PrepU inflammation
When providing discharge teaching for a client with uric acid calculi, the nurse would include an instruction to avoid which type of diet? a) Low calcium b) High purine c) Low oxalate d) High oxalate
b) High purine
Which statement indicates the client understands the lifestyle modifications required when managing ulcerative colitis? a) "I am allowed to have alcohol as long as I only drink wine." b) "I can eat popcorn for an evening snack." c) "I may have coffee with my meals." d) "I will have to stop smoking."
d) "I will have to stop smoking."
What is the most appropriate nursing diagnosis for the client with acute pancreatitis? a) Excess fluid volume b) Decreased cardiac output c) Ineffective gastrointestinal tissue perfusion d) Deficient fluid volume
d) Deficient fluid volume
During the first few weeks after a cholecystectomy, the client should follow a diet that includes: a) a decreased intake of fruits, vegetables, whole grains, and nuts, to minimize pressure within the small intestine. b) ingestion of pancreatic enzymes with meals to replace the normal enzyme secretion that has been surgically altered. c) at least four servings daily of meat, cheese, and peanut butter to increase protein intake that aids incisional healing. d) a limited intake of fat distributed throughout the day so there is not an excessive amount in the intestine at any one time.
d) a limited intake of fat distributed throughout the day so there is not an excessive amount in the intestine at any one time.
Which is a priority assessment for the client in shock who is receiving an IV infusion of packed red blood cells and normal saline solution? a) pain b) fluid balance c) altered level of consciousness d) anaphylactic reaction
d) anaphylactic reaction
The nurse administers theophylline to a client. When evaluating the effectiveness of this medication, the nurse should assess the client for: a) suppression of the client's respiratory infection. b) decrease in bronchial secretions. c) thinning of tenacious, purulent sputum. d) less difficulty breathing
d) less difficulty breathing
When preparing a client for surgery to treat appendicitis, the nurse formulates a nursing diagnosis of Risk for infection related to inflammation, perforation, and surgery. What is the rationale for choosing this nursing diagnosis? a) Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix. b) Infection of the appendix diminishes necrotic arterial blood flow and increases venous drainage. c) Obstruction of the appendix may increase venous drainage and cause the appendix to rupture. d) The appendix may develop gangrene and rupture, especially in a middle-aged client.
a) Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix.
A client diagnosed with acute pancreatitis is being transferred to another facility. The nurse caring for the client completes the transfer summary, which includes information about the client's drinking history and other assessment findings. Which assessment findings confirm his diagnosis? a) Recent weight loss and temperature elevation b) Presence of blood in the client's stool and recent hypertension c) Adventitious breath sounds and hypertension d) Presence of easy bruising and bradycardia
a) Recent weight loss and temperature elevation
Which symptom would the nurse most likely observe in a client with cholecystitis from cholelithiasis? a) nausea after ingestion of high-fat foods b) black stools c) elevated temperature of 103°F (39.4°C) d) decreased white blood cell count
a) nausea after ingestion of high-fat foods
A client with pancreatitis has been receiving total parenteral nutrition (TPN) for the past week. Which nursing intervention helps determine if TPN is providing adequate nutrition? a) Recording fluid intake and output b) Monitoring the client's weight every day c) Accelerating the infusion if it falls behind schedule d) Ensuring that the TPN tubing has an in-line filter
b) Monitoring the client's weight every day
An apartment fire spreads to seven apartment units. Victims suffer burns, minor injuries, and broken bones from jumping from windows. Which client should be transported first? a) a 20-year-old with first-degree burns on her hands and forearms b) a middle-aged man with no injuries who has rapid respirations and coughs c) a 10-year-old with a simple fracture of the humerus who is in severe pain d) a woman who is 5 months pregnant with no apparent injuries
b) a middle-aged man with no injuries who has rapid respirations and coughs
A client is admitted with acute pancreatitis. The nurse should monitor which laboratory values? a) decreased urine amylase level b) increased serum amylase and lipase levels c) increased calcium level d) decreased glucose level
b) increased serum amylase and lipase levels
A 45-year-old client is admitted to the facility with excruciating paroxysmal facial pain. He reports that the episodes occur most often after feeling cold drafts and drinking cold beverages. Based on these findings, the nurse determines that the client is most likely suffering from which neurologic disorder? A. Trigeminal neuralgia B. Angina Pectoris C. Migraine Headache D. Bells Palsy
A. Trigeminal neuralgia
A client has an allergy to latex. What intervention would be of importance? a) Maintain standard precautions with powder free gloves. b) Use allergy free lotion to prevent skin breakdown. c) Determine if client is also allergic to kiwi and strawberries. d) Keep an epinephrine pen at the bedside.
a) Maintain standard precautions with powder free gloves.
