quiz 4

A client is admitted with the diagnosis of acute pancreatitis. Which clinical manifestations should a nurse assess in the client? Select all that apply. Jaundice Acute pain Hypertension Hypoglycemia Increased amylase

1.Jaundice 2.Acute pain 5.Increased amylase

The nurse is teaching a client about the prescribed diet after a Whipple procedure for cancer of the pancreas. Which statement should the nurse include in the dietary teaching? "Meals should be restricted in protein because of your compromised liver function." "Low-fat meals should be eaten to prevent interference with your fat digestion mechanism." "There are no dietary restrictions because the tumor has been removed." "Your diet should be low in calories to prevent taxing your diseased pancreas

"Low-fat meals should be eaten to prevent interference with your fat digestion mechanism."

The nurse is caring for a client with a 25-year history of excessive alcohol use. Which assessment finding is consistent with the client's history? Signs of liver infection A low blood ammonia level A small liver with a rough surface An elevated temperature and a generalized rash

A small liver with a rough surface

A client is diagnosed with chronic pancreatitis. Which dietary instruction is most important for the nurse to share with the client? Eat a low-fat, low-protein diet Avoid foods high in carbohydrates Avoid ingesting alcoholic beverages Eat a bland diet with no snacks in between

Avoid ingesting alcoholic beverages

A nurse is instructing a client with peptic ulcer disease (PUD) about the diet that should be followed during the acute phase. Which type of diet should the nurse stress? Bland foods Regular diet Gluten-free foods Low-carbohydrate foods

Bland foods

The nurse is creating a discharge teaching plan for a client who had a subtotal gastrectomy. The nurse should include what instructions about minimizing dumping syndrome? Select all that apply. Eat small frequent meals Select foods that are low in fiber Drink fluids with meals Lie down for one hour after eating Chew food five times before swallowing

Eat small frequent meals Lie down for one hour after eating

A nurse is assessing a client with severe liver disease. Which assessment finding will the nurse expect to observe? Icterus Urticaria Uremic frost Hemangioma

Icterus

A nurse is caring for a client who had a pancreaticoduodenectomy for cancer of the pancreas. The nurse provides education about hypoinsulinism, a long-term complication related to this type of surgery. The nurse evaluates that the teaching is understood when the client states that he will seek medical supervision if he experiences which symptom? Oliguria Weight gain Anorexia Increased thirst

Increased thirst

A nurse is caring for a client with hepatic encephalopathy and ascites. Which elements are important to include in this client's diet? Select all that apply. High fat Low sodium High vitamins Moderate protein Low carbohydrates

Low sodium High vitamins

The nurse is caring for a client scheduled to have a percutaneous liver biopsy. Which assessment findings warrant the postponement of the procedure? Select all that apply. Hemosiderosis Marked ascites Hepatic cirrhosis Hemoglobin of less than 9 g/dL (90 mmol/L) Platelet count of 150,000/mm 3(150 × 10 9/L)

Marked ascites Hemoglobin of less than 9 g/dL (90 mmol/L)

A client has circumgastric banding, a bariatric surgical procedure. The nurse provides discharge teaching about signs and symptoms of dumping syndrome and includes what physiologic response? Constipation Vomiting Fever Palpitations

Palpitations

A nurse instructs a client with viral hepatitis about the type of diet that should be ingested. Which lunch selected by the client indicates understanding about dietary principles associated with this diagnosis? Turkey salad, french fries, sherbet Cottage cheese, mixed fruit salad, milkshake Salad, sliced chicken sandwich, gelatin dessert Cheeseburger, tortilla chips, chocolate pudding

Salad, sliced chicken sandwich, gelatin dessert

A nurse is developing a discharge plan for a client hospitalized with severe cirrhosis of the liver. What should be included in this plan? The need for a high-protein diet The use of a sedative for relaxation The need to increase fluids The importance of reporting personality changes to the primary healthcare provider

The importance of reporting personality changes to the primary healthcare provider

The nurse provides teaching to a client who has received a prescription for oral pancreatic enzymes, pancrelipase. The nurse evaluates that teaching is understood when the client identifies which time for medication scheduling? On arising each morning At bedtime One hour before meals With meals

