Nokea
The nurse is caring for a client with cirrhosis. Which manifestations indicate deficient vitamin K absorption caused by this liver disease?
- A. Dyspnea and fatigue
- B. Ascites and orthopnea
- C. Purpura and petechiae
- D. Gynecomastia and testicular atrophy
Correct Answer: C
Rationale: A liver disorder, such as cirrhosis, can disrupt the liver's normal use of vitamin K to produce prothrombin (a clotting factor). Because of this, the nurse should monitor the client for signs of bleeding, including purpura and petechiae. Dyspnea and fatigue suggest anemia. Ascites and orthopnea are unrelated to vitamin K absorption. Gynecomastia and testicular atrophy result from decreased estrogen metabolism by the diseased liver.
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A client with viral hepatitis has no appetite, and food makes the client nauseated. Which of the following interventions would be most appropriate?
- A. Explain that high-fat diets usually are tolerated better.
- B. Encourage intake of foods high in protein.
- C. Explain that the majority of calories need to be consumed in the evening hours.
- D. Monitor for fluid and electrolyte imbalance.
Correct Answer: D
Rationale: If nausea occurs and persists, the client will need to be assessed for fluid and electrolyte imbalance. Explaining to the client that the majority of calories should be eaten in the morning hours is important because nausea occurs most often in the afternoon and evening. Clients should select a diet high in calories because energy is required for healing. Protein increases the workload on the liver. Changes in bilirubin interfere with fat absorption, so low-fat diets are tolerated better.
The hospitalized client with gastroesophageal reflux disease is complaining of chest discomfort that feels like heartburn following a meal. After administering an ordered antacid, the nurse encourages the client to lie in which of the following positions?
- A. Supine with the head of the bed flat
- B. On the stomach with the head flat
- C. On the left side with the head of the bed elevated 30 degrees
- D. On the right side with the head of the bed elevated 30 degrees
Correct Answer: C
Rationale: The discomfort of reflux is aggravated by positions that compress the abdomen and the stomach. Lying flat on the back (supine) or on the stomach (prone) after a meal can exacerbate symptoms. Similarly, lying on the right side can worsen reflux. The most appropriate position to alleviate discomfort in a client with gastroesophageal reflux disease is lying on the left side with the head of the bed elevated at a 30-degree angle. This position helps prevent the backflow of stomach contents into the esophagus, providing relief to the client.
Which of the following would be an expected nutritional outcome for a client who has undergone a subtotal gastrectomy for cancer?
- A. Regain weight loss within 1 month after surgery
- B. Resume normal dietary intake of three meals per day
- C. Control nausea and vomiting through regular use of antiemetics
- D. Achieve optimal nutritional status through oral or parenteral feedings
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client is taking an antacid for treatment of a peptic ulcer. Which of the following statements best indicates that the client understands how to correctly take the antacid?
- A. I should take my antacid before I take my other medications.
- B. I need to decrease my intake of fluids so that I don't dilute the effects of my antacid.
- C. My antacid will be most effective if I take it whenever I experience stomach pains.
- D. It is best for me to take my antacid 1 to 3 hours after meals.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client with suspected gastric cancer undergoes an endoscopy of the stomach. Which of the following assessments made after the procedure would indicate the development of a potential complication?
- A. The client complains of a sore throat
- B. The client displays signs of sedation
- C. The client experiences a sudden increase in temperature
- D. The client demonstrates a lack of appetite
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.