An adolescent, age 14, is hospitalized for nutritional management and drug therapy after experiencing an acute episode of ulcerative colitis. Which nursing intervention is appropriate? a) Providing small, frequent meals b) Providing high-fiber snacks c) Administering digestive enzymes before meals as ordered d) Administering antibiotics with meals as ordered
a) Providing small, frequent meals
A client is recovering from an abdominal-perineal resection. To promote wound healing after the perineal drains have been removed the nurse should encourage the client to: a) use a heating pad on the area. b) take sitz baths. c) shower daily. d) apply moist dressings to the area.
b) take sitz baths
A nurse should expect to administer which medication to a client with gout? a) Aspirin b) Calcium gluconate c) Colchicine d) Furosemide
c) Colchicine
A client presents to the emergency department with reports of acute GI distress, bloody diarrhea, weight loss, and fever. A family history of which of the following would be significant to this client's diagnosis? a) Peptic ulcers b) Crohn's disease c) Ulcerative colitis d) Appendicitis
c) Ulcerative colitis
When a client has an acute attack of diverticulitis, the nurse should first: a) encourage the client to drink a glass of water every 2 hr. b) prepare the client for a colonoscopy. c) assess the client for signs of peritonitis. d) encourage the client to eat a high-fiber diet.
c) assess the client for signs of peritonitis.
A 13-year-old girl is being evaluated for possible Crohn's disease. The nurse expects to prepare her for which diagnostic study? a) Genetic testing b) Myelography c) Cystoscopy d) Colonoscopy with biopsy
d) Colonoscopy with biopsy
After receiving a dose of penicillin, a client develops dyspnea and hypotension. The nurse suspects the client is experiencing anaphylactic shock. What should the nurse do first? a) Administer epinephrine, as ordered, and prepare to intubate the client, if necessary. b) Administer the antidote for penicillin, as ordered, and continue to monitor the client's vital signs. c) Insert an indwelling urinary catheter and begin to infuse I.V. fluids, as ordered. d) Prepare to administer a corticosteroid IV.
a) Administer epinephrine, as ordered, and prepare to intubate the client, if necessary.
Pancreatic enzyme replacements are prescribed for the client with chronic pancreatitis. When should the nurse instruct the client to take them to obtain the most therapeutic effect? a) with each meal and snack b) every 4 hours, at specified times c) in the morning and at bedtime d) three times daily between meals
a) with each meal and snack
An adolescent client scheduled for an emergency appendectomy is to be transferred directly from the emergency department to the operating room. Which statement by the client should the nurse interpret as most significant? a) "It hurts when you press on my stomach." b) "I feel like I am going to throw up." c) "All of a sudden it does not hurt at all." d) "The pain is centered around my navel."
c) "All of a sudden it does not hurt at all."
The mother of a 16-year-old girl calls the emergency department, suspecting her daughter's abdominal pain may be appendicitis. In addition to pain, her daughter has a temperature of 100° F (37.7° C) and has vomited twice. What should the nurse tell the mother? a) "It's most likely the flu because your daughter is too young to have appendicitis." b) "Give your daughter a laxative to rule out the possibility that constipation is causing the pain." c) "Gently press on the lower left quadrant of your daughter's abdomen to test for rebound tenderness." d) "Bring your daughter into the emergency department immediately before her appendix has a chance to rupture."
d) "Bring your daughter into the emergency department immediately before her appendix has a chance to rupture."
While listening to a client's chest, the nurse notes a rub during inspiration and expiration with a grating sound. When communicating to the health care provider, what should the nurse request in the SBAR communication? a) Chest x-ray b) Arterial blood gasses c) Broncodialator small volume nebulizer treatments d) Narcotic pain medications
a) Chest x-ray
A client newly diagnosed with ulcerative colitis who has been placed on steroids asks the nurse why steroids are prescribed. The nurse shuld tell the client: a) "The side effects of steroids outweigh their benefits to clients with ulcerative colitis." b) "Ulcerative colitis can be cured by the use of steroids." c) "Steroids are used in severe flare-ups because they can decrease the incidence of bleeding." d) "Long-term use of steroids will prolong periods of remission."
c) "Steroids are used in severe flare-ups because they can decrease the incidence of bleeding."
A child is admitted to the emergency department and diagnosed with a suspected ruptured appendix. The parents are anxious about the child's condition and ask the nurse what to expect for immediate treatment. What is the best response by the nurse? a) "We will place a referral to the social worker to help you through this." b) "We will modify pain management strategies to control the situation." c) "We will be preparing your child for emergency surgery." d) "The focus of treatment is the initiation of antibiotic therapy."
c) "We will be preparing your child for emergency surgery."
