Ch. 49 - PrepU Adaptive Learning
b
A client is admitted for suspected GI disease. Assessment data reveal muscle wasting, a decrease in chest and axillary hair, and increased bleeding tendency. The nurse suspects the client has: a) cholelithiasis b) cirrhosis c) peptic ulcer disease d) appendicitis
a
Clients diagnosed with esophageal varices are at risk for hemorrhagic shock. Which is a sign of potential hypovolemia? a) Hypotension b) Polyuria c) Bradycardia d) Warm moist skin
c
What test should the nurse prepare the client for that will locate stones that have collected in the common bile duct? a) Abdominal x-ray b) Cholecystectomy c) Endoscopic retrograde cholangiopancreatography (ERCP) d) Colonoscopy
d
A client was admitted for critical care due to esophageal varices and precarious physical condition. What could cause the client's varices to hemorrhage? a) rough food b) chemical irritation c) little protective tissue to protect fragile veins d) All options are correct
a
A client with a lengthy history of alcohol addiction is being seen for jaundice. The appearance of jaundice would most likely indicate: a) liver disorder. b) glucose underproduction. c) bile overproduction. d) gallbladder disease.
c
A client with cirrhosis has portal hypertension, which is causing esophageal varices. What is the goal of the interventions that the nurse will provide? a) Cure the cirrhosis. b) Treat the esophageal varices. c) Reduce fluid accumulation and venous pressure. d) Promote optimal neurologic function.
d
A client with severe and chronic liver disease is showing manifestations related to inadequate vitamin intake and metabolism. He reports difficulty driving at night because he cannot see well. Which of the following vitamins is most likely deficient for this client? a) Thiamine b) Riboflavin c) Vitamin K d) Vitamin A
d
A nurse educator is providing an in-service to a group of nurses working on a medical floor that specializes in liver disorders. What is an important education topic regarding ingestion of medications? a) medications becoming ineffective in clients with liver disease b) need for increased drug dosages c) need for more frequently divided doses d) metabolism of medications
c
A nurse is caring for a client with cirrhosis. The nurse assesses the client at noon and discovers that the client is difficult to arouse and has an elevated serum ammonia level. The nurse should suspect which situation? a) The client is relaxed and not in pain. b) The client is avoiding the nurse. c) The client's hepatic function is decreasing. d) The client didn't take his morning dose of lactulose (Cephulac).
b
A student accepted into a nursing program must begin receiving the hepatitis B series of injections. The student asks when the next two injections should be administered. What is the best response by the instructor? a) "You must have the second one in 1 year and the third the following year." b) "You must have the second one in 1 month and the third in 6 months." c) "You must have the second one in 2 weeks and the third in 1 month." d) "You must have the second one in 6 months and the third in 1 year."
a
The mode of transmission of hepatitis A virus (HAV) includes which of the following? a) Fecal-oral b) Blood c) Saliva d) Semen
c
The nurse is administering medications to a client that has elevated ammonia due to cirrhosis of the liver. What medication will the nurse give to detoxify ammonium and to act as an osmotic agent? a) Spironolactone b) Cholestyramine c) Lactulose d) Kanamycin
c
The nurse is assisting the physician with a procedure to remove ascitic fluid from a client with cirrhosis. What procedure does the nurse ensure the client understands will be performed? a) Upper endoscopy b) Thoracentesis c) Abdominal paracentesis d) Abdominal CT scan
a
The nurse is caring for a client with cirrhosis. Which assessment findings indicate that the client has deficient vitamin K absorption caused by this hepatic disease? a) Purpura and petechiae b) Dyspnea and fatigue c) Gynecomastia and testicular atrophy d) Ascites and orthopnea
a b
The nurse is caring for a patient who has ascites as a result of hepatic dysfunction. What intervention can the nurse provide to determine if the ascites is increasing? Select all that apply. *[Separate answer(s) with spaces only] a) Perform daily weights. b) Measure abdominal girth daily. c) Monitor number of bowel movements per day. d) Assess and document vital signs every 4 hours. e) Measure urine output every 8 hours.
d
The nurse is providing care to a patient with gross ascites who is maintaining a position of comfort in the high semi-Fowler's position. What is the nurse's priority assessment of this patient? a) Urinary output related to increased sodium retention b) Skin assessment related to increase in bile salts c) Peripheral vascular assessment related to immobility d) Respiratory assessment related to increased thoracic pressure
b
Total parental nutrition (TPN) should be used cautiously in clients with pancreatitis because such clients: a) are at risk for hepatic encephalopathy. b) cannot tolerate high-glucose concentration. c) can digest high-fat foods. d) are at risk for gallbladder contraction.
d
When caring for a client with advanced cirrhosis and hepatic encephalopathy, which assessment finding should the nurse report immediately? a) Anorexia for more than 3 days b) Weight loss of 2 pounds in 3 days c) Constipation for more than 2 days d) Change in the client's handwriting and/or cognitive performance
c
Which assessments are important in a client diagnosed with ascites? a) Palpation of abdomen for a fluid shift b) Foul smelling breath c) Measurement of abdominal girth d) Weight
a
Which medication is used to decrease portal pressure, halting bleeding of esophageal varices? a) Vasopressin b) Citmetidine c) Spironolactone d) Nitroglycerin