Nokea
The experienced nurse is instructing the new nurse. The experienced nurse explains that the definitive diagnosis of PUD involves which test?
- A. A urea breath test
- B. Upper GI endoscopy with biopsy
- C. Barium contrast studies
- D. The string test
Correct Answer: B
Rationale: A. A urea breath test only tests for the presence of Helicobacter pylori (H. pylori). B. The gastric mucosa can be visualized with an endoscope. A biopsy is possible to differentiate PUD from gastric cancer and to obtain tissue specimens to identify H. pylori. These are used to make a definitive diagnosis of PUD. C. Barium studies do not provide an opportunity for biopsy and H. pylori testing. D. A urea breath test and a string test only test for the presence of H . pylori.
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While reviewing the client’s medical records, the nurse notes the diagnosis of biliary colic. Considering this diagnosis, which additional sign will the nurse most likely find in the client’s medical record?
- A. Bloody diarrhea
- B. Heartburn and regurgitation
- C. Abdominal distention
- D. Severe abdominal pain
Correct Answer: D
Rationale: A. Diarrhea is not related to biliary colic. B. Heartburn and regurgitation are not related to biliary colic. C. Abdominal distention is not related to biliary colic. D. Biliary colic is the term used for the severe pain that is caused by a gallstone lodged in the cystic or common bile duct and/or traveling through the ducts. The presence of the stone causes the duct to spasm, causing severe abdominal pain.
The client is admitted to a medical unit. The client’s medication list includes rifaximin, lactulose, and propranolol. Which assessment should be the nurse’s priority based on the client’s medication list?
- A. Assess the client for a history of PUD.
- B. Assess the client for abdominal pain.
- C. Place the client on airborne precautions.
- D. Assess neurological status and abdominal girth.
Correct Answer: D
Rationale: A. Antibiotics and acid-reducing medications are expected with the treatment of PUD, but propranolol (Inderal) would not be expected. Although these medications may cue the nurse to further explore a history of PUD, this is not the most likely conclusion. B. There is no indication that the client has abdominal pain, and there isn’t an analgesic on the medication list. C. There is no indication that the client has an infectious condition necessitating airborne precautions. D. All medications listed are used to treat liver cirrhosis and its complications of portal hypertension and hepatic encephalopathy. The antibiotic rifaximin (Xifaxan) and the laxative lactulose (Cephulac) are used for treating hepatic encephalopathy. Thus, assessing the client’s neurological status and measuring abdominal girth are most important.
Which instruction should the nurse discuss with the client who is in the icteric phase of hepatitis C?
- A. Decrease alcohol intake.
- B. Encourage rest periods.
- C. Eat a large evening meal.
- D. Drink diet drinks and juices.
Correct Answer: B
Rationale: Rest periods conserve energy and support recovery during the icteric phase of hepatitis C, when jaundice and fatigue are prominent. Alcohol avoidance is general advice, and diet changes are less specific.
The client with a diagnosis of rule-out colon cancer is two (2) hours post-sigmoidoscopy procedure. Which assessment data warrant immediate intervention by the nurse?
- A. The client has hyperactive bowel sounds.
- B. The client is eating a hamburger the family brought.
- C. The client is sleepy and wants to sleep.
- D. The client's BP is 96/60 and apical pulse is 108.
Correct Answer: D
Rationale: Low BP (96/60) and tachycardia (pulse 108) suggest hypovolemia or bleeding post-sigmoidoscopy, requiring immediate intervention. Hyperactive bowel sounds, eating, and sleepiness are less urgent.
The nurse is preparing a client diagnosed with GERD for surgery. Which information warrants notifying the HCP?
- A. The client's Bernstein esophageal test was positive.
- B. The client's abdominal x-ray shows a hiatal hernia.
- C. The client's WBC count is 14,000/mm3.
- D. The client's hemoglobin is 13.8 g/dL.
Correct Answer: C
Rationale: An elevated WBC count (14,000/mm3) suggests infection or inflammation, which could complicate surgery and requires immediate attention. A positive Bernstein test and hiatal hernia are expected in GERD, and a hemoglobin of 13.8 g/dL is within normal limits.