ATI questions- Hepatic/DKA/DI/SIADH/Pituitary

a nurse is collecting the medical hx from a client who has manifestations of SIADH. The nurse should as the client if he has a history of of which of the following conditions

lung cancer

a nurse is teaching a client who has hepatitis A. Which of the following information should the nurse include

manifestations of the virus are similar to flu like symptoms

A nurse is assessing a client who had a craniotomy and has developed syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following manifestations should the nurse anticipate?

oliguria

a nurse is preparing to administer the hepatitis B vaccine to a client. Which of the following techniques should the nurse use to locate the deltoid muscle

place on finger across acromion process and measure 3 finger breaths below to the midpoint and center the lateral aspect if the upper arm

a nurse is caring for a client who has acquired hepatitis A from consuming contaminated food. The clients mouth is an example of which of the following links in the chain of infection

portal of entry

a nurse is caring for a client who has SIADH and a sodium level of 123. which fo the following prescriptions should the nurse anticipate

restrict fluid intake to 1,000ml per day

a nurse is assessing a client who has diabetes insipid. Which of the following findings is a manifestations of this diagnsos hypertension bounding peripheral pulses tachycardia hyperglycemia

tachycardia

A nurse is caring for a client who has been diganosed with end stage liver cancer. Which of the following responses is an indication the client is in the denial phase of the grief process

" The doctor says I inly have a few months to live, but I know he is exaggerating to get me to take my medication"

a nurse in the emergency department is caring for c client who has diabetic Ketoacidosis and a blood sugar of 925. The nurse should anticipate which of the following prescriptions from the provider

0.9% NaCl IV bolus

a nurse is assessing a client who has diabetes insipid. which of the following findings should the nurse expect 1. urine specific gravity 1.002 2. bounding peripheral pulses 3. bradycardia 4. most mucous membranes

1. urine specific gravity 1.002

A nurse administers demopressin to a client who has diagnosis of diabetes insipid. The Nurse recognizes that which the following laboratory findings indicates a therapeutic effect fo the medication 1. sodium 146 2. blood glucose 80 3. Urine specific gravity 1.015 4. BUN 15

3. Urine specific gravity 1.015

A nurse is assessing clients in a health clinic for risk factors for contracting hepatitis. Which of the following clients is at risk for developing hepatitis C? A client who eats raw shellfish A client who has multiple tattoos A client who works in a child care center A client who has recently traveled to a underdeveloped country

A client who has multiple tattoos Hepatitis C is transmitted via blood-to-blood contact. The nurse should recognize that improperly maintained tattoo equipment may aid in transmission and could increase the client's risk for contracting hepatitis C.

A nurse is planning care for a client who has cirrhosis of the liver. Which of the following actions should the nurse include in the plan? (Select all that apply.) Administer furosemide. Administer warfarin. Implement a low-sodium diet. Measure the client's abdominal girth. Encourage weight lifting during physical therapy.

Administer furosemide is correct. The nurse should administer furosemide to the client to reduce fluid accumulation in the abdomen. Administer warfarin is incorrect. The nurse should avoid administering warfarin to the client due to possible destruction of platelets caused by splenomegaly, which can result in spontaneous bleeding.Propranolol is prescribed instead to discourage bleeding. Implement a low-sodium diet is correct. The nurse should implement a low-sodium diet to control fluid accumulation in the abdomen. Measure the client's abdominal girth is correct. The nurse should measure the client's abdominal girth. Daily weights are an even more reliable indicator of fluid accumulation. Encourage weight lifting during physical therapy is incorrect. The nurse should understand weight lifting can cause bleeding.

A nurse is planning for a client who has cirrhosis of the liver. Which of the following actions should the nurse include on the plan? (Select all that apply) Administer furosemide, implement a low-sodium diet, measure abdominal girth, administer warfarin, encourage weight lifting

Administer furosemide, implement a low-sodium diet, measure abdominal girth

A nurse is teaching a community education course about the physical complications related to substance use disorder. Which of the following findings should the nurse identify as the primary cause of liver cirrhosis? Alcohol Caffeine Cocaine Inhalant

Alcohol Chronic alcohol use disorder is one of the primary causes of cirrhosis of the liver.

A nurse is preparing to administer a dose of lactulose to a client who has cirrhosis. The client states, "I don't need this medication. I am not constipated." The nurse should explain that in clients who have cirrhosis, lactulose is used to decrease levels of which of the following components in the bloodstream? Glucose Ammonia Potassium Bicarbonate

Ammonia Lactulose, a disaccharide, is a sugar that works as an osmotic diuretic. It prevents absorption of ammonia in the colon. Accumulation of ammonia in the bloodstream, which occurs in pathologic conditions of the liver, such as cirrhosis, may affect the central nervous system, causing hepatic encephalopathy or coma.

A nurse is teaching a class about preventive care to clients who are at risk for acquiring viral hepatitis. Which of the following information should the nurse include in the presentation? Avoid covering sores with bandages. Avoid handwashing after eating. Avoid foods prepared with tap water. Avoid eating meat.