A client is diagnosed with deep vein thrombosis (DVT). Which nursing diagnosis should receive highest priority at this time? a) Impaired gas exchange related to increased blood flow b) Excess fluid volume related to peripheral vascular disease c) Ineffective peripheral tissue perfusion related to venous congestion d) Risk for injury related to edema
c) Ineffective peripheral tissue perfusion related to venous congestion
A nurse is providing dietary instructions to a client with a history of pancreatitis. Which of the following instructions would be most appropriate? a) Maintain a low-carbohydrate, low-fat diet. b) Maintain a high-fat, high-carbohydrate diet. c) Maintain a high-carbohydrate, low-fat diet. d) Maintain a high-fat, low-carbohydrate diet.
c) Maintain a high-carbohydrate, low-fat diet.
The health care provider prescribes sulfasalazine for the client with ulcerative colitis. Which instruction should the nurse give the client about taking this medication? a) Take the total dose at bedtime. b) Avoid taking it with food. c) Take it with a full glass (240 mL) of water. d) Stop taking it if urine turns orange-yellow.
c) Take it with a full glass (240 mL) of water.
A 4-year-old child who has been ill for 4 hours is admitted to the hospital with difficulty swallowing, a sore throat, and severe substernal retractions. The child's temperature is 104° F (40° C), and the apical pulse is 140 bpm. The white blood cell count is 16,000/mm3 (16,000 X 109/L). What is priority for nursing intervention? a) difficulty breathing b) potential for aspiration c) airway obstruction d) infection
c) airway obstruction
A client is admitted to the health care facility with abdominal pain, a low-grade fever, abdominal distention, and weight loss. Based on the diagnosis of acute pancreatitis the nurse will provide which explanation for the prescribed interventions? a) "I will be starting antibiotic therapy once the blood cultures are obtained." b) "I can offer you ibuprofen for pain with a small sip of water." c) "Activity is important, so you will be scheduled for physical therapy." d) "You are not allowed anything by mouth so that your pancreas can rest"
d) "You are not allowed anything by mouth so that your pancreas can rest"
A client is admitted for a transurethral resection of the prostate (TURP). Preoperative teaching will include which of the following information? a) "You will need to keep your abdominal incision clean and dry and cannot shower until the sutures are removed." b) "You will return from surgery and have a suprapubic catheter for 48 hours." c) "You will need to use a urinal and remain on bed rest for 24 hours after surgery." d) "You will return from surgery with a catheter in your bladder and fluid flowing into and out of it continuously."
d) "You will return from surgery with a catheter in your bladder and fluid flowing into and out of it continuously."
An adult with appendicitis has severe abdominal pain. Which action will be the most effective to assist the client to manage pain prior to surgery? a) Apply moist heat to the abdomen. b) Teach client to massage the painful area. c) Provide distraction with music. d) Place the client in semi-Fowler's position with the knees to the chest.
d) Place the client in semi-Fowler's position with the knees to the chest
A woman at 22 weeks' gestation has right upper quadrant pain radiating to her back. She rates the pain as 9 on a scale of 1 to 10 and says that it has occurred 2 times in the last week for about 4 hours at a time. She does not associate the pain with food. Which nursing measure is the highest priority for this client? a) Educate the client concerning changes occurring in the gallbladder as a result of pregnancy. b) Discuss nutritional strategies to decrease the possibility of heartburn. c) Support the client's use of acetaminophen to relieve pain. d) Refer the client to her health care provider for evaluation and treatment of the pain
d) Refer the client to her health care provider for evaluation and treatment of the pain
Which is an appropriate nursing goal for the client who has ulcerative colitis? The client: a) uses a heating pad to decrease abdominal cramping. b) maintains a daily record of intake and output. c) accepts that a colostomy is inevitable at some time in his life. d) verbalizes the importance of small, frequent feedings.
d) verbalizes the importance of small, frequent feedings.
The nurse notes that a client with acute pancreatitis occasionally experiences muscle twitching and jerking. How should the nurse interpret the significance of these symptoms? a) The client is experiencing a reaction to meperidine. b) The client needs a muscle relaxant to promote rest. c) The client has a nutritional imbalance. d) The client may be developing hypocalcemia.
d) The client may be developing hypocalcemia.
A client with rheumatoid arthritis tells the nurse that she feels "quite alone" in adjusting to changes in her lifestyle. The nurse should respond by: a) telling the client about her community's arthritis support group. b) referring the client and her husband for counseling to decrease her sense of isolation. c) suggesting that the client develop a hobby to occupy her time. d) suggesting that the client discuss her feelings with her minister.
a) telling the client about her community's arthritis support group.
A client develops chronic pancreatitis. What would be the appropriate home diet for a client with chronic pancreatitis? a) A high-calcium, soft diet distributed over three meals and an evening snack daily b) A low-fat, bland diet distributed over five to six small meals daily c) a low-protein, high-fiber diet distributed over four to five moderate-sized meals daily d) A diabetic exchange diet distributed over three meals and two snacks daily
b) A low-fat, bland diet distributed over five to six small meals daily
