pancreatitis Qs

Question 1

A hospitalized client with acute pancreatitis has nausea, vomiting, epigastric pain, and tachycardia. Laboratory results show elevated serum lipase levels. Which interventions would the nurse anticipate being prescribed for the client? Select all that apply.

Answer 1

administer hydromorphine IV PRN for pain
IV fluid
NGT for nasogastric suctioning

Question 2

The nurse is caring for a client with right upper quadrant pain and jaundice. The client’s alanine aminotransferase /aspartate aminotransferase (ALT/AST) levels are 7 times the normal values. What questions would be most helpful regarding the etiology for these findings? Select all that apply.

Answer 2

do you use IV drugs ?
how much alcohol
OTC drugs do you take ?

Question 3

The nurse understands that which of these body substances are modes of transmission for hepatitis B? Select all that apply.

Answer 3

blood , semen , Vaginal secretions

Question 4

The nurse assesses a client with suspected acute pancreatitis and anticipates the client reporting pain in which anatomical area?

Answer 4

left upper quadrant

Question 5

The nurse is admitting a client with cholelithiasis and acute cholecystitis. Suddenly, the client vomits 250 mL of greenish-yellow stomach contents and reports severe pain in the right upper quadrant with radiation to the right shoulder. Which intervention would have the highest priority?

Answer 5

maintain NPO

Question 6

The nurse is admitting a client with cholelithiasis and acute cholecystitis. Suddenly, the client vomits 250 mL of greenish-yellow stomach contents and reports severe pain in the right upper quadrant with radiation to the right shoulder. Which intervention would have the highest priority?

Answer 6

assist early ambulation

Question 7

An 80-year-old client has been hospitalized with pneumonia and malnutrition. Physical assessment findings include weakness and decreased muscle mass. Which finding best indicates that the client is responding to treatment?

Answer 7

weight gain of 2ib

Question 8

When assessing a client with cholelithiasis and acute cholecystitis, which findings might the nurse note during the health history and physical examination? Select all that apply.

Answer 8

low grade fever with chills

RUD - right shoulder

Question 9

The nurse is caring for a client with end-stage liver failure from hepatitis C who is being seen in the clinic for worsening ascites. The client is treated in the infusion center with intravenous (IV) albumin, IV furosemide, and oral spironolactone. The following day the nurse checks the client’s labs. Which of the following lab findings is most important for the nurse to communicate to the health care provider?

Answer 9

K 3.0

Question 10

The nurse is preparing medication for 4 clients on a respiratory medical-surgical unit. Which situation would prompt the nurse to clarify the prescribed treatment with the health care provider?

Answer 10

client with bronchospasm who is due ti receive nebulizer acetlcystein

Question 11

The nurse is caring for a client with asthma exacerbation. Blood pressure is 146/86 mm Hg, pulse is 110/min, and respirations are 32/min. The respiratory therapist administers nebulized albuterol as prescribed. One hour after the treatment, the nurse assesses which finding that indicates the drug is producing the therapeutic effect?

Answer 11

respiration of 24

Question 12

The nurse is assessing a client diagnosed with tuberculosis who started taking rifapentine a week ago. Which statement by the client warrants further assessment and intervention by the nurse?

1. "I do not want to get pregnant, so I restarted my oral contraceptive last month." [65%]    2. "I have been taking my medications with breakfast every morning." [11%]    3. "I should alert my health care provider if I notice yellowing of my skin." [11%]
4. "Since I started this medicine, my saliva has become a red-orange color." [11%]

Answer 12

1

Question 13

A pediatric client is diagnosed with an acute asthma attack. Which immediate-acting medications should the nurse prepare to administer to this client? Select all that apply.

1. Albuterol
2. Ibuprofen
3. Ipratropium
4. Montelukast
5. Tobramycin

Answer 13

1,3

Question 14

The community health nurse prepares a teaching plan for a client with latent tuberculosis who is prescribed oral isoniazid (INH). Which instructions should the nurse include? Select all that apply.

1. Avoid drinking alcohol
2. Expect body fluids to change color to red
3. Report yellowing of skin or sclera
4. Report numbness and tingling of extremities
5. Take with aluminum hydroxide to prevent gastric irritation

Answer 14

1,3,4

Question 15

A client is having a severe asthma attack lasting over 4 hours after exposure to animal dander. On arrival, the pulse is 128/min, respirations are 36/min, pulse oximetry is 86% on room air, and the client is using accessory muscles to breathe. Lung sounds are diminished and high-pitched wheezes are present on expiration. Based on this assessment, the nurse anticipates the administration of which of the following medications? Select all that apply.

1. Inhaled albuterol nebulizer every 20 minutes
2. Inhaled ipratropium nebulizer every 20 minutes
3. Intravenous methylprednisolone
4. Montelukast 10 mg by mouth STAT
5. Salmeterol metered-dose inhaler every 20 minutes

Answer 15

1,2,3,

Question 16

The nurse is providing discharge instructions on the proper use of prescribed short-acting beta agonist and inhaled corticosteroid metered-dose inhalers to a client with newly diagnosed asthma. Which instructions should the nurse include? Select all that apply.

1. "Omit the beclomethasone if the albuterol is effective."
2. "Rinse your mouth well after using the beclomethasone inhaler and do not swallow the water."
3. "Take the albuterol inhaler apart and wash it after every use."
4. "Use the albuterol inhaler first if needed, then the beclomethasone inhaler."
5. "Use the beclomethasone inhaler first, then the albuterol, if needed."

