Nokea
The nurse is screening individuals at risk for gastric cancer. It would be appropriate for the nurse to identify which of the following as a risk factor for gastric cancer?
- A. Irritable bowel syndrome
- B. Duodenal ulcer
- C. Chronic gastritis
- D. Sickle cell anemia
Correct Answer: C
Rationale: Chronic gastritis (C), often caused by H. pylori, is a known risk factor for gastric cancer. The other options are not directly associated.
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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 emergency department (ED) nurse is caring for a 45-year-old male client.
Item 2 of 6
Nurses’ Notes
0600: The client reports sudden, severe epigastric pain. He has a history of chronic alcohol use disorder (30+ years), GERD, and hypertension. His home medications include pantoprazole and lisinopril. Upon assessment, the client is noted to be alert and oriented x4. He is mildly diaphoretic, with pulses 2+ and regular. Abdomen is distended, guarding on palpation, diminished bowel sounds, and no stool in the last 24 hours. He reports nausea and vomiting, and his pain is worse after eating fatty foods, rated 7/10 and radiating to his back. Breath sounds slightly diminished bilaterally, no adventitious sounds, denies cough or dyspnea. He reports heavy alcohol intake two days ago. Fingerstick glucose is 145 mg/dL (8.06 mmol/L) [70-110 mg/dL; 4-6 mmol/L]. Temperature is 101.3°F (38.5°C), heart rate of 112 bpm, respiratory rate of 24 breaths/min, blood pressure of 98/64 mmHg, and oxygen saturation of 95% on room air.
Orders
0600
• Cardiac monitoring
• NPO
• CBC
• CMP
• LFTs
• Amylase
• Lipase
• CT abdomen with contrast
The nurse is reviewing assessment findings to differentiate between acute pancreatitis and cholecystitis. For each assessment finding below, click to specify if the finding is consistent with the disease process of acute pancreatitis or cholecystitis. Each finding may support more than one (1) disease process. Each column must have at least one (1) response option selected.
- A. Severe epigastric pain
- B. Gray-blue discoloration of the flanks
- C. Nausea and vomiting
- D. Leukocytosis
- E. Elevated lipase and amylase
- F. Hypocalcemia
Correct Answer: A,C,D,E,F;A,C,D
Rationale: Acute pancreatitis: A (Severe epigastric pain), C (Nausea and vomiting), D (Leukocytosis), E (Elevated lipase and amylase), F (Hypocalcemia). Cholecystitis: A, C, D. Elevated lipase/amylase and hypocalcemia are specific to pancreatitis.
The nurse is assessing a client who has appendicitis. Which of the following would be an expected finding? Select all that apply.
- A. Leukocytosis
- B. Melena
- C. Fever
- D. Nausea and Vomiting
- E. Anorexia
Correct Answer: A,C,D,E
Rationale: Appendicitis commonly presents with leukocytosis (A) due to infection, fever (C) from inflammation, nausea and vomiting (D), and anorexia (E) due to gastrointestinal irritation. Melena (B) is not typically associated with appendicitis.
The nurse is assessing a client with suspected acute cholecystitis. Which of the following findings would support a diagnosis of acute cholecystitis?
- A. Decreased serum bilirubin
- B. Increased high density lipoprotein cholesterol (HDL-C)
- C. Decreased serum aminotransferases
- D. Increased white blood cell count (WBC)
Correct Answer: D
Rationale: An increased WBC count (D) indicates inflammation or infection, supporting a diagnosis of acute cholecystitis. Bilirubin (A) and aminotransferases (C) may rise, and HDL-C (B) is unrelated.
The nurse is caring for a client who has ascites and hepatic encephalopathy. Which of the following prescriptions should the nurse anticipate from the primary healthcare provider (PHCP)? Select all that apply.
- A. Furosemide
- B. Neomycin
- C. Naproxen
- D. Lactulose
- E. Diazepam
Correct Answer: A,B,D
Rationale: Furosemide (A) manages ascites, neomycin (B) reduces gut ammonia production, and lactulose (D) treats hepatic encephalopathy. Naproxen (C) and diazepam (E) can worsen liver dysfunction or encephalopathy.