs c. Elevate the bed to semi-Fowler's position d. Perform percussion and postural drainage e. Instruct patient on incentive spirometry use

a. Obtain O2 saturation level c. Elevate the bed to semi-Fowler's position e. Instruct patient on incentive spirometry use

Which interventions should the nurse include in the plan of care for a patient with cirrhosis who is experiencing excess fluid volume? (Select all that apply) a. Obtain a daily weight b. Auscultate lung sounds c. Elevate lower extremities d. Encourage deep breathing e. Monitor PT, INR, and PTT

a. Obtain a daily weight b. Auscultate lung sounds c. Elevate lower extremities

Which patient statement about cancer treatment requires further education? a. Pain is just a part of having cancer b. Small, frequent meals help keep my caloric intake up c. I will look in my mouth daily to make sure it looks normal d. I have to swallow the oral chemotherapy drug whole

a. Pain is just a part of having cancer

Which statement made by the patient reflects an understanding of the nurse's instruction regarding the proper use of oral pancreatic enzymes? a. Pancreatic enzymes will help with food digestion b. I will take the enzymes regularly even if I skip a meal c. I should take the enzymes after meals, but not snacks d. I can open up the capsule and sprinkle the drug on food

a. Pancreatic enzymes will help with food digestion

Which statement made by the patient on chemotherapy with a low platelet count requires further nursing education? a. Playing football with my kids makes me feel normal b. I will use a soft toothbrush to brush with c. I am taking a stool softener every day d. I have stopped taking a daily baby aspirin

a. Playing football with my kids makes me feel normal

The nurse is providing care to a confused patient with hepatic encephalopathy who refuses to stay in bed and is at risk for falling. Which intervention will the nurse implement to keep the patient safe? a. Provide a low bed with the wheels locked b. Raise all four side rails on the patient's bed c. Obtain a prescription for soft-cloth restraints d. Have on nurse stay in the patient's room around the clock

a. Provide a low bed with the wheels locked

Which nursing assessment data requires immediate intervention for the patient with cancer? a. Redness around the IV site following chemotherapy administration b. Reports of nausea following a meal c. Increased loss of hair following chemotherapy d. Decreased sensation in the lower extremities

a. Redness around the IV site following chemotherapy administration

Which instructions regarding home management should the nurse include when preparing a patient with chronic pancreatitis for discharge? (Select all that apply) a. Take insulin as prescribed b. Self-monitor blood glucose levels c. Consume caffeine in small amounts only d. Take B and C complex vitamin supplements e. Stop smoking cigarettes and tobacco products

a. Take insulin as prescribed b. Self-monitor blood glucose levels e. Stop smoking cigarettes and tobacco products

The nurse is assessing a patient for pain related to pancreatitis. Which statements about pain would the nurse anticipate from the patient? (Select all that apply) a. The pain comes on suddenly b. The pain gets worse when I eat c. The pain is severe, deep, and piercing d. The pain gets better with passing gas e. The pain is centered on my belly button

a. The pain comes on suddenlyb. The pain gets worse when I eatc. The pain is severe, deep, and piercing

a nurse is caring for a patient with a long-standing history of cirrhosis. Which findings on admission would cue the nurse to ask for further information from the patient or caregiver? (Select all that apply) a. Uses acetaminophen for pain b. Lethargic and oriented to person c. Weight has stayed at 165 pounds d. Diminished lung sounds in both bases e. Consumes 1 to 2 alcoholic beverages per week

a. Uses acetaminophen for pain b. Lethargic and oriented to person e. Consumes 1 to 2 alcoholic beverages per week

Following teaching, the nurse is evaluating the patient's understanding of the need for both an endoscopic retrograde cholangiopancreatography (ERCP), plus endoscopic sphincterotomy, and a laparoscopic cholecystectomy. Which statement by the patient indicates the need for further teaching? a. All three procedures take care of the current problem and prevent if from happening again b. A laparoscopic cholecystectomy visualizes the colon, and the ERCP removes the gallstones c. An ERCP can visualize the biliary tract, and the endoscopic sphincterotomy cuts muscle layers d. The procedures work together to remove the gallstones and gallbladder and fix the sphincter of Oddi. The goal is to alleviate pain

b. A laparoscopic cholecystectomy visualizes the colon, and the ERCP removes the gallstones

