Exam 4

The nurse instructs a 50-yr-old woman about cholestyramine to reduce pruritus caused by gallbladder disease. Which patient statement indicates understanding of the instructions? "This medication will help me digest fats and fat-soluble vitamins." "I will apply the medicated lotion sparingly to the areas where I itch." "The medication is a powder and needs to be mixed with milk or juice." "I should take this medication on an empty stomach at the same time each day."

"The medication is a powder and needs to be mixed with milk or juice."

AST

10-30

ALT

10-40

Amylase

30-122

Lipase

31-186

ALP normal range

38-126

4. The nurse is caring for a group of patients. Which patient has the highest risk for developing pancreatic cancer? A 38-yr-old Hispanic woman who is obese and has hyperinsulinemia A 72-yr-old African American man who has smoked cigarettes for 50 years A 23-yr-old man who has cystic fibrosis-related pancreatic enzyme insufficiency A 19-yr-old patient who has a 5-year history of uncontrolled type 1 diabetes mellitus

A 72-yr-old African American man who has smoked cigarettes for 50 years

A nurse is preparing a community education program about hepatitis B. Which of the following statements should the nurse include in the teaching?

A hepatitis B immunization is given to infants and children

A nurse is assessing a client who is in the early stages of hepatitis A. Which of the following manifestations should the nurse expect?

Anorexia- early manifestation of Hep A + often severe. Jaundice, dark urine, and pale feces is a late manifestation of Hep A.

A patient with cholelithiasis is being prepared for surgery. Which patient assessment represents a contraindication for a cholecystectomy? Low-grade fever of 100°F and dehydration Incorrect Abscess in the right upper quadrant of the abdomen Multiple obstructions in the cystic and common bile duct Activated partial thromboplastin time (aPTT) of 54 seconds

Activated partial thromboplastin time (aPTT) of 54 seconds

A nurse is completing a history and physical assessment for a client who has chronic pancreatitis. Which of the following findings should the nurse identify as a likely cause of the client's condition?

Alcohol use-major cause of chronic pancreatitis high-calorie diet, tobacco, prior GI illness is not a major cause of pancreatitis

A nurse is caring for a client who has acute pancreatitis. Which of the following serum laboratory values should the nurse anticipate returning to the expected reference range within 72 hours after treatment begins?

Amylase Lipase: stays elevated for up to 14 days

A Nurse is caring for a client who is 2 days postoperative following a gastric bypass. The nurse notes that bowel sounds are present. Which of the following foods should the nurse provide at the initial feeding?

Clear Liquids

ALT

Elevated in various types of tissue damage

A nurse is providing dietary teaching to a client who has diverticulitis about preventing acute attacks. Which of the following foods should the nurse recommend?

Foods high in fiber Diverticulitis is associated with low-fiber diets

A nurse is caring for a client who has a history of cirrhosis and is admitted with manifestations hepatic encephalopath. The nurse should anticipate a perscription for which of the following laboratory tests to determine the possibility of recent excessive alcohol use>

Gamma-glutamyl transferase GGT

IG vs vaccine

Given to people exposed to hepatitis A Vaccine is only used for preexposure prophylaxis

The nurse is caring for a 55-yr-old man patient with acute pancreatitis resulting from gallstones. Which clinical manifestation would the nurse expect? Hematochezia Left upper abdominal pain Ascites and peripheral edema Temperature over 102o F (38.9o C)

Left Upper abdominal pain

A nurse is caring for a client who is 4 hr postoperative following a laparoscopic cholecystectomy. Which of the following findings should the nurse expect?

Right should pain-due to the gas that was injected in the abdominal cavity

A nurse is caring for a client who is dehydrated and is receiving continuous tube feeding through a pump at 75 ml/Hr. When the nurse assesses the client at 0800, which of the following findings requires interventions by the nurse>

The head of the bed is elevated 20 degrees. The head of the bed should be in a semi-Fowler's position

A nurse is assessing a client who is experiencing perforation of a peptic ulcer. Which of the following manifestations should the nurse expect?

boardlike abdomen

A community health nurse is planning an educational program about hepatitis A. When preparing the materials, the nurse should identify that which of the following groups is most at risk for developing hepatitis A?

children

Risk factors for pancreatic cancer

chronic pancreatitis, diabetes, age, cigareete smoking, fam hx of pancreatic pancer, high fat diet. SMOKING SMOKING SMOKING

The patient with RUQ abdominal pain is revealed to have cholelithiasis. What is the nurse's priority? Prevent all oral intake. Control abdominal pain. Provide enteral feedings. Avoid dietary cholesterol.

control abdominal pain

Serum Bilirubin

detects the function of the liver and its ability to excrete bilirubin. Elevated levels determine liver disease or biliary tract disease

A nurse is caring for a client who is receiving total parental nutrition( TPN) therapy and has just returned to the room following physical therapy. The nurse notes that the infusion pump for the client's TPN is turned off. After restarting the infusion pump, the nurse should monitor the client for which of the following findings?

diaphoresis

ALP

elevated in biliary obstruction and most forms of liver dysfunction.

A nurse is caring for a client who has fulminant hepatic failure. Which of the following procedures should the nurse anticipate for this client?

liver transplant

Prothrombin time

monitor for prolonged length

A nurse is caring for a client who has a PEG tube and is receiving intermittent feedings. Prior to initiating the feeding, which of the following actions should the nurse take first?

place the client in a semi-fowler position

A nurse is caring for a client who is scheduled to undergo a liver biopsy for a suspected malignancy. Which of the following laboratory findings should the nurse monitor prior to the procedure

prothrombin time

A nurse is assessing a client who was admitted with a bowel obstruction. The client reports severe abdominal pain. Which of the following findings should indicate to the nurse that a possible bowel perforation has occurred?

rigid abdomen someone with perforation would have hypotension, absent bowel sounds

a nursing is teaching a client who has barrett's espohagus and is scheduled to undergo an EGD. WHich of the following statements should the nurse include in the teaching?

the procedure can determine how well the lower part of your esophagus works

A nurse is caring for a client who is scheduled to undergo an EGD. The nurse should identify that this procedure is used to do which of the following?

to detect an ulceration in the stomach

A nurse in the emergency department is caring for a client who has bleeding esophageal varices. The nurse should anticipate a prescription for which of the following medications?

vasopressin

A nurse is caring for a client who has celiac disease. Which of the following foods should the nurse remove from the meal tray?

wheat toast