Module 9B - Edge Questions
A nurse educator is outlining the progression of a hepatitis B infection. Please place the following steps in the correct order. No signs or symptoms, although virus can be passed to others Reduction in hepatitis B virus (HBV) viral load to immune response No viral levels detected, high level of HBV antibodies Inflammatory reaction of the hepatocytes Inoculation with HBV
1. Inoculation with HBV 2. No signs or symptoms, although virus can be passed to others 3. Inflammatory reaction of the hepatocytes 4. Reduction in hepatitis B virus (HBV) viral load to immune response 5. No viral levels detected, high level of HBV antibodies
A patient arrives at the emergency department complaining of abdominal pain. Please place the following steps in order for this assessment. Inspection Percussion Vital signs Palpitation Auscultation
1. Vital signs 2. Inspection 3. Auscultation 4. Percussion 5. Palpitation
A female client who has just been diagnosed with hepatitis A asks, "How could I have gotten this disease?" What is the nurse's best response? •A. "You may have eaten contaminated restaurant food." •B. "You could have gotten it by using I.V. drugs." •C. "You must have received an infected blood transfusion." •D. "You probably got it by engaging in unprotected sex."
A
A male client with extreme weakness, pallor, weak peripheral pulses, and disorientation is admitted to the emergency department. His wife reports that he has been "spitting up blood." A Mallory-Weiss tear is suspected, and the nurse begins taking a client history from the client's wife. The question by the nurse that demonstrates her understanding of Mallory-Weiss tearing is: •A. "Tell me about your husband's alcohol usage." •B. "Is your husband being treated for tuberculosis?" •C. "Has your husband recently fallen or injured his chest?" •D. "Describe spices and condiments your husband uses on food."
A
A clinician is examining colonoscopy results. Which of the following findings points to Crohn's disease rather than to ulcerative colitis? The disease process is ascending from the rectum. Pseudopolyps can be seen in several locations. A cobblestone appearance is apparent. Only the inner lining of the intestine is damaged.
A cobblestone appearance is apparent.
A nurse is helping a patient diagnosed with a hiatal hernia. He does not understand what this means. Which of the following is the correct explanation for the nurse to provide? A portion of your stomach has prolapsed into your small intestine. A portion of your intestine has protruded through the abdominal wall. A portion of your gallbladder duct has become twisted. A portion of your stomach is pushing up through the opening of your diaphragm.
A portion of your stomach is pushing up through the opening of your diaphragm.
A patient is in the fetal position, complaining of right lower quadrant (RLQ) pain. Which of the following would be the most likely cause? Peptic ulcer disease Cholecystitis Appendicitis Crohn's disease
Appendicitis
A patient is worried about his risk for hepatitis C and is requesting to receive the vaccine. Which of the following is the correct response by the nurse? At this time, there is no vaccine for hepatitis C. Hepatitis B and C vaccines are normally given together. Do you want both? The hepatitis C vaccine requires three doses. The hepatitis C vaccine is given a single immunization.
At this time, there is no vaccine for hepatitis C.
To prevent gastroesophageal reflux in a male client with hiatal hernia, the nurse should provide which discharge instruction? •A. "Lie down after meals to promote digestion." •B. "Avoid coffee and alcoholic beverages." •C. "Take antacids with meals." •D. "Limit fluid intake with meals."
