Nokea
A nurse is developing a teaching plan for the client with viral hepatitis. The nurse plans to tell the client which of the following in the teaching session?
- A. Activity should be limited to prevent fatigue
- B. The diet should be low in calories
- C. Meals should be large to conserve energy
- D. Alcohol intake should be limited to 2 oz. per day.
Correct Answer: A
Rationale: The correct answer is A. For a client with viral hepatitis, limiting activity helps prevent fatigue and aids in recovery. Excessive activity can worsen symptoms. Choice B is incorrect because a low-calorie diet may not provide enough nutrients for the body to fight the infection. Choice C is incorrect as large meals can strain the liver and worsen symptoms. Choice D is incorrect as any alcohol intake can further damage the liver in viral hepatitis. In summary, choice A is correct as it promotes rest and aids recovery, while the other choices can potentially worsen the condition.
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Lactulose (Chronulac) is prescribed for a client with a diagnosis of hepatic encephalopathy. The nurse would determine that this medication has had a therapeutic effect if which of the following is noted?
- A. Increased red blood cell count
- B. Decreased serum ammonia level
- C. Increased protein level
- D. Decreased white blood cell level
Correct Answer: B
Rationale: The correct answer is B: Decreased serum ammonia level. Lactulose is used to treat hepatic encephalopathy by reducing serum ammonia levels through its laxative effect, promoting the excretion of ammonia in the feces. Decreased ammonia levels indicate that the medication is effectively managing the condition. Increased red blood cell count (A), increased protein level (C), and decreased white blood cell level (D) are not directly related to the therapeutic effect of lactulose in hepatic encephalopathy.
A 30-year-old woman is admitted to the hospital with complaints of severe abdominal cramping and diarrhea. The nurse evaluates the effectiveness of the patient's intravenous therapy. Which of the following laboratory tests BEST reflects hydration status?
- A. Erythrocyte sedimentation rate.
- B. White blood cell count.
- C. Hematocrit.
- D. Serum glucose.
Correct Answer: C
Rationale: The correct answer is C: Hematocrit. Hematocrit reflects the proportion of red blood cells in the blood and can indicate hydration status. When a person is dehydrated, their blood becomes more concentrated, leading to an increase in hematocrit levels. In this case, severe abdominal cramping and diarrhea can cause dehydration, making hematocrit the best indicator of hydration status.
Explanation for other choices:
A: Erythrocyte sedimentation rate is a nonspecific marker of inflammation and not directly related to hydration status.
B: White blood cell count is an indicator of infection or inflammation, not hydration status.
D: Serum glucose levels are related to blood sugar regulation, not hydration status.
The nurse provides discharge instructions to a patient with hepatitis B. Which of the following statements, if made by the patient, would indicate the need for further instruction?
- A. I can never donate blood.
- B. I can never have unprotected sex.
- C. I cannot share needles.
- D. I should avoid drugs and alcohol.
Correct Answer: D
Rationale: Rationale for Correct Answer (D): The patient should avoid drugs and alcohol to prevent further damage to the liver affected by hepatitis B. Substance abuse can exacerbate liver disease. This statement indicates understanding of the importance of liver health.
Summary of Other Choices:
A: This statement is correct because individuals with hepatitis B should not donate blood to prevent transmission.
B: This statement is correct because unprotected sex can transmit hepatitis B to sexual partners.
C: This statement is correct because sharing needles can spread hepatitis B through blood-to-blood contact.
The client with a colostomy has an order for irrigation of the colostomy. The nurse uses which solution for the irrigation?
- A. Distilled water
- B. Tap water
- C. Sterile water
- D. Lactated Ringer's
Correct Answer: B
Rationale: The correct answer is B: Tap water. Tap water is used for colostomy irrigation as it is isotonic and won't disrupt electrolyte balance. Distilled water (A) can cause electrolyte imbalances. Sterile water (C) may not be necessary, and Lactated Ringer's (D) is not typically used for colostomy irrigation.
The nurse is preparing a discharge teaching plan for the client who had an umbilical hernia repair. Which of the following would the nurse include in the plan?
- A. Restricting pain medication
- B. Maintaining bedrest
- C. Avoiding coughing
- D. Irrigating the drain
Correct Answer: C
Rationale: The correct answer is C: Avoiding coughing. After umbilical hernia repair, coughing can increase intra-abdominal pressure and strain the surgical site, leading to potential complications like hernia recurrence or wound dehiscence. It is crucial to advise the client to avoid coughing to promote proper healing.
A: Restricting pain medication is not necessary as pain management is essential for the client's comfort and recovery.
B: Maintaining bedrest is not typically required after umbilical hernia repair, as early ambulation is often encouraged to prevent complications like blood clots.
D: Irrigating the drain is not typically part of the discharge teaching plan for umbilical hernia repair, as drains are usually removed before discharge.