Nokea
A client with liver cirrhosis is prescribed lactulose. What is the purpose of this medication?
- A. To lower blood sugar levels
- B. To reduce ammonia levels
- C. To treat liver inflammation
- D. To improve bile flow
Correct Answer: B
Rationale: Rationale: Lactulose is prescribed for liver cirrhosis to reduce ammonia levels. It works by promoting the excretion of ammonia in the stool, preventing its accumulation in the bloodstream. This helps prevent hepatic encephalopathy, a serious complication of cirrhosis. Other choices are incorrect because lactulose does not directly affect blood sugar levels, liver inflammation, or bile flow in the context of liver cirrhosis.
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A patient with cirrhosis of the liver and ascites is scheduled for a paracentesis. What should the nurse do to prepare the patient for the procedure?
- A. Have the patient void immediately before the procedure.
- B. Position the patient flat in bed.
- C. Administer a full liquid diet.
- D. Encourage the patient to ambulate for 30 minutes.
Correct Answer: A
Rationale: The correct answer is A: Have the patient void immediately before the procedure. This step is crucial to prevent accidental puncture of the bladder during paracentesis. Voiding helps empty the bladder, reducing the risk of injury and ensuring a safer procedure.
Incorrect choices:
B: Position the patient flat in bed - Incorrect, as the patient should be in a sitting position with legs dangling over the side of the bed during the procedure.
C: Administer a full liquid diet - Incorrect, as a full liquid diet is not necessary for paracentesis preparation.
D: Encourage the patient to ambulate for 30 minutes - Incorrect, as ambulation is not relevant to preparing for paracentesis.
A client with a new diagnosis of diabetes mellitus is learning to self-administer insulin. Which instruction should the nurse include?
- A. Store the insulin in the freezer.
- B. Administer the insulin at the same site each time.
- C. Rotate injection sites within the same region.
- D. Shake the vial vigorously before drawing up the insulin.
Correct Answer: C
Rationale: The correct answer is C: Rotate injection sites within the same region. This is important to prevent lipohypertrophy and ensure proper insulin absorption. Administering insulin at the same site each time (B) can lead to tissue damage. Storing insulin in the freezer (A) can alter its effectiveness. Shaking the vial vigorously (D) can cause air bubbles and affect insulin dosage accuracy. Rotation of injection sites within the same region is crucial for consistent absorption and preventing complications.
Prior to elective surgery, a patient taking warfarin should receive which instruction regarding warfarin therapy?
- A. Continue taking warfarin until the day of surgery.
- B. Stop taking warfarin three days before surgery.
- C. Switch to aspirin before surgery.
- D. Stop taking warfarin one week before surgery.
Correct Answer: D
Rationale: The correct answer is D because stopping warfarin one week before surgery reduces the risk of excessive bleeding during the procedure. Warfarin's anticoagulant effect can persist for several days, so stopping it earlier allows time for its effects to diminish. Choice A is incorrect because continuing warfarin until the day of surgery increases bleeding risk. Choice B is incorrect as stopping warfarin only three days before surgery may not provide enough time for the anticoagulant effect to wear off. Choice C is incorrect as aspirin is not a suitable substitute for warfarin in most cases.
What is the primary action of a short-acting beta2-agonist (SABA) prescribed to a patient with an acute asthma exacerbation?
- A. Reduce inflammation
- B. Relieve bronchospasm
- C. Thin respiratory secretions
- D. Suppress cough
Correct Answer: B
Rationale: The correct answer is B: Relieve bronchospasm. Short-acting beta2-agonists (SABAs) like albuterol act by stimulating beta2 receptors in the airway smooth muscle, leading to bronchodilation and relieving bronchospasm. This helps to quickly open up the airways during an acute asthma exacerbation. Choice A is incorrect because SABAs do not directly reduce inflammation. Choice C is incorrect as SABAs do not affect respiratory secretions. Choice D is incorrect as SABAs do not suppress cough but rather target bronchospasm.
A client with liver cirrhosis is being educated about managing their condition. Which statement by the client indicates a need for further teaching?
- A. I will avoid drinking alcohol
- B. I need to limit my salt intake
- C. I can take acetaminophen for pain
- D. I should eat a balanced diet
Correct Answer: C
Rationale: The correct answer is C: "I can take acetaminophen for pain." Acetaminophen can be harmful to the liver, especially in individuals with liver cirrhosis. The liver is responsible for metabolizing acetaminophen, and in cirrhosis, its function is impaired, leading to potential toxicity. Choice A is correct as alcohol can worsen liver damage. Choice B is correct as excess salt can lead to fluid retention and complications. Choice D is correct as a balanced diet is important for overall health. Therefore, the statement about taking acetaminophen indicates a need for further teaching.