B
What laboratory finding is the primary diagnostic indicator for pancreatitis? •A. Elevated blood urea nitrogen (BUN) •B. Elevated serum lipase •C. Elevated aspartate aminotransferase (AST) •D. Increased lactate dehydrogenase (LD)
B
When evaluating a male client for complications of acute pancreatitis, the nurse would observe for: •A. increased intracranial pressure •B. decreased urine output •C. bradycardia •D. hypertension
B
A patient has been diagnosed with hepatitis B and wants to understand how he contracted the infection. Which of the following does the nurse share as a means of transmission of hepatitis B? Select all that apply. Blood-borne transmission Skin-to-skin contact Sexual activity Fecal-oral route Needle sharing with infected person
Blood-borne transmission Sexual activity Needle sharing with infected person
A patient with a diverticulitis flareup is relating her recent food choices to the nurse. Which of the following indicates further instruction for the patient is needed? Breakfast of bran cereal, whole wheat toast, and strawberries Lunch of boiled noodles with butter and a snack of applesauce Dinner of broiled salmon and instant mashed potatoes Snack of hard-boiled egg
Breakfast of bran cereal, whole wheat toast, and strawberries
The nurse is caring for a male client with cirrhosis. Which assessment findings indicate that the client has deficient vitamin K absorption caused by this hepatic disease? •A. Dyspnea and fatigue •B. Ascites and orthopnea •C. Purpura and petechiae •D. Gynecomastia and testicular atrophy
C
A patient with liver cirrhosis has severe portal hypertension. Which of the following does the nurse expect to observe? Select all that apply. Grey Turner's sign Caput medusa Retroperitoneal pain Esophageal varices Splenomegaly
Caput medusa Esophageal varices Splenomegaly
As pancreatic cancer may be diagnosed late in the disease course due to lack of early signs and symptoms. The nurse is researching cancer markers that can be monitored for pancreatic cancer. Which of the following should he considered? Alpha-fetoprotein (AFP) Cancer antigen (CA)-125 Carcinoembryonic antigen (CEA) Prostate-specific antigen (PSA)
Carcinoembryonic antigen (CEA)
A nursing student sees on a patient's chart the word "sprue." She wonders what that condition may also be called. Her colleague answers with which of the following terms? Form of dysphagia Esophageal varices Dumping syndrome Celiac disease
Celiac disease
A patient is suffering from liver failure. Which of the following does the nurse expect to see elevated? Select all that apply. Clotting times Plasma albumin Aspartate aminotransferase (AST) levels Risk for jaundice Total plasma bilirubin
Clotting times Aspartate aminotransferase (AST) levels Risk for jaundice Total plasma bilirubin
In order to diagnose Crohn's disease, which option does the clinician consider most useful? Patient self-report Fecal occult blood test Gastric biopsy Colonoscopy
Colonoscopy
A clinician is worried about renal failure in a patient suffering from acute pancreatitis. What should be addressed to prevent this development? Correct fluid imbalance to maintain renal perfusion Surgical reduction of pancreatic size Provide diuretics Begin hemodialysis
Correct fluid imbalance to maintain renal perfusion
Nurse Hannah is teaching a group of middle-aged men about peptic ulcers. When discussing risk factors for peptic ulcers, the nurse should mention: •A. A sedentary lifestyle and smoking. •B. A history of hemorrhoids and smoking •C. Alcohol abuse and a history of acute renal failure •D. Alcohol abuse and smoking
D
A patient is vomiting blood. Which of the following values would support the nurse's concerns about an upper gastrointestinal (GI) bleed (UGIB)? Hypertension Lower-than-normal heart rate Decreased hematocrit Elevated white blood cell (WBC) count
Decreased hematocrit
A patient is suffering from cholecystitis. Which of the following food choices by the patient may the nurse need to discuss further given his condition? Dessert of pie and ice cream Lunch of spaghetti with an apple for dessert Dinner of steamed rice and salmon Snacking on gummy candies
Dessert of pie and ice cream
In the emergency department, a patient arrives complaining of dizziness, sweating, and diarrhea after he eats. He is wondering if he has food poisoning. The nurse sees on his chart that he has had bariatric surgery. What does the nurse suspect? Gastroenteritis Dumping syndrome Volvulus Esophageal reflux
Dumping syndrome
Hepatic encephalopathy may begin to develop in a patient with which of the following? Hypernatremia Elevated serum ammonia levels Hypokalemia Deficient fat-soluble vitamins
Elevated serum ammonia levels
A patient with Crohn's disease is very worried about the possibility of intestinal surgery if the condition worsens. Which of the following is correct for the clinician to say to the patient? Everyone's disease progresses differently. Not everyone with Crohn's disease requires surgery. About 95% of patients with Crohn's disease will require intestinal surgery. Even if you have surgery, the good news is that you will only need intestinal surgery once. Surgery is not a management strategy ever used in Crohn's disease.
