Nokea
A nurse is reviewing the results of serum laboratory studies drawn on a client who is suspected of having hepatitis. The nurse interprets that an elevation in which of the following studies is the most specific indicator of the disease?
- A. Erythrocyte sedimentation rate
- B. Serum bilirubin
- C. Hemoglobin
- D. Blood urea nitrogen
Correct Answer: C
Rationale: The correct answer is C: Hemoglobin. In hepatitis, there is destruction of red blood cells, leading to decreased hemoglobin levels. This is a specific indicator of the disease. The other choices are incorrect because A (ESR) is a nonspecific marker of inflammation, B (serum bilirubin) is elevated in liver dysfunction but not specific to hepatitis, and D (BUN) is a measure of kidney function, not related to hepatitis. Hemoglobin, being directly affected by the disease process in hepatitis, is the most specific indicator among the options provided.
You may also like to solve these questions
A client is scheduled for an abdominal perineal resection with permanent colostomy. Which of the following measures would most likely be included in the plan for the client's preoperative preparation?
- A. Keep the client NPO for 2 days before surgery.
- B. Administer kanamycin (Kantrex) the night before surgery.
- C. Inform the client that chest tubes will be in place after surgery.
- D. Advise the client to limit activity.
Correct Answer: B
Rationale: The correct answer is B: Administer kanamycin (Kantrex) the night before surgery. This antibiotic is typically given preoperatively to reduce the risk of infection during the surgical procedure. It helps to eliminate or reduce the number of bacteria in the gastrointestinal tract, which could potentially contaminate the surgical site during the abdominal perineal resection with permanent colostomy.
A: Keeping the client NPO for 2 days before surgery is not necessary for this procedure and could lead to unnecessary dehydration and discomfort.
C: Informing the client that chest tubes will be in place after surgery is not directly related to preoperative preparation for this specific surgery.
D: Advising the client to limit activity is important for postoperative recovery, but it is not a preoperative measure specific to this surgery.
A client with ulcerative colitis is diagnosed with a mild case of the disease. The nurse doing dietary teaching gives the client examples of foods to eat that represent which of the following therapeutic diets?
- A. High-fat with milk
- B. High-protein without milk
- C. Low-roughage without milk
- D. Low-roughage with milk
Correct Answer: C
Rationale: The correct answer is C: Low-roughage without milk. In mild cases of ulcerative colitis, a low-roughage diet is recommended to reduce irritation to the colon. Roughage can exacerbate symptoms. Avoiding milk is also common as lactose intolerance may develop. High-fat (A) and high-protein (B) diets can be difficult to digest and may worsen symptoms. Low-roughage with milk (D) is incorrect as milk can irritate the colon in some individuals with ulcerative colitis.
A nurse is assigned to a 40-year-old client who has a diagnosis of chronic pancreatitis. The nurse reviews the laboratory result, anticipating a laboratory report that indicates a serum amylase level of
- A. 45 units/L
- B. 100 units/L
- C. 300 units/L
- D. 500 units/L
Correct Answer: C
Rationale: The correct answer is C (300 units/L) because in chronic pancreatitis, there is ongoing inflammation and damage to the pancreas, leading to elevated serum amylase levels. A level of 300 units/L is indicative of pancreatitis. Choices A and B are too low for chronic pancreatitis, and choice D is too high and would typically be seen in acute pancreatitis.
Which nursing measure would be most effective in helping the client cough and deep breathe after a cholecystectomy?
- A. Having the client take rapid, shallow breaths to decrease pain.
- B. Having the client lay on the left side while coughing and deep breathing.
- C. Teaching the client to use a folded blanket or pillow to splint the incision.
- D. Withholding pain medication so the client can be alert enough to follow the nurse's instructions.
Correct Answer: C
Rationale: The correct answer is C: Teaching the client to use a folded blanket or pillow to splint the incision. This measure helps support the incision site, reducing pain during coughing and deep breathing. Splinting the incision promotes effective coughing and deep breathing post-surgery, aiding in lung expansion and preventing complications like atelectasis.
Explanation of why other choices are incorrect:
A: Having the client take rapid, shallow breaths to decrease pain is incorrect as it can lead to inadequate lung expansion and retention of secretions.
B: Having the client lay on the left side while coughing and deep breathing is incorrect as it does not directly support the incision site and may not be as effective in reducing pain.
D: Withholding pain medication so the client can be alert enough to follow the nurse's instructions is incorrect as pain management is crucial post-surgery for comfort and optimal recovery.
A client who has had gastrectomy is not producing sufficient intrinsic factor. The nurse interprets that the client has lost the ability to absorb cyanocobalamin (vitamin B12) in the
- A. Stomach.
- B. Small intestine.
- C. Large intestine.
- D. Colon.
Correct Answer: B
Rationale: The correct answer is B: Small intestine. After a gastrectomy, where the stomach is removed or bypassed, intrinsic factor production is reduced, impacting the absorption of vitamin B12. Intrinsic factor is necessary for the absorption of B12 in the small intestine, specifically in the ileum. If vitamin B12 is not absorbed in the small intestine, it can lead to pernicious anemia. Therefore, the small intestine is crucial for the absorption of vitamin B12 in the absence of intrinsic factor. Choices A, C, and D are incorrect as the stomach, large intestine, and colon do not play a significant role in the absorption of vitamin B12.