Which laboratory value must the nurse assess before administration of lactulose? a. Total bilirubin b. Ammonia level c. Alkaline phosphatase level d. PT/INR

b. Ammonia level

Which priority assessments should the nurse make before a patient undergoes TIPS procedure? (Select all that apply) a. Sodium level b. Ammonia level c. PT timed. Last bowel movement e. Level of consciousness

b. Ammonia level c. PT time

Which student nursing action requires intervention from the nurse? a. Assessing the site of intravenous chemotherapy administrationb. Breaking an oral chemotherapeutic drug in half c. Using PPE to empty urine from a patient receiving chemotherapy d. Providing a head covering for a patient with alopecia

b. Breaking an oral chemotherapeutic drug in half

The nurse is reviewing the current prescriptions for a patient with pancreatitis. Following a recent assessment, the patient was found to have decreased bowel sounds and abdominal distention. Which current medication order would the nurse question for this patient? a. Dopamine b. Dicyclomine c. Omeprazole d. Pancrelipase

b. Dicyclomine

Which nursing intervention will the nurse select for a patient with cancer and dysgeusia? a. Encourage frequent oral care b. Discuss alternative seasonings for food c. Apply lotion to the skin d. Test the stool for occult blood

b. Discuss alternative seasonings for food

A patient presents to the primary care provider one week after hospital discharge for an episode of acute pancreatitis. The patient reports a fever that has lasted for the last few days and stools have had a "really foul smell" and "appear greasy." A finger stick of blood glucose indicates a glucose level of 220 mg/dL. Which does the nurse suspect may be occurring? a. Atelectasis with pneumonia b. Further pancreatic destruction c. Pancreatic pseudocyst formation d. New onset type 1 diabetes

b. Further pancreatic destruction

Which pathologic change would cue the nurse to assess for excess fluid volume in a patient with cirrhosis? a. Potassium retention b. Hyperaldosteronism c. Ammonia reabsorption d. Prolonged clotting times

b. Hyperaldosteronism

Which intervention with the nurse select to prevent mucositis? a. Administering antiemetics b. Oral cryotherapy c. Limiting visitors d. Avoiding sunlight

b. Oral cryotherapy

The nurse is awaiting orders for a patient being admitted from the emergency room for conservative therapy for pancreatitis. The nurse would include which goals in the plan of care for the newly admitted patient? (Select all that apply) a. Skin integrity will remain intact b. Patient will remain free of infection c. Patient will verbalize understanding of NPO status d. Fluid and electrolyte levels are within normal limits e. Patient will rate pain at less than 2 in a 24-hour period f. Patient will limit alcohol consumption to one beer per week

b. Patient will remain free of infection c. Patient will verbalize understanding of NPO status d. Fluid and electrolyte levels are within normal limits e. Patient will rate pain at less than 2 in a 24-hour period

What should the nurse include in the teaching for a patient with cirrhosis who has an elevated PT/INR ?a. Take lactulose as prescribed b. Use an electric razor for shaving c. Keep your lower extremities elevated d. Limit your daily intake of foods with sodium

b. Use an electric razor for shaving

Which teaching will the nurse include regarding skin care following radiation therapy? (Select all that apply) a. You may wash off the markings used to guide the radiation b. Use gentle soap to wash the irradiated area c. Use a washcloth, not your hand, to wash the aread. Do not expose the area to sunlight e. Soft clothing is suggested f. Do not apply heating pads to the area

b. Use gentle soap to wash the irradiated area d. Do not expose the area to sunlight e. Soft clothing is suggested f. Do not apply heating pads to the area

