Nokea
The disease that is on the increase because of the growing obesity population and is associated with coronary artery disease and use of corticosteroids is
Correct Answer: nonalcoholic fatty liver disease (NAFLD)
Rationale: NAFLD is a disease that is on the rise due to the increasing population of obese persons. The disease is also associated with CAD and the use of corticosteroids.
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Which assessment is the priority assessment for a patient who will be undergoing intravenous cholangiography?
- A. Patency of the intravenous line
- B. Ensure the patient is fasting prior to the exam
- C. An allergy to the iodine based radiographic dye
- D. Whether or not the patient has signed the consent form
Correct Answer: C
Rationale: If the patient is allergic to the radiographic dye, a potentially life-threatening anaphylactic reaction could occur. Assessing for patency of the intravenous line and ensuring the patient is fasting prior to the exam are important, but these would not likely cause a potentially life-threatening problem. It is crucial to determine if the patient has signed a consent form, but this is would not be life threatening to the patient. There would be legal ramifications for the nurse, health care provider, and facility.
Which medical intervention and management system controls the bleeding of esophageal varices?
- A. Transfusions
- B. Sengstaken-Blakemore (S/B) tube
- C. Band ligation
- D. Cryotherapy
- E. Portacaval shunt
- F. Large doses of vitamin B12
Correct Answer: B,C,E
Rationale: Band ligation, insertion of the tube, and various shunting surgeries are helpful in stopping the hemorrhage. Transfusions, cryotherapy, and water-soluble vitamins are not beneficial.
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.
Which should the nurse explain is the major purpose of the Sengstaken-Blakemore tube (S/B tube)?
- A. Decompress the stomach.
- B. Control esophageal varices bleeding.
- C. A route for tube feedings.
- D. Obtain specimen for gastric analyzing.
Correct Answer: B
Rationale: The major purpose of the S/B tube is to control bleeding by pressure against the vessels in the esophagus. The two balloons of the tube are inflated to put direct pressure on the esophagus and are anchored by the inflated balloon in the stomach. The tube can suction blood from the stomach as well.
What is the challenge in encouraging coughing and deep breathing for a postoperative patient who had an open cholecystectomy?
- A. High placement of incision
- B. Excessive nausea
- C. Weakened abdominal muscles
- D. Poor oxygenation
Correct Answer: A
Rationale: The high placement of the incision of the cholecystectomy makes the patient reluctant to cough. Splinting the incision is beneficial.