Nokea
A client with a history of chronic alcohol abuse is at risk for which of the following conditions?
- A. Liver cirrhosis
- B. Renal failure
- C. Chronic obstructive pulmonary disease (COPD)
- D. Peptic ulcer disease
Correct Answer: A
Rationale: The correct answer is A: Liver cirrhosis. Chronic alcohol abuse is a leading cause of liver cirrhosis due to the toxic effects of alcohol on the liver over time. Alcohol metabolism leads to liver inflammation, scarring, and ultimately cirrhosis. Renal failure (B) is not directly linked to alcohol abuse but can occur in severe cases. COPD (C) is primarily caused by smoking, not alcohol abuse. Peptic ulcer disease (D) can be exacerbated by alcohol but is not directly caused by chronic alcohol abuse. Therefore, the most significant risk for a client with a history of chronic alcohol abuse is developing liver cirrhosis.
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A client with acute pancreatitis is admitted to the hospital. What is the priority nursing intervention for this client?
- A. Administering oral pancreatic enzymes
- B. Encouraging a high-protein diet
- C. Maintaining NPO status and administering IV fluids
- D. Providing a low-fat diet
Correct Answer: C
Rationale: The priority nursing intervention for a client with acute pancreatitis is maintaining NPO status and administering IV fluids (Choice C). This is because pancreatitis causes inflammation of the pancreas, leading to digestive enzyme release and auto-digestion of pancreatic tissue. By keeping the client NPO, it helps rest the pancreas and decrease enzyme secretion, which can reduce further damage. Administering IV fluids is crucial to maintain hydration and replace lost fluids due to vomiting or decreased oral intake. Choices A, B, and D are incorrect as they focus on dietary interventions such as oral pancreatic enzymes, high-protein, or low-fat diet, which are not appropriate as initial priorities in the acute phase of pancreatitis.
When planning care for a 16-year-old with appendicitis presenting with right lower quadrant pain, what should the nurse prioritize as a nursing diagnosis?
- A. Imbalanced nutrition: Less than body requirements related to decreased oral intake
- B. Risk for infection related to possible rupture of the appendix
- C. Constipation related to decreased bowel motility and decreased fluid intake
- D. Chronic pain related to appendicitis
Correct Answer: B
Rationale: The correct answer is B: Risk for infection related to possible rupture of the appendix. This is the priority nursing diagnosis because appendicitis can lead to a life-threatening condition if the appendix ruptures. The nurse needs to monitor for signs of worsening infection such as fever and increased pain.
A: Imbalanced nutrition is not the priority as it is secondary to the risk of infection.
C: Constipation is not the priority as it is not directly related to the life-threatening complication of appendicitis.
D: Chronic pain is also not the priority as the risk of infection and potential rupture take precedence in the care of the patient.
What nursing intervention can help alleviate pruritus in a client with cirrhosis?
- A. Administering antihistamines
- B. Providing a high-protein diet
- C. Applying emollients to the skin
- D. Encouraging frequent baths with hot water
Correct Answer: C
Rationale: The correct answer is C: Applying emollients to the skin. Pruritus is common in cirrhosis due to bile salt accumulation. Emollients help hydrate and protect the skin, reducing itching. Antihistamines (A) may not be effective for pruritus in cirrhosis. High-protein diet (B) is unrelated to pruritus. Hot water baths (D) can worsen itching by drying out the skin.
What assessments should the nurse prioritize for a client with portal hypertension admitted to the medical floor?
- A. Assessment of blood pressure and evaluation for headaches and visual changes
- B. Assessment for signs and symptoms of venous thromboembolism
- C. Daily weights and measurement of abdominal girth
- D. Monitoring blood glucose every 4 hours
Correct Answer: C
Rationale: The correct answer is C: Daily weights and measurement of abdominal girth. Portal hypertension can lead to fluid retention and ascites, causing weight gain and abdominal distension. Monitoring these parameters helps assess fluid status and effectiveness of treatment.
A: Assessment of blood pressure and evaluation for headaches and visual changes is not a priority as they are not directly related to portal hypertension.
B: Assessment for signs and symptoms of venous thromboembolism is not a priority in this case unless there are specific risk factors present.
D: Monitoring blood glucose every 4 hours is not directly related to portal hypertension and is not a priority in this scenario.
The client was recently diagnosed with chronic gastritis. What health practice should the nurse address when teaching the client to limit exacerbations of the disease?
- A. Perform 15 minutes of physical activity at least three times per week.
- B. Avoid taking aspirin to treat pain or fever.
- C. Take multivitamins as prescribed and eat organic foods whenever possible.
- D. Maintain a healthy body weight.
Correct Answer: B
Rationale: The correct answer is B: Avoid taking aspirin to treat pain or fever. Aspirin can irritate the stomach lining, exacerbating gastritis symptoms. By avoiding aspirin, the client can reduce the risk of worsening gastritis.
A: Physical activity is beneficial for overall health but does not directly impact gastritis exacerbations.
C: While multivitamins and organic foods are generally healthy choices, they do not specifically address gastritis exacerbations.
D: Maintaining a healthy body weight is important for overall health but does not directly prevent gastritis exacerbations.