B3

Which of the following statements would reflect that the patient does not understand the long term effects of liver failure?

"If I stop drinking, my liver will get better."

Nursing priorities for the management of acute pancreatitis include: (Select all that apply.)

1: Managing respiratory dysfunction 2: Assessing and maintaining electrolyte balance 3: Utilizing supportive therapies aimed at decreasing gastrin release

A client is brought to the emergency department with partial-thickness and full-thickness burns on the left arm, left anterior leg, and anterior trunk. Using the Rule of Nines, what is the total body surface area that has been burned?

36%

The nurse is caring for a patient receiving intravenous ibuprofen for pain management. The nurse recognizes which laboratory assessment to be a possible side effect of the ibuprofen?

Creatinine: 3.1 mg/dL

An emergency department nurse assesses a patient admitted after a lightning strike. Which assessment would the nurse complete first?

Electrocardiogram (ECG)

Noninvasive diagnostic procedures used to determine kidney function include which of the following? (Select all that apply.)

Kidney, ureter, bladder (KUB) x-ray Renal ultrasound Magnetic resonance imaging (MRI)

When explaining the rationale for the use of lactulose syrup for the patient with chronic cirrhosis, the nurse would choose which of the following statements?

Lactulose suppresses the metabolism of ammonia and aids in its elimination through feces.

The primary mode of action for neuromuscular blocking agents used in the management of some ventilated patients is

Paralysis

The patient is receiving neuromuscular blockade. Which nursing assessment indicates a target level of paralysis?

Train-of-four yields two twitches

The patient is being admitted to the hospital. At home, the patient takes an over-the-counter supplement of vitamin D and is concerned because the doctor did not order that vitamin D to be given in the hospital. The nurse explains that

Vitamin D is stored in the liver with a 10 month supply to prevent deficiency

The nurse is caring for a critically ill patient with respiratory failure who is being treated with mechanical ventilation. As part of the patient's care to prevent stress ulcers, the nurse would provide: (Select all that apply.)

anticholinergic drugs. antacids. proton pump inhibitors.

The patient is admitted with the diagnosis of GI bleeding. The patient's heart rate is 140 beats per minute, and the blood pressure is 84/44 mm Hg. These values may indicate:

approximately 25% loss of total blood volume.

The patient is on intake and output (I&O), as well as daily weights. The nurse notes that output is considerably less than intake over the last shift, and daily weight is 1 kg more than yesterday. The nurse should

assess the patient's lungs.

The nurse is assessing a patient admitted with pancreatitis. In doing so, the nurse

assesses symptoms that could indicate involvement of the stomach.

Complications common to patients receiving hemodialysis for acute kidney injury include which of the following? (Select all that apply.)

hypotension and dysrhythmias

In patients with extensive burns, edema occurs in both burned and unburned areas because of

increased capillary permeability

A patient with a 60% burn in the acute phase of treatment develops a tense abdomen, decreasing urine output, hypercapnia, and hypoxemia. Based on this assessment, the nurse anticipates interventions to evaluate and treat the patient for:

intraabdominal hypertension

The patient is admitted with complaints of general malaise and fatigue, along with a decreased urinary output. The patient's urinalysis shows coarse, muddy brown granular casts and hematuria. The nurse determines that the patient has:

intrarenal disease, probably acute tubular necrosis.

An autograft is used to optimally treat a partial- or full-thickness wound that (Select all that apply.)

involves a joint. requires more than 2 weeks for healing. involves the face, hands, or feet.

Silver is used as an ingredient in many burn dressings because it

is effective against a wide spectrum of wound pathogens.

The nurse working in the ED is evaluating a client for signs and symptoms of appendicitis. Which of the client's signs/symptoms should the nurse report to the physician?

nausea

Acute kidney injury from postrenal etiology is caused by

obstruction of the flow of urine

The nurse is caring for a patient with an electrical injury. The nurse understands that patients with electrical injury are at a high risk for acute kidney injury secondary to

release of myoglobin from injured tissues.

Continuous renal replacement therapy (CRRT) differs from conventional intermittent hemodialysis in that

the process removes solutes and water slowly.

The nurse is managing the pain of a patient with burns. The provider has prescribed opiates to be given intramuscularly. The nurse contacts the provider to change the prescription to intravenous administration because

tissue edema may interfere with drug absorption of injectable routes.

After gastric bypass surgery, the patient is getting vitamin B12 injections. The patient asks about the purpose of this vitamin. The nurse explains that

vitamin B12 is needed for the formation of red blood cells.

