Acute Care Nursing: Socrative Exam 2 Review 2022/2023

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The nurse had taught the client w/ chronic pancreatitis about risk factor modification to reduce the incidence of recurrences. The nurse determines that the client has understood the information of th ... e if the client states it will be necessary to control which of the following? a. Diabetes Mellitus b. Alcohol Intake c. Duodenal Ulcers d. Crohn's Disease correct answerAlcohol Intake The most significant contributing factor to the development of chronic pancreatitis is alcohol ingestion. This is a straightforward knowledge question. The client w/ chronic pancreatitis needs information on dietary modification to manage health problems. The nurse teaches the client to limit which of the following items in the diet? a. Carbohydrates b. Fat c. Iron d. Water Soluble Vitamins correct answerFat Following a. low fat diet may help reduce the symptoms associated w/ chronic pancreatitis, because this will decrease the amount of enzymes needed to digest meals. The nurse is evaluating the effect of dietary counseling on the client w/ hepatic encephalopathy. The nurse would evaluate that the client understands the instruction given if the client stated that which of the following food items should be restricted in this diet? a. Fat b. Carbohydrates c. Protein d. Minerals correct answerProtein The symptoms for hepatic encephalopathy comes from the buildup of ammonia in the blood that the kidneys are unable to filter - ammonia is a byproduct of protein metabolism, so patients w/ hepatic encephalopathy should be on a protein-restricted diet (especially animal proteins) When caring for a client who has cirrhosis, which of the following assessment findings would be highest priority? a. Jaundice b. Increasing confusion c. Elevated AST & ALT levels d. Elevated ammonia levels correct answerIncreasing confusion This question is a priority question, so assume all of the findings are potentially appropriate to the patient w/ cirrhosis. They may have jaundice from increased bilirubin levels, elevated liver enzymes, & increased ammonia levels as well. However, these are anticipated findings in the client w/ cirrhosis - increasing confusion is a sign the client may be developing hepatic encephalopathy, when toxic levels of ammonia interfere w/ neurologic function & progress to coma and death. Since this is a priority question, imagine what could potentially happen if you didn't intervene w/ any of these results & decide what the worst case scenario is. That can help you identify which finding is of greatest concern. The nurse should evaluate which of the following lab tests for a client who has cirrhosis in order to plan for safe care? a. Prothrombin Time b. Urinalysis c. Serum Lipase d. Serum Troponin correct answerProthrombin Time Many clotting factors are produced by the liver, including factor II (prothrombin). The client's ability to form these factors may be impaired w/ cirrhosis, putting the client at risk for bleeding. Prothrombin time will evaluate blood clotting ability. The key word here is SAFE - w/ this in mind, choose the answer that could detect a potential problem or complication w/ cirrhosis. The client w/ diverticular disease is scheduled for a sigmoidoscopy. He suddenly complains of severe abdominal pain. On examination, the nurse notes a rigid abdomen w/ guarding. What action should the nurse take next? a. Notify the physician b. Evaluate the client's most recent lab values c. Keep the client distracted until the procedure begins d. Tell the client the test will show what is causing his pain & administer additional analgesics correct answerNotify the physician This client is exhibiting the symptoms of perforation w/ the potential for peritonitis - this is a potential complication of diverticular disease. Because the treatment for this complication is beyond the scope of independent nursing practice, the physician must be notified. This is a potentially emergent situation, so the best choice would be to address the problem directly & DO SOMETHING (not just more assessments). A client is being evaluated for possible duodenal ulcers. The nurse assesses the client for which of the following manifestations that would support this diagnosis? a. Epigastric pain relieved by food b. History of chronic aspirin use c. Distended abdomen d. Positive fluid wave correct answerEpigastric pain relieved by food The pain of a gastric ulcer is unrelieved (and often irritated) by anything that produces stomach acid production, like food. Aspirin is also an irritant to the stomach, causing gastric ulcers. ingesting food promotes the release of pancreatic enzymes into the duodenum, which are high in sodium bicarbonate. This helps reduce the acidity of the duodenum, so eating food relieves the pain. The nurse caring for a client w/ hemolytic jaundice anticipates which of the following findings on the laboratory results? a. Elevated serum bilirubin b. Decreased serum protein c. Increased fecal bilirubin excretion d. Decreased urine pH correct answerElevated serum bilirubin In hemolytic jaundice, excessive breakdown of RBCs causes bilirubin to buildup in quantities that the liver is unable to proces [Show More]

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