Nokea
The nurse is caring for a client with a diagnosis of cirrhosis and is monitoring the client for signs of portal hypertension. Which initial sign, if noted in the client, indicates the presence of portal hypertension?
- A. Flat neck veins
- B. Hypotension
- C. Weak pulse
- D. Crackles on auscultation of the lungs
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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The client being treated for esophageal varices has a Sengstaken-Blakemore tube inserted to control the bleeding. The most important assessment is for the nurse to:
- A. Check that the hemostat is on the bedside
- B. Monitor IV fluids for the shift
- C. Regularly assess respiratory status
- D. Check that the balloon is deflated on a regular basis
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Mucosal barrier fortifiers are used in peptic ulcer disease management for which of the following indications?
- A. To inhibit mucus production
- B. To neutralize acid production
- C. To stimulate mucus production
- D. To stimulate hydrogen ion diffusion back into the mucosa
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Which of the following best describes the method of action of medications, such as ranitidine (Zantac), which are used in the treatment of peptic ulcer disease?
- A. Neutralize acid
- B. Reduce acid secretions
- C. Stimulate gastrin release
- D. Protect the mucosal barrier
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis. The client is scheduled for surgery for 2 hours. The client begins to complain of increases abdominal pain and begins to vomit. On assessment the nurse notes that the abdomen distended and bowel sounds are diminished. Which of the following is the most appropriate nursing intervention?
- A. Administer the prescribed pain medication.
- B. Notify the physician.
- C. Call and ask the operating room team to perform the surgery as soon as possible.
- D. Reposition the client and apply a heating pad on warm setting to the client's abdomen.
Correct Answer: B
Rationale: Based on the signs and symptoms presented in the question, the nurse should suspect peritonitis and should notify the physician. Administering pain medication is not an appropriate intervention. Heat should never be applied to the abdomen of a client with suspected appendicitis. Scheduling surgical time is not within the scope of nursing practice, although the physician probably would perform the surgery earlier than the prescheduled time.
Which of the following tests is most commonly used to diagnose cholecystitis?
- A. Abdominal CT scan
- B. Abdominal ultrasound
- C. Barium swallow
- D. Endoscopy
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.