Nokea
The healthcare provider prescribes lactulose for a patient with hepatic encephalopathy. What will the nurse assess to determine the effectiveness of this medication?
- A. Decreased ammonia levels
- B. Relief of constipation
- C. Decreased liver enzymes
- D. Relief of abdominal pain
Correct Answer: A
Rationale: Lactulose works by reducing blood ammonia levels, which is its primary mechanism in treating hepatic encephalopathy.
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The nurse is caring for a client with cirrhosis and portal hypertension. Which statement by the client is cause for the greatest concern?
- A. I have a tight sensation in my lower leg when I forget to put my feet up.
- B. I can't button my pants anymore because my belly is so swollen.
- C. I'm very constipated and have been straining during bowel movements.
- D. When I sleep, I have to sit in a recliner so that I can breathe more easily.
Correct Answer: B
Rationale: This indicates new or worsening ascites, a serious complication of portal hypertension requiring evaluation.
A nurse is preparing to administer intermittent lipid emulsion and notes a layer of fat floating in the IV solution bag. Which action should the nurse take?
- A. Shake the bag to mix the fat.
- B. Administer the bag of solution.
- C. Return the bag to the pharmacy.
- D. Turn the bag upside down one time.
Correct Answer: C
Rationale: Fat separation indicates instability; solution should be returned to pharmacy as it could cause fat embolism.
A nurse is teaching a client who has acute kidney injury (AKI) about the oliguric phase. Which of the following information should the nurse include in the teaching?
- A. The glomerular filtration rate (GFR) recovers.
- B. Urine output is less than 400 mL per 24 hours.
- C. BUN and creatinine levels decrease.
- D. Renal function is reestablished.
Correct Answer: B
Rationale: Oliguria (<400mL/24hr) defines this phase of AKI with impaired urine production.
A nurse is obtaining a health history for a client with chronic pancreatitis. Which of the following indicates the primary cause of the client's condition?
- A. Weight gain
- B. Use of alcohol
- C. Abdominal pain relieved with food or antacids
- D. Exposure to occupational chemicals
Correct Answer: B
Rationale: The use of alcohol is the most common cause of chronic pancreatitis, accounting for about 70% of cases.
A nurse is reviewing the laboratory data of a client following a hemodialysis treatment. The nurse should expect to find a decrease in which of the following laboratory values?
- A. RBC count
- B. Protein
- C. Potassium
- D. Calcium
Correct Answer: C
Rationale: Potassium levels decrease after hemodialysis as it is effectively removed during the treatment.