Avoid foods prepared with tap water.To decrease the risk for acquiring viral hepatitis, clients should prepare foods with purified water.

A nurse is caring for a newborn whose mother is positive for the hepatitis B surface antigen. Which of the following treatments should the infant receive?A. Hepatitis B immune globulin at 1 week followed by the hepatitis B vaccine monthly for 6 monthsB. The hepatitis B vaccine monthly until the newborn tests negative for the hepatitis B surface antigenC. Hepatitis B immune goblin and the hepatitis B vaccine within 12 hr of birth D. The hepatitis B vaccine at 24 hr followed by hepatitis B immune globulin every 12 hr for 3 days

C. Hepatitis B immune goblin and the hepatitis B vaccine within 12 hr of birth

A nurse is planning care for a client who has a new diagnosis of diabetes insipidus. Which of the following interventions should the nurse include in the plan of care?

Check urine specific gravity

A nurse is planning care for a client who has cirrhosis and ascites. Which of the following interventions should the nurse include in the plan of care? Decrease the client's fluid intake. Increase the client's saturated fat intake. Increase the client's sodium intake. Decrease the client's carbohydrate intake.

Decrease the client's fluid intake. The nurse should restrict fluids for a client who has cirrhosis and ascites due to the client's risk for increased fluid retention.

A nurse is reviewing the laboratory results of a client who has liver failure with ascites and is receiving spironolactone. Which of the following findings should the nurse expect? Decreased sodium level Decreased phosphate level Decreased potassium level Decreased chloride level

Decreased sodium levelThe nurse should expect a decreased sodium level. Spironolactone is a potassium-sparing diuretic that inhibits the action of aldosterone, resulting in an increased excretion of sodium.

A nurse is caring for a client who has liver cirrhosis with ascites, bleeding esophageal varices, and portal hypertension. The nurse recognizes which of the following laboratory findings as indicating the client's gastrointestinal (GI) tract is digesting and absorbing blood? Elevated blood urea nitrogen (BUN) Elevated HbA1c Decreased chloride Decreased bilirubin

Elevated blood urea nitrogen (BUN) As the body digests blood, BUN rises. An elevated BUN is an indication of GI bleeding.

A nurse is planning care for a client who has hepatitis B. Which of the following interventions should the nurse include in the plan? Administer antibiotics. Provide a diet high in fat. Restrict fluids. Encourage short periods of ambulation.

Encourage short periods of ambulation. The nurse should encourage a client who has hepatitis B to alternate between activity and rest.

A nurse is caring for a client who has cirrhosis and has a prescription for bumetanide. When delivering the client's lunch tray, which of the following items should the nurse identify as contraindicated for the client? Baked potato Stewed tomatoes Ham sandwich Milkshake

Ham sandwich Ham is high in sodium and can increase fluid retention, leading to edema. Clients who have cirrhosis are prone to edema as the osmotic pressures change due to a decrease in plasma albumin and are placed on low-sodium diets.

A nurse is caring for a client who has esophageal varices and is hypotensive after vomiting 500 mL of blood. Which of the following actions is the nurse's priority? Elevate the client's feet. Increase the client's IV fluid rate. Initiate a dopamine IV infusion for the client. Administer a unit of packed RBCs.

Increase the client's IV fluid rate. When using the urgent vs. nonurgent approach to client care, the nurse should determine that the priority action is to increase the client's IV fluid rate. Providing fluid to the client will restore circulating volume and increase blood pressure.

A nurse is caring for a client who has bleeding esophageal varices and is being treated with a Sengstaken-Blakemore tube. Which of the following actions should the nurse perform? Deflate the balloons for 5 min every 2 hr to prevent tissue necrosis. Maintain constant observation while the balloons are inflated. Suction the tube every 2 hr and as needed to maintain patency. Keep the head of the bed flat at all times to prevent the development of shock.

Maintain constant observation while the balloons are inflated. A Sengstaken-Blakemore tube is used to stop or slow bleeding from the esophagus and stomach. When the balloons are inflated, they put pressure on the areas that are hemorrhaging to tamponade the bleeding. While the balloons are inflated, the client must be observed constantly because displacement can cause airway obstruction.

A nurse is teaching a client about causes of biliary cirrhosis. Which of the following information should the nurse include in the teaching? Excessive alcohol consumption Hepatitis C Hepatotoxic medications Obstruction of the bile duct

Obstruction of the bile duct Prolonged obstruction of the common bile duct is the most common cause of biliary cirrhosis.

A nurse is assessing a client who has advanced cirrhosis. Which of the following manifestations should the nurse expect? Petechiae Hypertension Osteoarthritis Peripheral ulcers

Petechiae A manifestation of advanced cirrhosis is petechiae due to impaired coagulation from a dysfunctional liver.

