A grade MED surg exam 2 review questions with accurate answers.

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1. The nurse is caring for a woman recently diagnosed with viral hepatitis A. Which individual should the nurse refer for an immunoglobulin (IG) injection? A. A caregiver who lives in the same househ... old with the patient Correct B. A friend who delivers meals to the patient and family each week C. A relative with a history of hepatitis A who visits the patient daily D. A child living in the home who received the hepatitis A vaccine 3 months ago IG is recommended for persons who do not have anti-HAV antibodies and are exposed as a result of close contact with persons who have HAV or foodborne exposure. Persons who have received a dose of HAV vaccine more than 1 mw3onth previously or who have a history of HAV infection do not require IG. 2. 2.ID: 14478179959 The nurse provides discharge instructions for a 64-yr-old woman with ascites and peripheral edema related to cirrhosis. Which patient statement indicates teaching was effective? A. “Lactulose should be taken every day to prevent constipation.” B. “It is safe to take acetaminophen up to four times a day for pain.” C. “Herbs and other spices should be used to season my foods instead of salt.” Correct D. “I will eat foods high in potassium while taking spironolactone (Aldactone).” A low-sodium diet is indicated for patients with ascites and edema related to cirrhosis. Table salt is a well-known source of sodium and should be avoided. Alternatives to salt to season foods include the use of seasonings such as garlic, parsley, onion, lemon juice, and spices. Pain medications such as acetaminophen, aspirin, and ibuprofen should be avoided because these medications may be toxic to the liver. The patient should avoid potentially hepatotoxic over-the-counter drugs (e.g., acetaminophen) because the diseased liver is unable to metabolize these drugs. Spironolactone is a potassium-sparing diuretic. Lactulose results in the acidification of feces in bowel and trapping of ammonia, causing its elimination in feces. 3. 3.ID: 14478179967 The nurse is caring for a 55-yr-old man patient with acute pancreatitis resulting from gallstones. Which clinical manifestation would the nurse expect? A. Hematochezia B. Left upper abdominal pain Correct C. Ascites and peripheral edema D. Temperature over 102o F (38.9o C) Abdominal pain (usually in the left upper quadrant) is the predominant manifestation of acute pancreatitis. Other manifestations of acute pancreatitis include nausea and vomiting, low-grade fever, leukocytosis, hypotension, tachycardia, and jaundice. Abdominal tenderness with muscle guarding is common. Bowel sounds may be decreased or absent. Ileus may occur and causes marked abdominal distention. Areas of cyanosis or greenish to yellow-brown discoloration of the abdominal wall may occur. Other areas of ecchymoses are the flanks (Grey Turner’s spots or sign, a bluish flank discoloration) and the periumbilical area (Cullen’s sign, a bluish periumbilical discoloration). 4. 4.ID: 14478179963 The nurse is caring for a group of patients. Which patient has the highest risk for developing pancreatic cancer? 1 A. A 38-yr-old Hispanic woman who is obese and has hyperinsulinemia B. A 72-yr-old African American man who has smoked cigarettes for 50 years Correct C. A 23-yr-old man who has cystic fibrosis–related pancreatic enzyme insufficiency D. A 19-yr-old patient who has a 5-year history of uncontrolled type 1 diabetes mellitus Risk factors for pancreatic cancer include chronic pancreatitis, diabetes mellitus, age, cigarette smoking, family history of pancreatic cancer, high-fat diet, and exposure to chemicals such as benzidine. African Americans have a higher incidence of pancreatic cancer than whites. The most firmly established environmental risk factor is cigarette smoking. Smokers are two or three times more likely to develop p [Show More]

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