Everyone's disease progresses differently. Not everyone with Crohn's disease requires surgery.
A nurse is monitoring a patient with irritable bowel syndrome for "alarm" symptoms. Which of the following are such symptoms? Select all that apply. Fever Family history of colon cancer Weight loss Iron deficiency anemia Rectal bleeding
Family history of colon cancer Weight loss Iron deficiency anemia Rectal bleeding
A patient has been diagnosed with hepatitis A and wants to know how he may have contracted this disease. What is the primary route of hepatitis A transmission? Blood transfusion Needle stick Sexual activity Fecal-oral
Fecal-oral
A patient presents with right upper quadrant pain. The patient has several risk factors for gallstones. Which of the following are considered risks by the nurse? Select all that apply. Female sex Oral contraceptive usage Low body mass index (BMI) Age greater than 40 years Low-calorie, low-fat diet
Female sex Oral contraceptive usage Age greater than 40 years
A patient is suffering a severe attack of ulcerative colitis. Which may be of greatest concern? Necrosis of colon tissue due to ischemia Erosion of the esophageal lining due to vomiting Bowel obstruction due to sphincter contraction Fluid and electrolyte loss due to severe diarrhea
Fluid and electrolyte loss due to severe diarrhea
A nurse is working with a child who has been diagnosed with celiac disease. The child will be attending a birthday party. What is an appropriate food choice for the child? Hamburger patty without the bun Ham sandwich on sourdough bread Pasta salad Cake and/or cookies as long as frosting is removed
Hamburger patty without the bun
A patient presents at the clinic with bright-red blood appearing in his stools. Which of the following may the nurse report? Upper gastrointestinal bleeding (UGIB) Esophageal varices Menorrhagia Hematochezia
Hematochezia
Which of the following laboratory values may indicate to a nurse the presence of a bleeding ulcer in a patient with a history of ulcers? Absence of melena Normal serum ferritin Hemoglobin of 15 g/dL Hematocrit of 30%
Hematocrit of 30%
An infection of hepatitis D virus requires which of the following for replication and expression? Hepatitis A virus Hepatitis B virus Hepatitis C virus Hepatitis E virus
Hepatitis B virus
A nurse is reviewing cases of liver cirrhosis. Which of the following risk factors concern her the most, as it is the leading cause of liver cirrhosis in the United States? Alcohol abuse Illegal drug use Hepatitis B infection Hepatitis C infection
Hepatitis C infection
A nursing educator notes that she hears borborygmi upon assessing a patient. What should he student nurse expect to observe? Decreased gastric motility High-pitched bowel sounds Absence of bowel sounds Dull percussive sounds in right upper quadrant
High-pitched bowel sounds
A patient with advanced liver failure has presented with edema. Which of the following likely played a role in this development? Excess clotting factors Decreased capillary permeability Hypoalbuminemia Hypovolemic hypernatremia
Hypoalbuminemia
A patient suffering from gastroesophageal reflux disease (GERD) is reviewing some of the instructions she has received to help manage her condition. Which of the following statements show correct understanding by the patient? I should wait for two to three hours after eating before I lie down. Larger, more filling meals will help my digestion. Smoking does not make my condition worse. Eating small, frequent meals makes my GERD worse.
I should wait for two to three hours after eating before I lie down.
A patient is suffering an attack of diverticulitis. Which of the following should the nurse be prepared for? Encouraging the patient to increase dietary fiber intake Inserting a nasogastric tube Providing any foods the patient requests Providing larger-than-normal meals to help with colon motility
Inserting a nasogastric tube
A patient presents with right lower quadrant pain that is worsening, along with a fever. Which of the following assessments may the clinician perform? Psoas sign Romberg test Brudzinski sign Homan sign
Psoas sign
A patient has elevated aspartate aminotransferase (AST), alanine transaminase (ALT), and total bilirubin levels. Which of the following does the nurse expect to observe? Red discoloration of the skin Elevated heart rate and blood pressure Jaundice Decreased urine output
Jaundice
A patient presents in the emergency department complaining of right upper quadrant pain radiating to the shoulder. The clinician wants to assess for Murphy's sign. What should the patient be directed to do? Lay on the left side and pull the right knee to chest. Lay supine and take a deep inspiration. Lay supine with arms overhead and knees pulled towards the chest. Lay prone and arch the back upwards.
