MEDSURG SAS 23-46

A client with acute hepatitis is prescribed lactulose. The nurse knows this medication will: a. prevent the absorption of ammonia from the bowel b. prevent hypoglycemia c. remove bilirubin from the blood. d. mobilize iron stores from the liver

A

Katrina Sterrett, a 26-year-old preschool teacher, is being seen by a physician who is part of the internist group where you practice nursing. She is undergoing her annual physical and is having many lab tests done as a condition of her employment and upcoming wedding. She is returning for her results and is devastated to learn that she has the sexually-transmitted infection, gonorrhea. What would contribute to her ignorance of her condition? a) Being asymptomatic b) All options are correct c) Being sexually inactive d) Knowing the signs and symptoms of STIs

A

Which opportunistic disease associated with AIDS is characterized by hyperpigmented lesions of skin, lungs, and gastrointestinal (GI) tract? a. Kaposi sarcoma b. Herpes simplex type 1 infection c. Candida albicans d. Varicella-zoster virus infection

A

Which type of hepatitis is transmitted by the fecal-oral route via contaminated food, water, or direct contact with an infected person? "1. Hepatitis A. 2. Hepatitis B. 3. Hepatitis C. 4. Hepatitis D."

A

The nurse is performing an assessment on a client being evaluated for viral hepatitis. Which symptom will the nurse most likely assess on this client? a. arthralgia b. excitability c. headache d. polyphagia

A Arthralgia describes joint stiffness. Arthralgia and arthritis is a common symptom of acute hepatitis.

Which laboratory value increases would the nurse expect to find in a client as a result of hepatitis? Select all that apply. a. SGPT (ALT) and SGOT (AST) b. Alkaline Phosphate c. bilirubin, ESR d. Leukocytes, Lymphocytes, Neutrophils

A, B, C

A client is suspected of having hepatitis. Which diagnostic test result will assist in confirming this diagnosis? a. Elevated hemoglobin level b. Elevated serum bilirubin level c. Elevated blood urea nitrogen level d. Decreased erythrocycle sedimentation rate"

B

A nurse is caring for a client diagnosed with a chlamydia infection. The nurse teaches the client about disease transmission and advises the client to inform his sexual partners of the infection. The client refuses, stating, "This is my business and I'm not telling anyone. Besides, chlamydia doesn't cause any harm like the other STDs. "How should the nurse proceed? a. do nothing because the client's sexual habits place him at risk for contracting other STDs. b. Educate the client about why its important to inform sexual contacts so they can receive treatment. c. Inform the health department that this client contracted an STD. d. inform the client's sexual contacts of their possible exposure to chlamydia

B

A patient comes to the clinic and requests testing for HIV infection. Before administering testing, what is most important for the nurse to do? a. ask the patient to identify all sexual partners b. determine when the patient thinks exposure to HIV occurred c. explain that all test results must be repeated at least twice to be valid d. discuss prevention practices to prevent transmission of the HIV to others

B

A patient with hepatitis B is being discharged in 2 days. In the discharge teaching plan the nurse should include instructions to: a. avoid alcohol for the first 3 weeks b. use a condom during sexual intercourse c. have a family members get an injection of immunoglobin d. follow a low-protein, moderate-carbohydrate, moderate-fat diet

B

An adult client complains for frequent episodes of constipation. What is an effective strategy for preventing constipation? a. Reducing fluid intake to encourage bulk formation in the intestinal lumen b. Use laxative daily to establish a regular elimination pattern. c. A regimen for exercise directed at toning the abdominal muscles. d. Setting a routine for bowel elimination just before bedtime.

B

To prevent the spread of hepatitis A virus (HAV) infection the nurse is especially careful when: a. disposing of food trays b. emptying bed pans c. taking an oral temperature d. changing IV

B

Treatment with two nucleoside reverse transcriptase inhibitors (NRTIs) and a protease inhibitor (PI) is prescribed for a patient with HIV infection who has a CD4+ T-cell count if <400/ul. The patient asks why so many drugs are necessary for treatment. What should the nurse explain as the primary rationale for combination therapy. a. cross-resistance between specific antiretroviral drugs is reduced when drugs are given in combination. b. Combinations of antiretroviral drugs decrease the potential for development of antiretroviral-resistant HIV variants. c. Side effects of the drugs are reduced when smaller doses of three different drugs are used rather than large doses of one drug d. When CD4+ T-cell counts are <500/ ul, a combination of drugs that have different actions is more effective in slowing HIV growth.

B

Which priority teaching information should the nurse discuss with the client to help prevent contracting hep. B? 1.Explain the importance of good hand washing. 2.Tell the client to take the hepatitis B vaccine in three (3) doses. 3.Tell the client not to ingest unsanitary food or water. 4.Discuss how to implement standard precautions.

B

Within the free clinic where you practice nursing, you hold weekly sexual education classes open to the public. Within the classroom, you communicate the CDC's numbers for the incidence of STIs and their impact upon public health. Which is the fastest-spreading bacterial STI in the United States? a) Gonorrhea b) Chlamydia c) Herpes simplex 1 d) HPV

B

The "rapid" HIV antibody testing is performed on a patient at high risk for HIV infection. What should the nurse explain about this test? a. the test measures the activity of the HIV and reports viral loads as real numbers. b. this test is highly reliable, and in 5 mins the patient will know if HIV infection is present. c. if the results are positive, another blood test and a return appointment for results will be necessary. d. this test detects drug- assistant viral mutations that are present in viral genes to evaluate resistance to antiretroviral drugs

C

What is one of the most significant in determining when to start antiretroviral therapy in a patient with HIV infections? a. whether the patient has high levels of HIV antibodies b. confirmation that the patient has contracted HIV infection c. the patient's readiness to commit to a complex, lifelong, uncomfortable drug regimen d. whether the patient has a support system to help manage the costs and side effects of the drugs

C

A 16-year-old patient comes to the free clinic and is diagnosed with primary syphilis. The patient states that she contracted this disease by holding hands with someone who has syphilis. What is the most appropriate nursing diagnosis for this patient? a. Alteration in comfort related to impaired skin integrity b. Fear related to complications c. Noncompliance with treatment regimen related to age d. Knowledge deficit related to modes of transmission

D

A nurse is teaching a client with genital herpes. Education for this client should include an explanation of: a. why the disease is transmittable only when visible lesions are present b. the need for the use of petroleum products. c. the option of disregarding safer-sex practices now that he's already infected. d. the importance of informing his partners of the disease.

D

The nurse questions a client with hepatitis B. How long ago could the client have been exposed to exposed to hepatitis B? a. 3-7 days b. 7-14 days c. 40-50 days d. 60-160 days

D. Hepatitis B incubation period is 50-180 days.