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The nurse is caring for a client who has ascites and hepatic encephalopathy. Which of the following prescriptions should the nurse clarify with the primary healthcare provider (PHCP)?
- A. Alprazolam
- B. Rifaximin
- C. Lactulose
- D. Spironolactone
Correct Answer: A
Rationale: Alprazolam (A), a benzodiazepine, can worsen hepatic encephalopathy by increasing sedation and ammonia levels. Rifaximin (B), lactulose (C), and spironolactone (D) are appropriate for managing hepatic encephalopathy and ascites.
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The nurse is caring for a client with cirrhosis of the liver who is receiving lactulose. Which of the following findings indicate a therapeutic response?
- A. Increased liver enzymes
- B. Increased level of consciousness
- C. Decreased urinary calcium
- D. Increased gastric pH
Correct Answer: B
Rationale: Lactulose reduces ammonia levels in cirrhosis by promoting its excretion, improving hepatic encephalopathy and thus increasing level of consciousness. Increased liver enzymes, decreased urinary calcium, and increased gastric pH are not therapeutic outcomes.
Your client has just undergone a fecal diversion surgery and will be discharged to their home. Which type of social support person or support network is most likely to benefit this client in terms of post-discharge self-care and physical adaptations necessary for this client?
- A. A peer support network like an ostomy group in the community to promote self-care
- B. An emotional support person to help the client cope with the altered bodily image
- C. An instrumental support network to help with activities of daily living (ADLs)
- D. A church group of volunteers who can transport the client to health care provider (HCP) appointments
Correct Answer: A
Rationale: A peer support network like an ostomy group (A) provides practical self-care education and emotional support, critical for adapting to a new colostomy.
Which of the following clients does the nurse suspect would benefit most from placement of a nasogastric tube?
- A. A 9-year-old client with a femur fracture.
- B. An 82-year-old client with congestive heart failure.
- C. A 65-year-old client on dialysis.
- D. A 52-year-old client with leukemia who is receiving chemotherapy.
Correct Answer: D
Rationale: A client receiving chemotherapy (D) may experience severe nausea and vomiting, necessitating an NG tube for decompression or feeding. The other conditions are less likely to require NG tube placement.
The nurse is caring for a client who has just been diagnosed with peritonitis. Which of the following medications should the nurse anticipate the primary health care provider (PHCP) will prescribe?
- A. Pantoprazole
- B. Ciprofloxacin
- C. Lactulose
- D. Loperamide
Correct Answer: B
Rationale: Ciprofloxacin, an antibiotic, is used to treat bacterial peritonitis. Pantoprazole reduces acid, lactulose treats hepatic encephalopathy, and loperamide slows motility, none of which address peritonitis directly.
The nurse is preparing a client for a scheduled colonoscopy. Which prescription should the nurse anticipate from the primary healthcare provider (PHCP) while the client is preparing for this procedure?
- A. Docusate
- B. Loperamide
- C. Polyethylene glycol 3350
- D. Famotidine
Correct Answer: C
Rationale: Polyethylene glycol 3350 is a bowel preparation agent used to clear the colon for a colonoscopy. Docusate softens stool but is insufficient for prep, loperamide slows motility, and famotidine reduces acid but is not for bowel prep.