Lay supine and take a deep inspiration.
A nurse suspects that a patient is suffering from diverticulitis. Which of the following are typical signs of diverticulitis? Select all that apply. Left lower quadrant pain Pain radiating to the shoulder Fever Right upper quadrant (RUQ) pain Nausea
Left lower quadrant pain Fever Nausea
A client is considering bariatric surgery. Which of the following statements by the client should the nurse correct? Bariatric surgery is primarily for those with morbid obesity. Only one type of bariatric surgery option exists. Patients who undergo bariatric surgery experience significant weight loss. Bariatric surgery may help with other issues, such as improving glucose control.
Only one type of bariatric surgery option exists.
Which of the following patients will a nurse most likely suspect to be most at risk for gallstone formation? A child under the age of 5 years Overweight female, age of 48 years Female. age 25 Elderly male, age of 70 years
Overweight female, age of 48 years
On serum blood laboratory results, a nurse notes elevated serum amylase. Which organ is likely damaged? Gallbladder Stomach Pancreas Appendix
Pancreas
A patient is listing complaints such as a "burning sensation" in the abdominal area. He states that the pain is worse when he has not eaten for some time. The pain is somewhat alleviated with eating. Which of the following does the nurse most likely suspect? Gastroesophageal reflux disease Peptic ulcer disease Zollinger-Ellison syndrome Hiatal hernia
Peptic ulcer disease
A clinician needs to determine whether a patient has hepatitis C. Which result would confirm this diagnosis? Positive HBeAg Positive HBV RNA assay Positive HAV RNA assay Positive HCV RNA assay
Positive HCV RNA assay
A nursing student is directed to assess a patient's acute pancreatitis severity. What scale should the nursing student use? Acute physiology, age, chronic health evaluation (APACHE) Glasgow Coma scale Ranson criteria Duke criteria
Ranson criteria
A clinician is palpating a patient's abdomen. The clinician places firm pressure on the abdomen. When the clinician removes her hand, the patient states that he feels pain. Which of the following should be charted based on this result? Acute abdomen syndrome Abdominal guarding Rebound tenderness Abdominal rigidity
Rebound tenderness
A nurse is assessing a patient for peritonitis. Which of the following signs and symptoms are present with peritonitis? Pain radiating down leg Rebound tenderness of abdomen Abdominal pain Absence of bowel sounds Abdominal rigidity
Rebound tenderness of abdomen Abdominal pain Abdominal rigidity
A patient has been diagnosed with a gastric ulcer. He wants to discuss dietary recommendations. Which of the following may the nurse share that will be helpful? Increase your caffeine intake to aid in stomach motility. Eat plenty of high-fat foods, such as ice cream. Refrain from or severely limit alcohol intake. The dietary choices you make do not directly impact healing of this disorder. Feel free to eat as you like.
Refrain from or severely limit alcohol intake.
A nursing educator is helping a nursing student to recognize the signs and symptoms of cholelithiasis in a patient. Which of the following should the student nurse be aware of? Projectile vomiting Severe abdominal pain between meals Burning sensation in sternal area Right upper quadrant (RUQ) pain that radiates to shoulder
Right upper quadrant (RUQ) pain that radiates to shoulder
A morbidly obese patient wants to discuss the possibility of bariatric surgery. Which of the following are common bariatric surgery techniques? Select all that apply. Roux-en-Y gastric bypass Gastric banding Gastric sleeve Gastric endoscopy Biliopancreatic diversion with duodenal switch
Roux-en-Y gastric bypass Gastric banding Gastric sleeve Biliopancreatic diversion with duodenal switch
A woman is stating that she feels she has celiac disease. Which diagnostic test may be indicated? Endoscopic examination Colonoscopy Serology panel Barium swallow test
Serology panel
A patient is suspected to have a hepatitis infection. Which of the following will be most helpful for the clinician's diagnosis? Presence of jaundice Presence of hepatomegaly Serology results Elevated aspartate aminotransferase (AST) and alanine transaminase (ALT)
Serology results
A clinician is admitting a patient with suspected acute pancreatitis. Which signs and symptoms would support this suspicion? Select all that apply. Severe abdominal pain radiating to back Cullen's sign Hypertension Diminished bowel sounds Petechiae
Severe abdominal pain radiating to back Cullen's sign Diminished bowel sounds
A patient is suffering from severe hepatitis B infection. Which of the following are dietary recommendations the nurse will make? Select all that apply. Small, frequent meals High-fat meals Liquid-only diet High-calorie meals High-protein meals
Small, frequent meals High-calorie meals High-protein meals
A patient has been diagnosed with pancreatic cancer. The family has been doing some research on the disease. Which of the following is an idea expressed by the family that the clinician should correct? The exact cause of pancreatic cancer is unknown. There may be no significant signs or symptoms early in pancreatic cancer. Survival rate of pancreatic cancer is very high. Pancreatic cancer is often a silent disease.
