Nokea
The nurse is reviewing the medication record of a client with acute gastritis. Which medication if noted on the client's record, would the nurse question?
- A. Digoxin (Lanoxin)
- B. Indomethacin (Indocin)
- C. Furosemide (Lasix)
- D. Propranolol hydrochloride (Inderal)
Correct Answer: B
Rationale: Indomethacin (Indocin) is a Nonsteroidal anti-inflammatory drug and can cause ulceration of the esophagus, stomach, duodenum, or small intestine. Indomethacin is contraindicated in a client with gastrointestinal disorders. Furosemide (Lasix) is a loop diuretic. Digoxin is an antidysrhythmic. Propranolol (Inderal) is a B- adrenergic blocker. Furosemide, digoxin, and propranolol are not contraindicated in clients with gastric disorders.
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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.
The nurse is caring for a client following a Billroth II procedure. On review of the post-operative orders, which of the following, if prescribed, would the nurse question and verify?
- A. Irrigating the nasogastric tube
- B. Coughing a deep breathing exercises
- C. Leg exercises
- D. Early ambulation
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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.
A client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching for this client, the nurse should stress:
- A. increasing fluid intake to prevent dehydration.
- B. wearing an appliance pouch at all times.
- C. consuming a low-protein, high-fiber diet.
- D. avoiding enteric-coated medications.
Correct Answer: A
Rationale: The correct answer is A: increasing fluid intake to prevent dehydration. An ileostomy typically drains liquid waste, so the client is at risk of fluid loss. By increasing fluid intake, the client can prevent dehydration. It's essential for the client to wear a collection appliance at all times because ileostomy drainage is incontinent. Consuming a low-protein, high-fiber diet is not recommended as high-fiber foods can cause intestinal irritation. Enteric-coated medications should be avoided because they may not be absorbed properly after an ileostomy.
The client with peptic ulcer disease is scheduled for a pyloroplasty. The client asks the nurse about the procedure. The nurse plans to respond knowing that a pyloroplasty involves:
- A. Cutting the vagus nerve
- B. Removing the distal portion of the stomach
- C. Removal of the ulcer and a large portion of the cells that produce hydrochloric acid
- D. An incision and resuturing of the pylorus to relax the muscle and enlarge the opening from the stomach to the duodenum.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.