Answer 16

2,3

Question 17

The nurse is teaching a client with advanced chronic obstructive pulmonary disease who was prescribed oral theophylline. Which client statement indicates that additional teaching is required?

1. “I need to avoid caffeinated products.” [4%]
2. “I need to get my blood drug levels checked periodically.” [11%]
3. “I need to report anorexia and sleeplessness.” [9%]
   4. “I take cimetidine rather than omeprazole for heartburn.” [74%]

Answer 17

4

Question 18

Exhibit

A client with a history of degenerative arthritis is being discharged home following an exacerbation of chronic obstructive pulmonary disease. After reviewing the discharge medications, the nurse should educate the client about which topics? Select all that apply. Click on the exhibit button for additional information.

1. Dryness of the mouth and throat may occur
2. Ringing in the ears is an expected, transient side effect
3. The albuterol canister should not be shaken before use
4. The health care provider should be notified if stools are black and tarry
5. Tiotropium capsules should not be swallowed

Answer 18

1,4,5

Question 19

A client with asthma was recently prescribed fluticasone/salmeterol. After the client has received instructions about this medication, which statement would require further teaching by the nurse?

1. “After taking this medication, I will rinse my mouth with water.” [7%]
   2. “At the first sign of an asthma attack, I will take this medication.” [73%]
2. “I have been smoking for 12 years, but I just quit a month ago.” [9%]
3. “I received the pneumococcal vaccine about a month ago.” [9%]

Answer 19

2

Question 20

A client with asthma was recently prescribed fluticasone/salmeterol. After the client has received instructions about this medication, which statement would require further teaching by the nurse?

1. “After taking this medication, I will rinse my mouth with water.” [7%]
   2. “At the first sign of an asthma attack, I will take this medication.” [73%]
2. “I have been smoking for 12 years, but I just quit a month ago.” [9%]
3. “I received the pneumococcal vaccine about a month ago.” [9%]

Answer 20

2

Question 21

An elderly client is prescribed codeine for a severe cough. The home health nurse teaches the client how to prevent the common adverse effects associated with codeine. Which client statements indicate an understanding of how to prevent them? Select all that apply.

1. "I'll be sure to apply sunscreen if I go outside."
2. "I'll drink at least 8 glasses of water a day."
3. "I'll drink decaffeinated coffee so I can sleep at night."
4. "I'll sit on the side of my bed for a few minutes before getting up."
5. "I'll take my medicine with food."

Answer 21

2,4,5

Question 22

A nurse has received new medication prescriptions for a client admitted with hypertension and an exacerbation of chronic obstructive pulmonary disease. Which prescription should the nurse question?

1. Amlodipine [12%]
   2. Codeine [63%]
2. Ipratropium [13%]
3. Methylprednisolone [11%]

Answer 22

2

Question 23

A client is scheduled for allergy skin testing to identify asthmatic triggers. Which medications should the nurse instruct the client to withhold before the test to ensure accurate results? Select all that apply.

1. Acetaminophen
2. Albuterol
3. Diphenhydramine
4. Enalapril
5. Loratadine

Answer 23

3,4

Question 24

The nurse reviews and reinforces an asthma action plan with a client who has moderate persistent asthma. Which statement by the client indicates an understanding of how to follow a plan appropriately when peak expiratory flow (PEF) readings are in the green, yellow, or red zones?

1. “If I am in the green zone (PEF 80%-100% of personal best) but am coughing, wheezing, and having more trouble breathing, I will not make any changes in my medications.”
2. “If I am in the yellow zone (50%-80%) and I return to the green zone after taking my rescue medication, I will not make any changes in my daily medications.”
3. “If I am in the yellow zone (50%-80%), I will take my rescue medication every 4 hours for 1-2 days and call my health care provider (HCP) for follow-up care.”
4. “If I remain in the red zone, my lips are blue, and my PEF is still <50% of my personal best reading after taking my rescue medication, I will wait 15 minutes before calling an ambulance.”

Answer 24

3

Question 25

A nurse is caring for a college athlete who was recently diagnosed with moderate persistent asthma. Which common asthma trigger should the nurse teach this client to avoid?

1. Latex-containing products [2%]
2. Penicillin antibiotics [0%]
   3. Secondhand cigarette smoke [62%]
3. Strenuous physical activity [34%]

Answer 25

3

Question 26

The nurse is reviewing discharge instructions with the parents of a child who just had a tracheostomy. Which statement made by the parents indicates teaching has been effective?

1. "I will always travel with two tracheostomy tubes, one of the same size and one a size smaller." [58%]    2. "I will immediately change the tracheostomy tube if my child has difficulty breathing." [8%]
3. "I will provide deep suctioning frequently to prevent any airway obstruction." [21%]    4. "I will remove the humidifier if my child starts developing more secretions." [11%]

Answer 26

1

Question 27

The nurse is administering IV hydromorphone to a client every 3-4 hours as needed for postoperative pain. Which interventions should the nurse implement? Select all that apply

Answer 27

Administer PRN steel softener

tell client to call for assistance

Question 28

A client presents to the emergency department with a stab wound to the chest. The nurse assesses tachycardia, tachypnea, and a sucking sound coming from the wound. Which of the following actions is priority?

Answer 28

cover the wound