Which of the following patients is at the greatest risk of developing acute kidney injury? A patient who

was discharged 2 weeks earlier after aminoglycoside therapy of 2 weeks

The patient's potassium level is 7.0 mEq/L. Besides dialysis, which of the following actually reduces plasma potassium levels and total body potassium content safely in a patient with renal dysfunction?

Sodium polystyrene sulfonate

The nurse instructs the client taking dexamethasone (Decadron) to take it with food or milk because this medication?

Stimulates hydrochloric acid production

The nurse is planning care to meet the patient's pain management needs related to burn treatment. The patient is alert, oriented, and follows commands. The pain is worse during the day, when various treatments are scheduled. Which statement to the provider best indicates the nurse's knowledge of pain management for this patient?

"The patient's pain varies depending on the treatment given. Can we try patient-controlled analgesia to see if that helps the patient better?"

A client presents to the emergency department following a burn injury. The client has burns to the abdomen and front of the left leg. Using the rule of nines, the nurse documents the total body surface area percentage as

18%

A client has burns to his anterior trunk and left arm. Using the Rule of the Nines, what is the TBSA burned?

27%

What is a minimally acceptable urine output for a patient weighing 75 kg?

37 mL/hour

The patient's serum creatinine level is 0.7 mg/dL. The expected BUN level should be

7-14 mg/Dl

The most common reasons for initiating dialysis in acute kidney injury include which of the following? (Select all that apply.)

Acidosis Volume overload Hyperkalemia Uremia

A postsurgical patient is on a ventilator in the critical care unit. The patient has been tolerating the ventilator well and has not required any sedation. On assessment, the nurse notes the patient is tachycardic and hypertensive with an increased respiratory rate of 28 breaths/min. The patient has been suctioned recently via the endotracheal tube, and the airway is clear. The patient responds appropriately to the nurse's commands. The nurse should:

Asses the patients level of pain

A client receiving peritoneal dialysis (PD) has outflow that is 100 mL less than the inflow for two consecutive exchanges. Which of the following actions would be best for the nurse to take first?

Change clients position

A client seen in the Emergency Department reports painful urination, frequency, and urgency. Which of the following conditions would the nurse suspect?

Cystitis

The 72-year-old client is admitted to the medical unit diagnosed with an acute exacerbation of diverticulosis. The health-care provider has prescribed the intravenous antibiotic ceftriaxone (Rocephin). Which intervention should the nurse implement first?

Determine if the client has any known allergies.

The nurse is collecting a 24-hour urine sampling for creatinine clearance on a client hospitalized with acute glomerulonephritis. While making rounds, the nurse learns that the client discarded the 2 a.m. voiding. The nurse should?

Discard the collected urine, obtain a new bottle, and begin the collection again

The patient is admitted with end-stage liver disease. The nurse evaluates the patient for which of the following? (Select all that apply.)

Disseminated intravascular coagulation Ascites Malnutrition

Which laboratory data should the nurse monitor for the client with inflammatory bowel disease who is prescribed sulfasalazine (Azulfidine), a sulfonamide antibiotic?

The client's serum creatinine level.

The nurse is caring for an elderly patient who was admitted with renal insufficiency. An expected laboratory finding for this patient may be

a normal serum creatinine level.

The critical care nurse is responsible for monitoring the patient receiving continuous renal replacement therapy (CRRT). In doing so, the nurse should

a. assess that the blood tubing is warm to the touch.

The liver detoxifies the blood by

a. converting fat-soluble compounds to water-soluble compounds.

The patient is diagnosed with acute kidney injury and has been getting dialysis 3 days per week. The patient complains of general malaise and is tachypneic. An arterial blood gas shows that the patient's pH is 7.19, with a PCO2 of 30 mm Hg and a bicarbonate level of 13 mEq/L. The nurse prepares to

administer intravenous sodium bicarbonate.

A client has a 10-year history of Crohn's disease and is seeing the physician due to increased diarrhea and fatigue. What is the recommended dietary approach to treat Crohn's disease?

dietary approach varies.

Infection by Helicobacter pylori bacteria is a major cause of

duodenal ulcers

The patient undergoes a cardiac catheterization that requires the use of contrast dyes during the procedure. To detect signs of contrast-induced kidney injury, the nurse should

evaluate the patient's serum creatinine for up to 72 hours after the procedure.

The patient is admitted with acute pancreatitis and is demonstrating severe abdominal pain, vomiting, and ascites. Using the Ranson classification criteria, the nurse determines that this patient

has a 15% chance of dying.