Nokea
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.
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A nurse is caring for a 57 year old client and is teaching them about screening for colorectal cancer. Which of the following information should the nurse include?
- A. It is recommended that colon cancer screening with a colonoscopy should begin at age 45.
- B. It is recommended that colon cancer screening with a colonoscopy should begin at age 70.
- C. It is recommended that colon cancer screening with a colonoscopy should begin at age 40.
- D. It is recommended that colon cancer screening with a colonoscopy should begin at age 65.
Correct Answer: A
Rationale: Current guidelines recommend colonoscopy screening for colorectal cancer starting at age 45 (A) for average-risk individuals.
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.
The following scenario applies to the next 1 items
The emergency department (ED) nurse is caring for a client with liver cirrhosis
Item 1 of 1
Nurses' Note
57-year-old male reporting increasing dyspnea and abdominal pressure after missing his previously scheduled paracentesis. The client reports he feels 'uncomfortable.' He is alert and oriented x 4; sclera is yellow along with jaundice skin appearance. Respirations were labored, tachypnea, and clear breath sounds. Abdominal distention noted, hypoactive bowel sounds in all four quadrants. Ascites and dependent edema were noted. Peripheral pulses were intact.
Vital Signs
• Oral Temperature 101 o F (38.3o C)
• Heart rate 94/minute
• Respirations 24/minute
• Blood pressure 104/68 mm Hg
• Oxygen saturation 95% on room air
Medical History
• Hepatitis C
• Liver cirrhosis
• Substance use disorder
• Hyperlipidemia
Which assessment findings require follow-up? Select all that apply.
- A. Jaundice
- B. Labored breathing
- C. Hypoactive bowel sounds
- D. Respiratory rate
- E. Oral temperature
- F. Yellow sclera
Correct Answer: B,D,E
Rationale: Labored breathing (B), elevated respiratory rate (D), and fever (E) indicate potential complications like infection or respiratory compromise in liver cirrhosis, requiring urgent follow-up. Jaundice and yellow sclera (A, F) are expected, and hypoactive bowel sounds (C) are less urgent.
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 has instructed self-management strategies for a client diagnosed with gastroesophageal reflux disease (GERD). Which statement by the client would indicate a correct understanding of the teaching?
- A. It's much better for me to wear loose-fitting clothes right now.
- B. I stopped eating grilled chicken and now eat more ground hamburger.
- C. If I wake up with GERD symptoms, I should lower the head of my bed while sleeping.
- D. I should take my prescribed omeprazole after meals.
Correct Answer: A
Rationale: Loose-fitting clothes (A) reduce abdominal pressure, helping manage GERD. Hamburger (B) is high-fat and worsens reflux, lowering the bed (C) increases symptoms, and omeprazole (D) is taken before meals.