With meals

A nurse is caring for an older adult who is taking acetaminophen for the relief of chronic pain. Which substance is most important for the nurse to determine if the client is taking because it intensifies the most serious adverse effect of acetaminophen? Alcohol Caffeine Saw palmetto St. John's wort

alcohol

A client with a long history of alcohol abuse develops acute pancreatitis. What should be done to best prevent stimulation of the pancreas? Maintain the gastric pH at a level less than 3.5. Ensure that the nasogastric tube remains in the fundus of the stomach. Administer the histamine H2-receptor antagonist as prescribed Encourage the resumption of activities of daily living

Administer the histamine H2-receptor antagonist as prescribed

A nurse is caring for a client with a diagnosis of acute pancreatitis and alcoholism. The client asks, "What does my drinking have to do with my diagnosis?" What effect of alcohol should the nurse include when responding? Promotes the formation of calculi in the cystic duct Stimulates the pancreas to secrete more insulin than it can immediately produce Alters the composition of enzymes so they are capable of damaging the pancreas Increases enzyme secretion and pancreatic duct pressure that causes backflow of enzymes into the pancreas

Increases enzyme secretion and pancreatic duct pressure that causes back-flow of enzymes into the pancreas

A client with an inoperable cancer of the head of the pancreas involving the common bile duct has a T-tube inserted. During the first 48 hours after insertion of the tube, what should the nurse do? Ensure that the T-tube is connected to low intermittent suction Use normal saline to irrigate the T-tube every two hours Avoid positioning the client on the right side where the T-tube is located Maintain T-tube patency via gravity drain

Maintain T-tube patency via gravity drain

A nurse is caring for a client who is scheduled for a gastric bypass to treat morbid obesity. Which diet should the nurse teach the client to maintain because it will help minimize clinical manifestations of dumping syndrome? Low-protein, high-carb diet Fluid intake below 500mL Small, frequent feeding schedule Low-residue, bland diet

Small, frequent feeding schedule

The nurse provides teaching to a client who has received a prescription for oral pancreatic enzymes, pancrelipase. The nurse evaluates that teaching is understood when the client identifies which time for medication scheduling? At bedtime With meals One hour before meals On arising each morning

With meals

A client is admitted to the hospital for medical management of acute pancreatitis. Which nursing action is most likely to reduce the pancreatic and gastric secretions of a client with pancreatitis? Encouraging clear liquids Obtaining a prescription for morphine Assisting the client into a semi-Fowler position Administering prescribed anticholinergic medication

Administering prescribed anticholinergic medication

A client is admitted to the hospital with jaundice. After numerous diagnostic tests, the healthcare provider makes the diagnosis of cancer of the pancreas. What does the nurse conclude is the most likely cause of the client's jaundice? Necrosis of the parenchyma caused by the neoplasm Excessive serum bilirubin caused by red blood cell destruction Obstruction of the common bile duct by the pancreatic neoplasm Impaired liver function, resulting in incomplete bilirubin metabolism

Obstruction of the common bile duct by the pancreatic neoplasm

Which is the priority intervention for the dependent client with peptic ulcer disease (PUD) who is vomiting bright red blood? Apply oxygen Place the client in a side-lying position Prepare to administer packed red blood cells Assess the client's pulse and blood pressure

Place the client in a side-lying position

A client with a diagnosis of gastric cancer has a gastric resection with a vagotomy. Which clinical response should alert the nurse that the client is experiencing dumping syndrome? Constipation Clay-colored stools Reactive hypoglycemia Sensations of hunger

Reactive hypoglycemia

A primary health care provider prescribes total parenteral nutrition for a client with cancer of the pancreas. A central venous access device is inserted. What does the nurse identify as the most important reason for using this type of access? It permits free use of the hands. The chance of the infusion infiltrating is decreased. The amount of blood in a major vein helps to dilute the solution. Infection is uncommon.

The amount of blood in a major vein helps to dilute the solution.

