Biliary/Pancrea/Hepatic/Neuro EAQ Questions
Which statement by the client recovering from an acute case of viral hepatitis indicates understanding of the discharge instructions presented by the nurse? "I will avoid alcohol because my liver is scarred and the alcohol causes more damage." "I will eat four to seven small snacks/meals per day." "I will take acetaminophen for pain rather than aspirin." "I will eat foods high in carbohydrates but moderate in fats and proteins." "I will not have to use condoms during intercourse because I have beaten this."
"I will avoid alcohol because my liver is scarred and the alcohol causes more damage." "I will eat four to seven small snacks/meals per day." "I will eat foods high in carbohydrates but moderate in fats and proteins."
Which client statement indicates that the instructions to a client with a seizure disorder receiving phenytoin and phenobarbital are understood? "I will not have any seizures with these medications." "These medications must be continued to prevent falls and injury." "Stopping these medications can cause continuous seizures and I may die." "By my staying on the medicines I will prevent postseizure confusion."
"Stopping these medications can cause continuous seizures and I may die."
Which response would the nurse make to the family of a client with hepatitis A who experiences anorexia, fatigue, and jaundice when the client's spouse and adult children living at home ask whether they should receive gamma globulin? "Gamma globulin is unnecessary, as long as you follow droplet precautions until the client is asymptomatic." "Gamma globulin injections provide passive immunity for hepatitis B, not hepatitis A." "You should call your primary health care provider immediately about obtaining gamma globulin injections." "Your family member's type of hepatitis is no longer communicable, and gamma globulin is not required."
"You should call your primary health care provider immediately about obtaining gamma globulin injections."
A client is hospitalized with a diagnosis of acute pancreatitis. The plan of care is focused on the goals of maintaining nutrition, promoting rest, maintaining fluids and electrolytes, and decreasing anxiety. Which interventions would the nurse implement? Select all that apply Provide low-fat diet Administer analgesics Teach relaxation exercises Encourages walking in the hall Monitor cardiac rate and rhythm Observe for signs of hypercalcemia
Administer analgesics Teach relaxation exercises Monitor cardiac rate and rhythm
The nurse is providing discharge instructions to a client diagnosed with cirrhosis and varices. Which information would the nurse include in the teaching session? Select all that apply Adhering to a low-carb diet Avoiding aspirin and aspirin-containing products Limiting alcohol consumption to two drinks weekly Avoiding acetaminophen and products containing acetaminophen Avoiding coughing, sneezing, and straining to have a bowel movement
Avoiding aspirin and aspirin containing products Avoiding acetaminophen and products containing acetaminophen Avoiding coughing, sneezing, and straining to have a bowel movement
Which complication would the nurse assess in both clients who have Parkinson disease and clients who have myasthenia gravis? Cogwheel gait Impaired cognition Difficulty swallowing Nonintention tremors
Difficulty swallowing
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 endocrine functions of the pancreas, and expects that postoperatively, the client's dietary regimen will be focused on the management of which substances? Alcohol and caffeine Fluids and electrolytes Vitamins and minerals Fats and carbohydrates
Fluids and electrolytes
Which potential complication may occur early in the recovery period when providing care for a client with paraplegia secondary to a spinal cord injury? Impairment of bladder control Inadequacy of nutritional intake Insufficient quadriceps setting Unskillful use of aids for ambulation
Impairment of bladder control
Which nursing action would have the highest priority when the nurse is moving a client with a neck and spinal cord injury during the assessment process? Removing the cervical spine collar Monitoring for autonomic dysreflexia Implementing the logrolling technique Administering the prescribed pain medication
Implementing the logrolling technique
The nurse is caring for a client that is 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 Hgb of less than 9 g/dL (90 mmol/L) Platelet count of 150,000 mm3 (150x10^9/L)
Marked ascites Hgb of less than 9 g/dL (90 mmol/L)
Which medication will the nurse question when it is prescribed for a client with acute pancreatitis? Ranitidine Cimetidine Meperidine Promethazine
Meperidine - should be avoided bc accumulation of its metabolites can cause CNS irritability and even tonic-clonic seizures All other options are useful in acute pancreatitis
