Metabolic Disorder (ATI/NCLEX/FA) Flashcards
A client is admitted to the hospital with a suspected diagnosis of acute pancreatitis is being assessed by the nurse which assessment findings would be consistent with acute pancreatitis. Select all that apply
A. Diarrhea
B. Black, tarry stools
C. Hyperactive bowel sounds
D. Gray blue color at the flank
E. Abdominal guarding and tenderness
F. Left upper quadrant pain with radiation to the back
D. Gray blue color at the flank
E. Abdominal guarding and tenderness
F. Left upper quadrant pain with radiation to the back
A client diagnosed with viral hepatitis, complaining of “no appetite” and “losing my taste for food”.What instructions should the nurse give the client to provide adequate nutrition?
A. Select food high in fat
B. Increase intake of fluids , including juices
C. Eat a good supper when anorexia is not severe
D. Eat less often , preferably only 3 large meals daily
B. Increase intake of fluids , including juices
A client has developed Hepatitis A after eating contaminated oysters. The nurse is assessing the client for which expected assessment findings ?
A.malaise
B. Dark stools
C. Weight gain
D. Left upper quadrant discomfort
A.malaise
A client has undergone esophagogastroduodenoscopy. The nurse should place highest priority, on which item as part of the clients care plan ?
A. Monitoring the temperature
B. Monitoring complaints of heartburn
C. Giving warm gargles for a sore throat
D. Assessing for the return of gag reflux’s
D. Assessing for the return of gag reflux’s
The nurse has taught the client about an upcoming endoscopic retrograde cholangiopancreatography (ERCP) procedure. The nurse determines that the client needs further information if the client makes which statement?
A. ‘ i know i must sign a consent form”
B. “ i hope the throat spray keeps me from gagging”
C. “ I’m glad i don’t have to lie still for this procedure “
D. “ I’m glad some intravenous medication will be given to help me relax”
C. “ I’m glad i don’t have to lie still for this procedure “
The healthcare provider has determined that a client has contracted hepatitis A based on flu like symptom and jaundice, which statement made by the client supports this medical diagnosis?
A. “ i have had unprotected sex with multiple partners”
B. “ I ate shellfish about 2 weeks ago at a local restaurant “
C. “I was an intravenous drug abuser in the past and shared needles”
D. “ i had a major blood transfusion 30 years ago after major abdominal surgery”
B. “ I ate shellfish about 2 weeks ago at a local restaurant “
Nurses assessing a client 24 hours following a cholecystectomy. The nurse notes that the t-tube has drained 750 ml of green -brown drainage since the surgery. Which intervention is most appropriate?
A. Clamp the t-tube
B.irrigate the t-tube
C. Document the findings
D. Notify the HCP
C. Document the findings
The nurse is caring for a client following a gastrojejunostomy. Which operative prescription should the nurse question and verify?
A. Leg exercise
B. Early ambulation
C. Irrigating the NGtube
D. Coughing and deep breathing
C. Irrigating the NGtube
Nurse is providing discharge instructions to a client following gastrectomy, and should instruct a client to take which measure to assist in preventing dumping syndrome ?
A. Ambulate following a meal
B. Eat a high carbohydrate foods
C. Limit the fluids taken with meals
D. Sit in a high fowlers position during meals
C. Limit the fluids taken with meals
The nurses reviewing the prescription for client admitted to the hospital with a diagnosis of acute pancreatitis. Which intervention should the nurse expect to be prescribed for this client.? SATA
A. Maintain NPO
B. Encourage Coughing and deep breathing
C. Give small, frequent high calorie feedings
D.maintain the client in a supine and flat position
E. Give hydromorphone IV as prescribed for pain
F. Maintain IV fluids at 10ml/hr to keep the vein open
A. Maintain NPO
B. Encourage Coughing and deep breathing
E. Give hydromorphone IV as prescribed for pain
The nurse is reviewing the record of a client with a diagnosis of cirrhosis and notes that there is documentation of the presence of asterixis. How should the nurse assess for its presence?
A. Dorsiflex the clients foot
B. Measure the abdominal girth
C. Ask the client to extend the arms
D. Instruct the client to lean forward
C. Ask the client to extend the arms
The nurse is reviewing the laboratory results for a client with cirrhosis and notes the ammonia level is 85 mcg/dL. Which dietary selection does the nurse suggest to the client ?
A. Roast pork
B. Cheese omelet
C. Pasta with sauce
D. Tuna fish sandwich
C. Pasta with sauce
An older client recently has been taking cimetidine the nurse monitors the client for which most frequent central nervous system side effect for this medication?
A. Tremors
B. Dizziness
C. Confusion
D. Hallucinations
C. Confusion
A Client has been taking omeprazole for 4 weeks. The ambulatory care nurse evaluates that the client is receiving the optimal intended effect of the medication if the client reports the absence if which symptom?
