Nokea
A patient with cirrhosis of the liver will have which blood test results monitored?
- A. Blood urea nitrogen (BUN)
- B. Platelet counts
- C. Aspartate aminotransferase (AST)
- D. Hemoglobin and Hematocrit (HGB and HCT)
Correct Answer: C
Rationale: The nurse will monitor the patient with cirrhosis for an elevated AST level which would indicate worsening liver function. The BUN monitors kidney function. The platelet count is part of the complete blood count which is not necessary to monitor with cirrhosis. The HGB and HCT monitor for anemia.
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Why is morphine contraindicated in the patient with pancreatitis?
- A. Meperidine is less expensive.
- B. Tylenol is more effective at managing this type of pain.
- C. Morphine may cause spasms of the sphincter of Oddi.
- D. These patients do not experience pain.
Correct Answer: C
Rationale: A common complaint is constant, severe pain; in such cases, meperidine is often administered. Morphine may cause spasms of the sphincter of Oddi.
The nurse clarifies that which event happens to unconjugated bilirubin, which is made up of broken-down red cells?
- A. It is stored in the gallbladder to make bile.
- B. Water-insoluble bilirubin must be converted by the liver.
- C. A by-product is excreted directly into the bowel for excretion.
- D. Red blood cells are necessary for digestion of fats.
Correct Answer: B
Rationale: Unconjugated bilirubin is a water-insoluble product that must be converted in the liver to conjugated bilirubin (water soluble) so that it may be excreted through the bowel.
The nurse assisting in the treatment of a patient with ruptured esophageal varices who has received vasopressin IV will carefully assess for which complication?
- A. muscular twitching/spasm.
- B. hematuria.
- C. macular rash on trunk and arms.
- D. evidence of cardiac ischemia.
Correct Answer: D
Rationale: Vasopressin is a strong vasoconstrictor given to try to stop the hemorrhage of the varices. Unfortunately it also constricts all vessels and may cause cardiac ischemia.
A patient with pancreatitis is on nothing by mouth status (NPO). The patient asks the nurse 'Why am I unable to have anything by mouth?'. Which is the best response?
- A. Diagnostic tests depend on you not eating anything.'
- B. The pancreas is stimulated whenever you eat or drink and causes pain.'
- C. Eating causes the need for a bowel movement, which excretes your medication too rapidly.'
- D. Resting your gastrointestinal tract will cure your pancreatitis.'
Correct Answer: B
Rationale: Food and fluids are withheld to avoid stimulating pancreatic activity, and IV fluids are administered.
The nurse clarifies that deterioration progresses through stages before presenting with liver disease. The first stage is destruction. What is the last stage?
- A. Liver disease
- B. Inflammation
- C. Hepatic insufficiency
- D. Destruction
- E. Fibrotic regeneration
Correct Answer: A
Rationale: Liver deterioration follows a pattern of stages: destruction, inflammation, fibrotic regeneration; hepatic insufficiency then presents as liver disease.