Which nursing action would be a priority for a client with a spinal cord injury who has developed sudden autonomic dysreflexia? Place in sitting position Give nifedipine as prescribed Examine for symptoms of pressure injuries Monitor blood pressure (BP) every 10-15 minutes
Monitor blood pressure every 10-15 min
Which finding would the nurse expect when completing an admission physical for a client with Parkinson Disease? Select all that apply Muscle rigidity Blank facial expression Leaning toward the affected side Intention tremors with movement Hyperextension of the affected extremity
Muscle rigidity Blank facial expression
Which finding would the nurse expect when assessing a client who is an early stage of multiple sclerosis? Select all that apply Headache Nystagmus Skin infection Scanning speech Intention tremors
Nystagmus Scanning speech Intention tremors
A client with an obstruction of the pancreatic ducts is diagnosed with acute pancreatitis. A subtotal pancreatectomy is performed. The nurse would monitor the client for which postoperative complication? Constipation Cholecystitis Paralytic ileus Respiratory distress
Paralytic ileus
The nurse is taking care of a client with cirrhosis of the liver and ascites. Which lunch is an appropriate choice for a client with this disorder? Ham sandwich with cheese, whole milk, and potato chips Penne pasta, spinach, banana, and decaffeinated iced tea Baked lasagna with sausage, salad, and milkshake Hamburger, french fries, and cola
Penne pasta, spinach, banana, and decaffeinated iced tea
For which reason would a lumbar puncture (LP) be performed on a client? Select all that apply Confirming spinal cord injuries Assessing sensory nerve problems Measuring blood flow in many areas Reading cerebrospinal fluid (CSF) pressure Injecting contrast medium for diagnostic study
Reading CSF pressure Injecting contrast medium for diagnostic study
Which action would be the highest priority for the nurse to implement for a client experiencing an eclamptic seizure? Prevent injury Assess fetal heart tones Place an oral airway Increase the magnesium sulfate infusion rate
Prevent Injury
The nurse provides education for a client with cirrhosis of the liver who has a prolonged prothrombin time and a low platelet count. A regular diet is prescribed. Which instruction would the nurse include in the teaching? Avoid foods high in phytonadione Check pulse several times a day Drink a glass of milk when taking aspirin Report signs of bleeding no matter how slight
Report signs of bleeding no matter how slight
Which mechanism of action would the nurse identify for levodopa therapy prescribed to a client diagnosed with Parkinson disease? Blocks the effects of acetylcholine Increases production of dopamine Restores dopamine levels in brain Promotes production of acetylcholine
Restores dopamine levels in brain
The nurse provides education for a client about prophylactic measures that minimize the risk of contracting hepatitis B. Which actions would be included in the teaching plan? Select all that apply Preventing constipation Screening of blood donors Avoiding shellfish in the diet Limiting hepatotoxic medication therapy Maintaining a monogamous sexual relationship
Screening of blood donors Maintaining a monogamous relationship
The nurse is caring for a client with acute pancreatitis. Which elevated laboratory rsult is most indicative of acute pancreatitis? Blood glucose Serum lipase Serum bilirubin level White blood cell count
Serum lipase
Which skin change would the nurse expect to observe when performing a physical assessment on a client with primary biliary cirrhosis? Vitiligo Hirsutism Melanoma Telangiectasia
Telangiectasia - vascular lesion associated with cirrhosis - though to be related to increased estrogen levels Hirsutism = INCORRECT - cirrhosis = loss of hair The remaining are unrelated to cirrhosis
A client is diagnosed as having hepatitis B. The nurse reviews the client's health history for situations in which exposure may have occurred. Which event does the nurse determine is most likely the source of this infection? The client received a small tattoo on the arm 3 months ago The client assisted in the emergency birth of a baby 2 weeks ago The client worked for a month in an underdeveloped area in a foreign country 4 months ago The client attended an ecological conference in a large urban center 2 months ago
The client received a small tattoo on the arm 3 months ago
A client is admitted to the hospital with a diagnosis of acute pancreatitis. The HCP's prescriptions include nothing by mouth and TPN. The nurse explains that TPN therapy provides which 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 eating
Will meet the client's nutritional needs without causing the discomfort precipitated by eating