A client with a history of pancreatitis is scheduled for surgery to excise a pseudocyst of the pancreas. The client asks, "What is a pseudocyst?" Which information should the nurse include in a response to this question? Malignant growth Pocket of undigested food particles Sac filled with pus from necrotic pancreatic tissue Walled-off space of pancreatic enzymes and exudate

Walled-off space of pancreatic enzymes and exudate

A nurse reviews the laboratory results of a client with acute pancreatitis. Which test is most significant in determining the client's response to treatment? Platelet count Amylase level Red blood cell count Erythrocyte sedimentation rate

Amylase level

After a subtotal gastrectomy a client demonstrates signs of dumping syndrome. About 90 minutes after the initial attack, the client reports feeling shaky. What does the nurse determine is the cause of the latter effect? A distention of the duodenum from an excessive amount of chyme A second more extensive rise in glucose An overproduction of insulin that occurs in response to the rise in blood glucose An overwhelmed insulin-adjusting mechanism

An overproduction of insulin that occurs in response to the rise in blood glucose

A client is admitted to the hospital with a diagnosis of acute pancreatitis. The health care provider's prescriptions include nothing by mouth and total parenteral nutrition (TPN). The nurse explains that the TPN therapy provides what benefit? Is the easiest method for administering needed nutrition Is the safest method for meeting the client's nutritional requirements Will satisfy the client's hunger without the discomfort associated with eating Will meet the client's nutritional needs without causing the discomfort precipitated by

Will meet the client's nutritional needs without causing the discomfort precipitated by

The nurse is caring for a client who is scheduled for a gastric bypass to treat morbid obesity. Which statement by the client indicates a good understanding of preventing dumping syndrome after meals? Select all that apply. I will not drink fluids when I eat meals I will eat a bland diet I will eat a low-protein, high carb diet I will avoid artificially-sweetened foods I will eat small, frequent meals instead of three large meals a day

I will not drink fluids when I eat meals I will avoid artificially-sweetened foods I will eat small, frequent meals instead of three large meals a day

A nurse is assessing a malnourished client with a history of cirrhosis. The client is experiencing nausea, ascites, and gastrointestinal bleeding. What is the primary cause of the client's ascites? A decrease in vitamins to maintain cell coenzyme functions A decrease in iron to maintain adequate hemoglobin synthesis A decrease in sodium to maintain its concentration in tissue fluid A decrease in plasma protein to maintain adequate capillary-tissue circulation

A decrease in plasma protein to maintain adequate capillary-tissue circulation

A client is admitted with a diagnosis of acute pancreatitis. The medical and nursing measures for this client are aimed toward maintaining nutrition, promoting rest, maintaining fluid and electrolytes, and decreasing anxiety. Which interventions should the nurse implement? Select all that apply. Provide a low-fat diet Administer analgesics Teach relaxation exercises Encourage walking in the hall Monitor cardiac rate and rhythm Observe for signs of hypercalcemia

Administer analgesics, teach relaxation exercises, monitor cardiac rate and rhythm

After surgery for cancer of the pancreas, the client's nutrition and fluid regimen are influenced by the remaining amount of functioning pancreatic tissue. The nurse considers both the exocrine and the endocrine functions of the pancreas and expects that, postoperatively, the client's dietary regimen will be focused on the management of what substances? Fats and carbohydrates Alcohol and caffeine Fluids and electrolytes Vitamins and minerals

Fats and carbohydrates

After a client has a total gastrectomy, the nurse plans to include in the discharge teaching the need for what treatment? Monthly injections of cyanocobalamin Regular daily use of a stool softener Weekly injections of iron dextran Daily replacement therapy of pancreatic enzymes

Monthly injections of cyanocobalamin

A client newly diagnosed with cancer of the pancreas is scheduled for surgery. The client says to the nurse, "Wouldn't I be better off with some other treatment instead of surgery?" What response by the nurse is the best? "Surgery is the recommended approach. Why don't you discuss this further with the healthcare provider?" "It's a good idea to explore other acceptable treatments for your cancer. There is information available for you." "Maybe you will be more confident with a second opinion. I think you need a referral to another healthcare provider." "With your disease your prognosis will improve if you follow the suggestion to have the recommended surgery."

"Surgery is the recommended approach. Why don't you discuss this further with the healthcare provider?"

A client with cirrhosis is scheduled for a liver biopsy. The client asks if there are any risks after the procedure. Which response by the nurse is the best? There are relatively no risks associated with this procedure." The major risk is infection at the biopsy site." The major risk is bleeding postprocedure." The major risk is liver failure postprocedure."

The major risk is bleeding postprocedure."