Survival rate of pancreatic cancer is very high.
A patient arrives in emergency department complaining of severe abdominal pain and demanding immediate pain medication What is the appropriate response by the nurse? Ask the patient whether he has ever had pain medications before and whether he is allergic to any pain medications. Ask the patient which type of pain medications he prefers. Tell that patient that for proper assessment, pain medications may be withheld until a diagnosis can be made. Tell the patient to stop asking. The clinician will prescribe pain medications when he or she feels it is necessary.
Tell that patient that for proper assessment, pain medications may be withheld until a diagnosis can be made.
Upon being discharged, a patient with chronic pancreatitis is reviewing the dietary recommendations. Which of the following indicates that further instruction is needed? The best option is to eat one large meal per day, with smaller snacks when I am hungry. I should refrain from caffeine. A meal of a cheeseburger and fries is not my best option. I should choose easily digestible foods and eat frequent meals.
The best option is to eat one large meal per day, with smaller snacks when I am hungry.
A clinician is asking a patient with severe liver diseases about bruising and other signs of bleeding. Which of the following explains why the clinician is concerned? All medications for liver failure work on thinning the blood to reduce clotting. The liver synthesizes clotting factors, which may be affected by the patient's liver disease. The patient has likely developed an autoimmune response to clotting factors. Liver diseases disrupt portal circulation that may appear as bruising on the extremities.
The liver synthesizes clotting factors, which may be affected by the patient's liver disease.
On a patient's chart is listed "achalasia." Which of the following can the nurse expect? The patient has difficulty chewing food and moving it into the throat area. The patient has motility issues of the esophagus. The patient has reflux of stomach acid into the esophagus. The patient has an inability to move substances from the stomach to the duodenum.
The patient has motility issues of the esophagus.
A patient with acute pancreatitis has developed bruising around the flank area. What is the correct interpretation by the nurse? The patient is displaying Cullen's sign. The acute pancreatitis is destroying clotting factors. The pancreas has ruptured. The patient is displaying Grey Turner's sign.
The patient is displaying Grey Turner's sign.
A patient with suspected appendicitis is found lying on his side with his knees drawn up in the fetal position. What is the appropriate response by the nurse to the patient? Please lie down straight on your back. You must be doing better. If you had appendicitis, you would not be able to lie in this position. This position is likely helping you feel less pain because it lessens the tension on your abdominal wall. This position is dangerous for you to be in now because it cuts off the blood supply to vital organs.
This position is likely helping you feel less pain because it lessens the tension on your abdominal wall.
A nurse notes on a patient's chart a prescription for corticosteroids. The patient has severe Crohn's disease. What is the primary purpose of the mediation? To decrease bouts of diarrhea To actively repair the intestinal lining To aid in nutrient absorption To suppress inflammatory response in the gastrointestinal (GI) tract
To suppress inflammatory response in the gastrointestinal (GI) tract
A patient is admitted for acute pancreatitis. Which of the following are assessed as Ranson criteria initially upon admission? Select all that apply. White blood cell (WBC) count Glucose Hematocrit Calcium Aspartate aminotransferase (AST)
White blood cell (WBC) count Glucose Aspartate aminotransferase (AST)
