Nokea
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.
You may also like to solve these questions
The client with chronic pancreatitis needs information on dietary modification to manage the health problem. The nurse teaches the client to limit which of the following items in the diet?
- A. Carbohydrate
- B. Protein
- C. Fat
- D. Water-soluble vitamins
Correct Answer: C
Rationale: The correct answer is C: Fat. In chronic pancreatitis, the pancreas struggles to produce digestive enzymes, leading to poor fat digestion. Limiting fat intake can help reduce symptoms like abdominal pain and diarrhea. Carbohydrates and proteins are essential for energy and tissue repair, so limiting them is not ideal. Water-soluble vitamins are generally well-absorbed and do not require restriction in chronic pancreatitis.
A home care nurse is visiting a client with a diagnosis of pernicious anemia that developed as a result of gastric surgery. The nurse instructs the client that because the stomach lining produces a decreased amount of intrinsic factor in this disorder, the client will need
- A. Vitamin B12 injections.
- B. Vitamin B6 injections.
- C. An antibiotic.
- D. An antacid.
Correct Answer: A
Rationale: The correct answer is A: Vitamin B12 injections. Pernicious anemia results from a lack of intrinsic factor, which is necessary for the absorption of vitamin B12 in the intestines. Therefore, the client with this disorder will need vitamin B12 injections to bypass the need for intrinsic factor.
Choice B (Vitamin B6 injections) is incorrect because pernicious anemia specifically involves a deficiency in vitamin B12, not B6. Choice C (An antibiotic) is incorrect as antibiotics are not indicated for pernicious anemia. Choice D (An antacid) is also incorrect as it does not address the underlying issue of vitamin B12 deficiency caused by the lack of intrinsic factor.
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 giving dietary instructions to a client who has a new colostomy. The nurse encourages the client to eat foods representing which of the following diets for the first 4 to 6 weeks postoperatively?
- A. High-protein
- B. High-carbohydrate
- C. Low-calorie
- D. Low-residue
Correct Answer: D
Rationale: The correct answer is D: Low-residue. After colostomy surgery, the bowel needs time to heal. A low-residue diet helps reduce the amount of undigested food passing through the colon, easing digestion and minimizing strain on the stoma. This diet typically includes easily digestible foods like white bread, rice, pasta, and well-cooked vegetables. High-protein (choice A) and high-carbohydrate (choice B) diets can be harder to digest and may cause discomfort. A low-calorie diet (choice C) is not necessary during the initial postoperative period when the focus should be on promoting healing and comfort.
Of the following signs and symptoms of bowel obstruction, which is related primarily to small bowel obstruction rather than large bowel obstruction?
- A. Profuse vomiting.
- B. Cramping abdominal pain.
- C. Abdominal distention.
- D. High-pitched bowel sounds above the obstruction.
Correct Answer: A
Rationale: The correct answer is A: Profuse vomiting. In small bowel obstruction, the vomitus is typically profuse, as the small bowel is narrower and more distensible than the large bowel. This leads to rapid accumulation of gastric contents resulting in frequent vomiting. Cramping abdominal pain (B) can occur in both small and large bowel obstruction. Abdominal distention (C) is a common symptom in both types of obstruction due to the accumulation of gas and fluid. High-pitched bowel sounds above the obstruction (D) are indicative of partial obstruction and can be present in both small and large bowel obstruction.