Which characteristics are consistent with Turner syndrome? Select all that apply Webbed neck Impaired language Tall stature with long legs Low position of posterior hairline Shield-shaped chest with wide space between the nipples
need answer
Which clinical manifestations are found in the client diagnosed with stage 3 of Parkinson disease? Select all that apply Akinesia Masklike face Postural instability Unilateral limb involvement Increased gait disturbances
need answer
Which intervention would be in the plan of care of a client with kidney dysfunction who is about to undergo renal testing using a contrast medium? Select all that apply Assessing the client for a history of cirrhosis Asking the client about known shellfish allergies Assessing for a history of lactic acidosis Evaluating the client's hydration status by checking blood pressure and respiratory rate Discontinuing metformin for 24 hrs from the time of contrast medium administration
Assessing the client for a history of cirrhosis Asking the client about known shellfish allergies Evaluating the client's hydration status by checking blood pressure and respiratory rate Discontinuing metformin for 24 hrs from the time of contrast medium administration
Which finding would the nurse be most concerned about when reviewing the chart of a client scheduled for an amniocentesis? Hepatitis B Prior uterine surgery Active genital herpes B negative blood type
B negative blood type
Which medication would the nurse anticipate being beneficial for a client on antipsychotic medication therapy who develops parkinsonism? Select all that apply Levodopa Benztropine Amantadine Bromocriptine Diphenhydramine
Benztropine Amantadine Diphenhydramine
Which clinical finding would the nurse anticipate for a client who has an exacerbation of multiple sclerosis? Select all that apply Double vision Resting tremors Flaccid paralysis Scanning speech Intellectual disability
Double vision Scanning speech
The nurse is performing a physical assessment of a client admitted to the hospital with a diagnosis of cirrhosis. The nurse expects to observe which skin conditions? Select all that apply Vitiligo Hirsutism Melanosis Ecchymoses Telangiectasia
Ecchymoses Telangiectasia
The nurse teaches a client who is concerned about hepatitis transmission routes. Which type of hepatitis spreads more frequently through food?
Hep A
Which type of hepatitis is commonly spread by consuming contaminated food and water or by fecal contamination? Select all that apply Hep A Hep B Hep C Hep D Hep E
Hep A, E
Which type of hepatitis develops into a chronic form of the disease? Select all that apply Hep A Hep B Hep C Hep D Hep E
Hep B, C, D
Which problem in a client presenting to the clinic for a follow-up after starting pyridostigmine for management of myasthenia gravis is an adverse effect of pyridostigmine? Select all that apply Respiratory depression Increased urinary frequency Diplopia Muscle twitching Diarrhea
Increased urinary frequency Muscle twitching Diarrhea
Which information would the nurse include in the teaching plan for a client diagnosed with epilepsy? The client will take anticonvulsant medications for life Individuals taking phenytoin must floss their teeth regularly A diagnosis of epilepsy prevents individuals from ever obtaining a driver's license Loss of consciousness during a seizure requires emergency evaluation
Individuals taking phenytoin must floss their teeth regularly
The nurse is caring for a client with a diagnosis of acute pancreatitis and alcoholism. The client asks, "How does my drinking relate to my diagnosis?" Which effect of alcohol would the nurse include when responding? It promotes the formation of calculi in the cystic duct It stimulates the pancreas to secrete more insulin than it can immediately produce It alters the composition of enzymes so they are capable of damaging the pancreas It increases enzyme secretion and pancreatic duct pressure that causes backflow of enzymes into the pancreas
It increases enzyme secretion and pancreatic duct pressure that causes backflow of enzymes into the pancreas
Which clinical manifestations would the nurse expect to identify in a client experiencing spinal shock IMMEDIATELY after sustaining a functional transection of the spinal cord at C7-C8? Select all that apply Spasticity Incontinence Flaccid paralysis Respiratory failure Lack of reflexes below the injury
need answer
Which nursing action would the nurse take when a child with a seizure disorder has a generalized seizure? Select all that apply Assessing the seizure Taking the child's vital signs Turning the child on the side Pulling the padded side rails up Initiating O2 administration
Assessing the seizure Taking the child's vital signs Turning the child on the side Pulling the padded side rails up