Nokea
The nurse is caring for a client who has ascites and hepatic encephalopathy. Which of the following prescriptions should the nurse anticipate from the primary healthcare provider (PHCP)? Select all that apply.
- A. Furosemide
- B. Neomycin
- C. Naproxen
- D. Lactulose
- E. Diazepam
Correct Answer: A,B,D
Rationale: Furosemide (A) manages ascites, neomycin (B) reduces gut ammonia production, and lactulose (D) treats hepatic encephalopathy. Naproxen (C) and diazepam (E) can worsen liver dysfunction or encephalopathy.
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The nurse is caring for a client receiving total parenteral nutrition (TPN), which was initiated twelve hours ago. The priority assessment for this client is which of the following?
- A. Urine output
- B. Oral temperature
- C. Weight
- D. Capillary blood glucose
Correct Answer: D
Rationale: TPN contains high concentrations of glucose, which can lead to hyperglycemia, especially in the early stages of administration. Monitoring capillary blood glucose is critical to detect and manage this potential complication.
The health care provider (HCP) places an order to administer gentamicin intravenously to a client with acute diverticulitis. It is important the nurse knows that intravenous gentamicin is administered:
- A. Over one minute via IV push
- B. Over two minutes via IV push
- C. As an IV infusion over 15-20 minutes
- D. As an IV infusion over 30 minutes to two hours
Correct Answer: D
Rationale: Gentamicin (D) is administered as an IV infusion over 30 minutes to two hours to ensure safe delivery and minimize toxicity risks like nephrotoxicity.
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.
The nurse is assessing a client with acute cholecystitis. Which of the following physical assessment findings would be expected?
- A. Stools that contain blood and mucus
- B. Pain with urination
- C. Episodic upper abdominal pain
- D. Hypoactive bowel sounds
Correct Answer: C
Rationale: Episodic upper abdominal pain (C), often in the right upper quadrant, is a hallmark of acute cholecystitis due to gallbladder inflammation.
The nurse is caring for a client with appendicitis. Which of the following statements are correct regarding this condition? Select all that apply.
- A. McBurney's point tenderness is a sign of appendicitis
- B. Appendicitis is more common among males
- C. A low carbohydrate diet is a risk factor for appendicitis
- D. Diagnosis of appendicitis is confirmed by endoscopic retrograde cholangiopancreatography
- E. The client may have an elevated white blood cell count (WBC)
Correct Answer: A,E
Rationale: McBurney's point tenderness (A) and elevated WBC (E) are hallmark signs of appendicitis. It is not more common in males (B), low-carb diets (C) are not a risk factor, and ERCP (D) is not used for diagnosis.