Nokea
Treatment of the patient with appendicitis includes:
- A. Transfusion to replace blood loss.
- B. Bowel prep for cleansing.
- C. Surgical removal of appendix.
- D. Medications to lower pH within the stomach.
Correct Answer: C
Rationale: The correct answer is C: Surgical removal of appendix. Appendicitis is inflammation of the appendix, which requires surgical intervention (appendectomy) to prevent rupture and potential life-threatening complications. Transfusion (A) is not a standard treatment for appendicitis unless severe bleeding occurs post-surgery. Bowel prep (B) is unnecessary for appendicitis treatment as it is not related to colon cleansing. Medications to lower stomach pH (D) are used to treat conditions like acid reflux, not appendicitis. In summary, surgical removal of the inflamed appendix is the definitive treatment for appendicitis to prevent complications.
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Priority Decision: A patient treated for vomiting is to begin oral intake when the symptoms have subside To promote rehydration
- A. the nurse plans to administer which fluid first?
- B. Water
- C. Hot tea
- D. Gatorade
Correct Answer: A
Rationale: Step 1: The priority is to administer fluids to rehydrate the patient.
Step 2: Intravenous fluids are not mentioned, so the nurse should start with oral fluids.
Step 3: Option A is the most appropriate choice as it addresses the need for fluid intake to promote rehydration.
Step 4: Water (Option B) lacks electrolytes that aid in rehydration.
Step 5: Hot tea (Option C) may irritate the stomach and not provide adequate hydration.
Step 6: Gatorade (Option D) contains electrolytes but may be too heavy for initial rehydration.
An endoscopic biopsy of gastric mucosa reveals small intestinal type epithelium. This finding is most likely due to:
- A. chronic gastritis
- B. congenital heterotopia
- C. precancerous dysplasia
- D. metastatic carcinoma
Correct Answer: B
Rationale: The correct answer is B: congenital heterotopia. This is because the presence of small intestinal type epithelium in the gastric mucosa indicates ectopic tissue that is not normally found in the stomach. This condition is known as congenital heterotopia, where tissues from one organ are found in another due to developmental abnormalities.
A: Chronic gastritis would not lead to the presence of small intestinal type epithelium in the gastric mucosa.
C: Precancerous dysplasia refers to abnormal cellular changes that can progress to cancer but does not explain the presence of small intestinal type epithelium.
D: Metastatic carcinoma would involve the spread of cancer cells from another primary site, not the presence of ectopic tissue.
The patient has peritonitis, which is a major complication of appendicitis. What treatment will the nurse plan to include?
- A. Peritoneal lavage
- B. Peritoneal dialysis
- C. IV fluid replacement
- D. Increased oral fluid intake
Correct Answer: C
Rationale: The correct answer is C: IV fluid replacement. IV fluids are essential in managing peritonitis to maintain hydration and electrolyte balance. It helps to support the patient's circulation and prevent shock. Peritoneal lavage (choice A) is not typically used in the treatment of peritonitis. Peritoneal dialysis (choice B) is used for kidney failure, not peritonitis. Increased oral fluid intake (choice D) may not be sufficient in cases of peritonitis where IV fluids are needed for rapid rehydration and support.
A nurse is providing instructions for a 52-year-old client who is scheduled for a colonoscopy. The client reports that he has not had the procedure before and is very anxious about feeling pain during the procedure. Which of the following responses by the nurse is appropriate?
- A. Don't worry; most clients dislike the prep more than the procedure itself.'
- B. Before the examination, your provider will give you a sedative that will make you sleepy.'
- C. I know you're anxious, but this procedure is recommended for people your age.'
- D. After you have signed the consent form, we can talk more about this.'
Correct Answer: B
Rationale: Step 1: Providing a sedative before the colonoscopy is appropriate as it helps reduce anxiety and discomfort during the procedure.
Step 2: Sedatives induce relaxation and drowsiness, making the client feel sleepy and less likely to experience pain.
Step 3: Addressing the client's anxiety by mentioning the sedative shows empathy and reassurance.
Step 4: This option focuses on addressing the client's concern about pain during the procedure effectively.
Summary:
- Option A dismisses the client's concerns and does not provide a solution.
- Option C acknowledges the anxiety but does not offer a specific solution.
- Option D delays addressing the client's anxiety without providing immediate reassurance or information.
Cimetidine and a calcium-containing antacid preparation administered in an appropriate dosage regimen for treating peptic ulcer differ in that:
- A. Only the calcium-containing antacid may increase gastric acid secretion.
- B. Only cimetidine is likely to cause an increase in urinary pH.
- C. Only cimetidine is likely to produce a laxative effect.
- D. Only cimetidine can prevent the rise in gastric pH after the consumption of a meal.
Correct Answer: A
Rationale: The correct answer is A because only the calcium-containing antacid may increase gastric acid secretion. This is because calcium-containing antacids can stimulate the release of gastrin, which in turn increases gastric acid secretion. Choices B, C, and D are incorrect because cimetidine, not a calcium-containing antacid, is the one that can cause an increase in urinary pH, produce a laxative effect, and prevent the rise in gastric pH after a meal, respectively. Therefore, A is the only statement that accurately distinguishes between cimetidine and a calcium-containing antacid in the context of treating peptic ulcers.