A. Diarrhea
B. Heartburn
C. Flatulence
D. Constipation
B. Heartburn
A client with a peptic ulcer is diagnosed with a helicobacter pylori infection. The nurse is teaching the client about the medications prescribed, including clarithromycin, esomeprazole, and amoxicillin. Which statement by the client indicates the best understanding of medication regimen ?
A.“ my ulcer will heal because these medications will kill the bacteria”
B.” These medications are only taken when i have pain form my ulcer”
C. “ the medication will kill the bacteria and stop the acid production”
D. “ these medications will coat the ulcer and decrease the acid production in my stomach “
C. “ the medication will kill the bacteria and stop the acid production”
A client has a new prescription for metoclopramide. On review of the chart the nurse identifies that this medication can be safely administered with which condition?
A. Intestinal obstruction
B. Peptic ulcer with melena
C. Diverticulitis with perforation
D. Vomiting following cancer chemotherapy
D. Vomiting following cancer chemotherapy
The nurse determines the client needs further instructions on cimetidine if which statements were made?
SATA
A. “ I will take the cimetidine with my meals”
B. “ i will know the medication is working if my diarrhea stops”
C. ‘ my episodes of heartburn will decrease if the medication is effective”
D. “ taking the cimetidine with an antacid will increase it effectiveness’
E. ‘ i will notify my HCP if i become depressed or anxious “
F. “ some of my blood levels will need to monitored closely since i also take warfarin for a fib”
A. “ I will take the cimetidine with my meals”
B. “ i will know the medication is working if my diarrhea stops”
D. “ taking the cimetidine with an antacid will increase it effectiveness’
The nurse recognizes which patient is at greatest risk for type 1 autoimmune hepatitis ?
A. A 45 y.o postmenopausal female
B. A 30 ny.o female with a history of hyperthyroidism
C. A 16 y.o female with Type 1 diabetes mellitus
D. A 12 y.o female with autism
C. A 16 y.o female with Type 1 diabetes mellitus
In reviewing diagnostic results of a patient with suspected hepatitis, the nurse correlates which result as consistent with hepatitis A?
A. Prolonged Prothrombin time (PT)
B.decreased WBC
C. Presence of IgM anti-HAV
D. Detectable Serum HBV DNA
C. Presence of IgM anti-HAV
Elevated ammonia levels can lead to hepatic encephalopathy. Which provider order best reduces the risk in patients with cirrhosis ?
A. Administer furosemide and spironolactone
B. Administer antibiotics
C. Restrict protein intake
D. Restrict caloric intake
C. Restrict protein intake
In a patient with cirrhosis, the nursing diagnosis “ risk for injury and bleeding associated with prolonged clotting factors “ is most appropriate associated with which disorder ?
A. Pruritus
B. Vitamin K deficiency
C. Hyponatremia
D. Ascites
B. Vitamin K deficiency
The most specific laboratory result in the patient with acute pancreatitis is an elevation in which laboratory value ?
A. Serum bilirubin
B. Serum lipase
C. Serum trypsin
D. Serum lactase
B. Serum lipase
A nurse is reviewing the admission laboratory results of a client who has acute pancreatitis. Which of the following findings should the nurse expect?
A. Decreased blood lipase level
B. Decreased amylase level
C. Increased blood calcium
D. Increased blood glucose
D. Increased blood glucose
A nurse is preparing to administer pancrelipase to a client who has pancreatitis. Which of the following actions should the nurse take?
A. Instruct the client to chew the medication before swallowing
B. Offer a glass of water following medication administration
C. Administer the medication 30 min before meals
D. Sprinkle the contents o in peanut butter
B. Offer a glass of water following medication administration
A nurse is completing an admissions assessment of a client who has pancreatitis. Which of the following findings should the nurse expect?
A. Pain in the right upper quadrant to right shoulder
B. Report of pain being worse when sitting upright
C. Pain relived with defecation
D. Epigastric pain radiating to the left shoulder
D. Epigastric pain radiating to the left shoulder
A nurse is assessing a client who has pancreatitis. Which of the following findings should the nurse identify as manifestation of pancreatitis ?
A. Generalized weakness
B. Hyperactive bowel sounds
C. Gray-blue discoloration of the skin around the umbilicus
D. Wheezing in the lower lung fields
C. Gray-blue discoloration of the skin around the umbilicus
A nurse is completing nutrition teaching for a client who has pancreatitis, which of the following statements by the client indicates an understanding of the teaching? SATA
A. “I plan to eat small, frequent meals”
B. “ i will eat easy to digest foods with limited spice “
C. “ i will use skim milk when cooking”
D. ‘ i plan to drink regular cola”
E. “ i will limit alcohol intake to two drink per day”
A. “I plan to eat small, frequent meals”
B. “ i will eat easy to digest foods with limited spice “
C. “ i will use skim milk when cooking”
