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A client with a peptic ulcer is prescribed sucralfate. Which statement by the client indicates an understanding of the medication?
- A. I should take sucralfate at least 1 hour before meals and at bedtime.
- B. I will avoid taking antacids completely while I'm on sucralfate.
- C. I should take sucralfate right before meals and at bedtime.
- D. I can expect immediate relief of my ulcer symptoms after taking sucralfate.
Correct Answer: A
Rationale: Sucralfate (A) should be taken 1 hour before meals and at bedtime to coat the stomach effectively. Antacids (B) can be used cautiously, and immediate relief (D) or taking it with meals (C) is incorrect.
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The following scenario applies to the next 1 items
The nurse is caring for an older adult in the medical-surgical unit
Item 1 of 1
Health History
84-year-old female was admitted to the medical-surgical unit with a three-day history of abdominal pain, distention, nausea, and persistent vomiting. She reports that she has not had a bowel movement in five days and has no appetite.
Vital Signs
Oral temperature 101.1° F (38.3° C)
Pulse 108/minute
Respirations 22/minute
Blood pressure 100/64 mm Hg
Oxygen saturation 96% on room air.
The nurse reviews the client's health history and vital signs. Click to specify if the findings are consistent with a small bowel obstruction or appendicitis. Each row must have at least one but may have more than one response option selected.
- A. Unable to pass stool
- B. Fever
- C. Distended abdomen
- D. Right lower quadrant abdominal pain
- E. Nausea and vomiting
Correct Answer: A,B,C,E;A,B,C,D,E
Rationale: Small bowel obstruction: A (Unable to pass stool), B (Fever), C (Distended abdomen), E (Nausea and vomiting). Appendicitis: A, B, C, D (Right lower quadrant abdominal pain), E. Both conditions can present with these symptoms, though right lower quadrant pain is more specific to appendicitis.
The nurse has just finished assisting the physician in performing a paracentesis. What should be the priority nursing intervention following the procedure?
- A. Administer analgesics to control pain
- B. Monitor for signs of infection
- C. Monitor for signs of hypovolemia
- D. Ensure that the ascitic fluid is sent to the lab for analysis
Correct Answer: C
Rationale: Monitoring for hypovolemia (C) is critical after paracentesis due to the risk of fluid shifts from removing large volumes of ascitic fluid.
The nurse is caring for a client with appendicitis experiencing pain. Which pain relief method would be inappropriate for this client?
- A. Applying ice packs to the abdomen
- B. Practicing breathing exercises with the patient
- C. Using a heating pad on the abdomen
- D. Encouraging rest
Correct Answer: C
Rationale: Using a heating pad on the abdomen is inappropriate for a client with appendicitis as it may increase inflammation or risk perforation of the appendix. Ice packs, breathing exercises, and rest are safer and more appropriate for pain management.
The nurse is admitting a client newly diagnosed with acute pancreatitis. The nurse should anticipate a prescription for which medication?
- A. 3% saline infusion
- B. Fentanyl
- C. Diphenoxylate-atropine
- D. Sucralfate
Correct Answer: B
Rationale: Fentanyl is used for pain management in acute pancreatitis, which is often severe. 3% saline is not standard, diphenoxylate-atropine treats diarrhea (not a primary symptom), and sucralfate is for ulcers, not pancreatitis.
The nurse is caring for an undernourished client who recently began receiving total parenteral nutrition (TPN). Which laboratory value would indicate that the client is responding to treatment?
- A. Fasting blood glucose: 129 mg/dL (7.15 mmol/L) [70-110 mg/dL, 4.0–6.0 mmol/L]
- B. White blood cell (WBC) count: 12,000 mm3 (0.012×10⁹/L) [4,000-11,000 cells/µL,3.5–10.5 × 10⁹/L]
- C. Albumin: 3.6 g/dL [3.5-5 g/dL]
- D. Urine specific gravity: 1.040 [1.005-1.030]
Correct Answer: C
Rationale: Albumin within the normal range (3.6 g/dL) indicates improved nutritional status, a goal of TPN. Elevated glucose, WBC, and urine specific gravity suggest other issues (e.g., hyperglycemia, infection, dehydration) not directly related to TPN’s therapeutic effect.