A nurse is teaching a client who has hepatitis A about preventing transmission of the virus. Which of the following strategies should the nurse include in the teaching? Avoid eating at fast food restaurants. Avoid serving raw foods. Practice effective hand hygiene. Wear barrier protection during vaginal intercourse

Practice effective hand hygiene. Effective hand hygiene—along with immunization, sewer sanitation, and a safe water supply—are the most effective strategies for preventing the transmission of hepatitis A.

A nurse is planning care for a client who has viral hepatitis. Which of the following actions should the nurse include in the plan of care? Provide a high carbohydrate diet. Administer acetaminophen for pain. Encourage eating three large meals daily. Include high protein snacks.

Provide a high carbohydrate diet.A client with hepatitis should have a diet high in carbohydrates due to altered nutrient metabolism.

A nurse is caring for a client who was admitted with bleeding esophageal varices and has an esophagogastric balloon tamponade with a Sengstaken-Blakemore tube to control the bleeding. Which of the following actions should the nurse take? Ambulate the client four times per day. Encourage the client to consume clear liquids. Provide frequent oral and nares care. Keep the client in a supine position.

Provide frequent oral and nares care. A client who has a Sengstaken-Blakemore tube in place is unable to swallow. If the client is alert, the nurse should encourage the client to spit saliva into a tissue or basin. If the client is not alert, gentle suctioning of the oral cavity and nares might be required to remove secretions.

A nurse is planning care for a client who has end-stage cirrhosis of the liver with encephalopathy. Which of the following interventions should the nurse plan to implement to decrease the client's ammonia level? Administer diuretics. Restrict the client's intake of fluids. Reduce the client's intake of protein. Administer vitamin K.

Reduce the client's intake of protein. Ammonia is formed in the gastrointestinal tract by the action of bacteria on protein. Limiting dietary protein intake can assist with decreasing the client's ammonia level. Protein is necessary for healing, so strict limitation of dietary protein is not recommended.

A nurse is teaching self-management to a client who has hepatitis B. Which of the following Instructions should the nurse include in the teaching? You may donate blood 6 months after completing the medication regimen. Consume a high-protein diet. Rest frequently throughout the day. Take acetaminophen every 4 hr, as needed, for discomfort

Rest frequently throughout the day. Limiting activity is usually recommended until the symptoms of hepatitis have subsided. The nurse should recommend the client rest frequently throughout the day to reduce the metabolic demands upon the liver and decrease energy demands.

A nurse is assessing a client who has cirrhosis. Which of the following is an expected finding for this client? Moist skin Spider angiomas Tarry stools Blood in the urine

Spider angiomas Spider angiomas are lesions with a red center and numerous extensions that spread out like a spider web. This is an expected finding for a client who has cirrhosis.

A nurse is admitting a client who has hepatitis C. Which of the following precautions should the nurse implement? Droplet Contact Airborne Standard

Standard Hepatitis C is a blood-borne pathogen that is commonly spread by needle stick injury, sharing of IV drug paraphernalia and sexual contact. The nurse should implement standard precautions when in contact with blood, body fluids (except sweat), broken skin, and mucous membranes. The nurse should wear additional personal protective equipment if there is possible blood contact or a risk for splashes or sprays of blood or body fluids.

A nurse is planning care for a client who is postoperative following a liver transplant. and weighs 65 kg. Which of the following actions should the nurse plan to take? Keep the client NPO for the first week postoperative. Limit caloric content once the client resumes eating. Stress the importance of safe food-handling practices. Decrease foods high in carbohydrates once the client resumes eating.

Stress the importance of safe food-handling practices. The nurse should stress the importance of safe food-handling practices to avoid foodborne illness due to the immunosuppressant medications the client is taking.

A nurse is caring for a client who has cirrhosis and a prothrombin time of 30 seconds. Which of the following medications should the nurse plan to administer? Vitamin K Heparin Warfarin Ferrous sulfate

Vitamin K A prothrombin time of 30 seconds indicates the clotting time is prolonged and bleeding could occur. Vitamin K injection increases the synthesis of prothrombin by the liver; therefore, the nurse should plan to administer vitamin k.

A nurse is caring for a client who has cirrhosis and a new prescription for lactulose. Which of the following manifestations indicates an adverse effect of the medication? Dry mouth Vomiting Headache Peripheral edema

Vomiting The nurse will monitor for vomiting as an adverse effect of lactulose.

a nurse is caring for a client who has diabetes insipid and is receiving vasopressin. The nurse should identify which of the following findings as an indication that the medication is effective

a decreased in urine specific gravity

a nurse is reviewing guidelines to prevent DKA during periods of illness with a client who has T1DM. Which of the following instructions should the nurse include in the teaching

check your urine for ketones when blood glucose levels are greater than 240

a nurse is assessing a client who has diabetes insipid. which of the following findings should the nurse expect dehydration polyphagia hyperglycemias bradycardia

dehydration

a nurse is administering an IM injection to a client who has hepatitis C. Before placing the syringe and needle in a puncture resistant container, which of the following actions should the nurse take

dispose of the needle uncapped