Nokea
A client with liver dysfunction is having difficulty with protein metabolism. The nurse anticipates that the results of which of the following serum laboratory studies will be elevated?
- A. Lactic acid
- B. Ammonia
- C. Albumin
- D. Lactase
Correct Answer: B
Rationale: During deamination of proteins, the liver splits the amino group from the carbon-containing compound, which results in the formation of ammonia and a carbon residue. The liver then converts the toxic ammonia substance into urea, which can be excreted by the kidneys. Clients with liver dysfunction may have high serum ammonia levels as a result.
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The nurse is evaluating the plan of care for a client with peptic ulcer disease with a nursing diagnosis of Acute Pain. The nurse would determine that the client has not met the expected outcomes if the client states
- A. That pain is relieved with histamine H2 receptor antagonists.
- B. That irritating foods have been eliminated from the diet.
- C. The client is being awakened at 2 AM with heartburn.
- D. The client has absence of pain before meals.
Correct Answer: C
Rationale: Expected outcomes for the client with peptic ulcer disease experiencing pain include elimination of irritating foods from the diet, ability to take prescribed medications that will reduce pain, reporting that the pain is relieved or prevented with medication, and an ability to sleep through the night without pain. The client who continues to be awakened by pain requires further modification of medication therapy, which may include adjustment of timing of histamine H2 receptor antagonist or an additional dose of antacid before the time when pain awakens the client.
Mucosal barrier fortifiers are used in peptic ulcer disease management for which of the following indications?
- A. To inhibit mucus production
- B. To neutralize acid production
- C. To stimulate mucus production
- D. To stimulate hydrogen ion diffusion back into the mucosa
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The nurse is caring for a client with chronic gastritis. The nurse monitors the client, knowing that this client is at risk for which of the following vitamin deficiencies?
- A. Vitamin A
- B. Vitamin B12
- C. Vitamin C
- D. Vitamin E
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A female client complains of gnawing epigastric pain for a few hours after meals. At times, when the pain is severe, vomiting occurs. Specific tests are indicated to rule out:
- A. Cancer of the stomach
- B. Peptic ulcer disease
- C. Chronic gastritis
- D. Pylorospasm
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The client has orders for a nasogastric (NG) tube insertion. During the procedure, instructions that will assist in the insertion would be:
- A. Instruct the client to tilt his head back for insertion in the nostril, then flex his neck for the final insertion
- B. After insertion into the nostril, instruct the client to extend his neck
- C. Introduce the tube with the client's head tilted back, then instruct him to keep his head upright for final insertion
- D. Instruct the client to hold his chin down, then back for insertion of the tube
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.