Nokea
The nurse has taught a client scheduled for a liver biopsy. Which of the following statements by the client would indicate a correct understanding of the teaching?
- A. I will not be conscious during this procedure.
- B. I should not take any acetaminophen one week before this procedure.
- C. I will need to cough and deep breathe every two hours after this procedure.
- D. I may be asked to hold my breath during the insertion of the biopsy needle.
Correct Answer: D
Rationale: Holding the breath (D) during needle insertion stabilizes the liver, reducing complications. The procedure is typically done under local anesthesia (A is incorrect), acetaminophen restriction (B) is not standard, and coughing (C) is not required post-procedure.
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The nurse has provided medication instruction to a client prescribed sucralfate. Which of the following statements, if made by the client, would require further teaching? Select all that apply.
- A. I should take this medication one hour after meals.
- B. I will remain upright for 30 minutes after taking this medicine.
- C. This medication will help with my peptic ulcer disease.
- D. I know this medication works when my nausea and vomiting are gone.
- E. I may dissolve this medication in warm water.
Correct Answer: A,D,E
Rationale: Sucralfate is taken 1 hour before meals, not after; it treats ulcers but does not primarily relieve nausea/vomiting; and it should not be dissolved in water. Remaining upright and ulcer treatment are correct.
The nurse is caring for a client with a hiatal hernia who is being discharged today. The nurse talks to them regarding methods to manage symptoms and promote overall well-being associated with their condition. Which of the following statements from the client indicate that teaching is successful?
- A. I need to wear loose-fitting clothes.
- B. After a meal, I must lie down to avoid dumping syndrome.
- C. I need to eat three large meals a day.
- D. I can go to my favorite Indian restaurant anytime of the week.
Correct Answer: A
Rationale: Wearing loose-fitting clothes (A) reduces pressure on the stomach, helping manage hiatal hernia symptoms. Lying down after meals (B) can worsen reflux, large meals (C) increase symptoms, and spicy foods (D) may exacerbate reflux.
The nurse is admitting a client newly diagnosed with acute pancreatitis. The nurse should anticipate a prescription for which medication?
- A. 3% saline infusion
- B. Fentanyl
- C. Diphenoxylate-atropine
- D. Sucralfate
Correct Answer: B
Rationale: Fentanyl is used for pain management in acute pancreatitis, which is often severe. 3% saline is not standard, diphenoxylate-atropine treats diarrhea (not a primary symptom), and sucralfate is for ulcers, not pancreatitis.
The nurse is caring for a client who is receiving prescribed metoclopramide for gastroparesis. Which of the following findings require immediate notification to the primary healthcare provider (PHCP)?
- A. Muscle rigidity of the neck
- B. Hyperactive bowel sounds
- C. Frequent diarrhea
- D. Abdominal distention
Correct Answer: A
Rationale: Muscle rigidity of the neck (dystonia) is a serious extrapyramidal side effect of metoclopramide, requiring immediate PHCP notification. Hyperactive bowel sounds, diarrhea, and distention are less urgent or expected with gastroparesis.
A 52-year-old client with a 20-year history of alcohol abuse is hospitalized with mild ascites, jaundice, and bruising. Imaging demonstrates the presence of esophageal varices, while the client's elevated serum ammonia level indicates hepatic encephalopathy. The nurse is concerned the client's esophageal varices may rupture and proceeds to educate the client accordingly. Which item should the nurse include in the client's education session?
- A. Do not lift heavy objects.
- B. Avoid walking briskly.
- C. Avoid taking barbiturates.
- D. Avoid ingesting antacids.
Correct Answer: A
Rationale: Avoiding heavy lifting (A) reduces intra-abdominal pressure, decreasing the risk of esophageal variceal rupture. The other options are less directly related to preventing variceal bleeding.