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The nurse is caring for a patient who is diagnosed with acute hepatitis B. Which of the following information should the nurse include in the teaching plan?
- A. Ways to increase exercise and activity level
- B. Self-administration of ?±-interferon
- C. Adverse effects of nucleoside and nucleotide analogs
- D. Measures that will be helpful in improving appetite
Correct Answer: D
Rationale: Maintaining adequate nutritional intake is important for regeneration of hepatocytes. Interferon and antivirals may be used for persistent hepatitis B, but they are not prescribed for acute hepatitis B infection. Rest is recommended.
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The nurse is preparing a teaching plan for a young adult patient who is diagnosed with early alcoholic cirrhosis. Which of the following topics is most important to include in patient teaching?
- A. Need to abstain from alcohol
- B. Use of vitamin B supplements
- C. Maintenance of a nutritious diet
- D. Treatment with lactulose
Correct Answer: A
Rationale: The disease progression can be stopped or reversed by alcohol abstinence. The other interventions may be used when cirrhosis becomes more severe to decrease symptoms or complications, but the priority for this patient is to stop the progression of the disease.
Which of the following assessment findings in a patient with acute pancreatitis should the nurse report urgently to the health care provider?
- A. Nausea and vomiting
- B. Hypotonic bowel sounds
- C. Abdominal tenderness and guarding
- D. Muscle twitching and finger numbness
Correct Answer: D
Rationale: Muscle twitching and finger numbness indicate hypocalcemia, which may lead to tetany unless calcium gluconate is administered. Numbness or tingling around the lips and in the fingers is an early indicator of hypocalcemia. Although the other findings also should be reported to the health care provider, they do not indicate complications that require rapid action.
The nurse is admitting a patient with acute cholecystitis. Which of the following findings is most important for the nurse to report to the health care provider?
- A. The patient's urine is bright yellow.
- B. The patient's stools are clay coloured.
- C. The patient complains of persistent heartburn.
- D. The patient has an increase in pain after eating.
Correct Answer: B
Rationale: The clay-coloured stools indicate biliary obstruction, which requires rapid intervention to resolve. The other data are not unusual for a patient with this diagnosis, although the nurse also would report the other assessment information to the health care provider.
The nurse is caring for a patient with acute pancreatitis. Which of the following findings is of most concern?
- A. Absent bowel sounds
- B. Abdominal tenderness
- C. Left upper quadrant pain
- D. Palpable abdominal mass
Correct Answer: D
Rationale: A palpable abdominal mass in acute pancreatitis may indicate a pancreatic pseudocyst or abscess, which are serious complications requiring urgent intervention. Absent bowel sounds, abdominal tenderness, and left upper quadrant pain are common findings in acute pancreatitis but are less concerning unless accompanied by other critical symptoms.
The nurse is caring for a patient with severe cirrhosis who has an episode of bleeding esophageal varices. Which of the following laboratory tests should the nurse monitor to detect possible complications of the bleeding episode?
- A. Bilirubin
- B. Ammonia
- C. Potassium
- D. Prothrombin time
Correct Answer: B
Rationale: The blood in the gastrointestinal (GI) tract will be absorbed as protein and may result in an increase in ammonia level because the liver cannot metabolize protein well. The prothrombin time, bilirubin, and potassium levels also should be monitored, but these will not be affected by the bleeding episode.