A patient admitted for evaluation of pancreatitis is scheduled for a chest x-ray. Which explanation provided by the nurse to the patient explains the need for a chest x-ray? a. We need to assess for cardiac complications related to pancreatitis b. We need to assess for pulmonary complications relate to pancreatitis c. We will use the chest x-ray to assess the pancreas and look for abscesses and pseudocysts d. The chest x-ray is performed to determine pulmonary changes in every admitted to the hospital

b. We need to assess for pulmonary complications relate to pancreatitis

The nurse is caring for a patient being treated for acute pancreatitis and notes that the patient's arms are jerking and that they are experiencing muscular twitching. The patient is also complaining of numbness and tingling in the fingers. Which should be the nurse's initial action? a. Administer sublingual nitroglycerin b. Obtain STAT ECG c. Assess for Chvostek's sign or Trousseau's sign d. Initiate IV fluids of LR at 150 mL/hour

c. Assess for Chvostek's sign or Trousseau's sign

A patient being treated for pancreatitis says to the nurse, "I thought nitroglycerin was only given for chest pain." Which explanation provided by the nurse best addresses this statement? a. Nitroglycerin can relieve the pain you are experiencing from oversecretion of gastric acids b. Nitroglycerin helps to minimize fluid and electrolyte loss in patients with chronic pancreatitis c. Some antispasmodic medications can cause chest pain, so we give nitroglycerin to relax smooth muscle d. This medication is prescribed by your primary health care provider for all patients admitted with pancreatitis

c. Some antispasmodic medications can cause chest pain, so we give nitroglycerin to relax smooth muscle

Which nursing action is appropriate to improve nutrition for a patient with cancer? a. Provide large meals so the patient can eat more b. Avoid the use of high protein shakes c. Use alternative seasonings for food d. Encourage nothing by mouth until chemotherapy is complete

c. Use alternative seasonings for food

The nurse is reviewing the admission history and physical examination findings for a patient with a history of cirrhosis who is being admitted for the third time in 6 months. Which laboratory finding would indicate the patient has not followed the plan of care previously discussed at discharge? a. Albumin level 2.8 g/dL b. Sodium level 133 mEq/dL c. Potassium 3.4 mEq/dL d. Blood alcohol level 160 mg/dL

d. Blood alcohol level 160 mg/dL

The nurse is preparing to administer a unit of fresh frozen plasma to a patient with cirrhosis admitted for a TIPS procedure. The patient's caregiver asks why the patient will be receiving fresh frozen plasma. What is the nurse's best response? a. The fresh frozen plasma will help the patient make more red blood cells and platelets b. Fresh frozen plasma will expand the patient's blood volume to improve the blood pressure c. The fresh frozen plasma will be enough to stimulate the bone marrow to make red blood cells d. Fresh frozen plasma provides the patient with the necessary clotting factors that the liver is not producing

d. Fresh frozen plasma provides the patient with the necessary clotting factors that the liver is not producing

The nurse is caring for a patient with cirrhosis and an elevated PT/INR. Which complication is this patient most at risk for developing? a. Ascites b. Malnutrition c. Hepatic encephalopathy d. GI hemorrhage

d. GI hemorrhage

Which intervention should the nurse include when planning care to improve the nutritional status of a patient with cirrhosis? a. Provide the patient with preferred foods b. Implement fluid restriction of 1500 mL per day c. Monitor the ammonia levels and metabolic panel d. Give the patient smaller meals and snacks throughout the day

d. Give the patient smaller meals and snacks throughout the day

The caregiver of a patient with suspected pancreatitis asks the nurse why both serum amylase and serum lipase tests are being done if they are both enzymes related to the pancreas. Which explanation by the nurse accurately explains why both are being done? a. The serum amylase and lipase are decreased in acute pancreatitis b. These tests are always done at the same time to determine severity c. Serum amylase diagnoses pancreatitis; lipase determines if it is acute or chronic d. The serum amylase can be high due to other causes, so we also run the serum lipase

d. The serum amylase can be high due to other causes, so we also run the serum lipase

A nurse is revieing medications with a patient who is being discharged after having an esophageal variceal bleed. The patient questions why propranolol is being prescribed when blood pressure is low. What is the nurse's best response? a. Propranolol works in conjunction with vasopressin to provide systemic vasoconstriction b. this medication is prescribed by the primary health care provider to stop disease exacerbations c. the propranolol keeps your blood pressure within the normal range to ward off hypertensive crises d. propranolol will help decrease the portal pressure to prevent further bleeding from existing varices

d. propranolol will help decrease the portal pressure to prevent further bleeding from existing varices