Nokea
When assessing a client for acute pancreatitis, which of the following symptoms will the nurse observe?
- A. Increased thirst and urination
- B. Hypertension and nausea
- C. Rapid breathing and pulse rate
- D. Frothy, foul-smelling stools
Correct Answer: C
Rationale: The correct answer is C: Rapid breathing and pulse rate. In acute pancreatitis, inflammation of the pancreas can lead to systemic complications, including respiratory distress and tachycardia. This occurs due to the release of inflammatory mediators affecting the respiratory and cardiovascular systems. Increased thirst and urination (Choice A) are more indicative of diabetes or renal issues. Hypertension and nausea (Choice B) are not typical symptoms of acute pancreatitis. Frothy, foul-smelling stools (Choice D) are more likely linked to malabsorption disorders rather than acute pancreatitis. Rapid breathing and pulse rate are key signs that indicate the severity of the condition and the need for prompt intervention.
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Which of the following characterizes the biologic nature of carcinoid tumors (argentaffinomas)?
- A. benign but produce systemic symptoms
- B. production of systemic symptoms when they metastasize to the liver
- C. especially malignant when primary in the appendix
- D. production of jejunal ulceration due to gastrin elaboration
Correct Answer: B
Rationale: Step-by-step rationale for why choice B is correct:
1. Carcinoid tumors can produce systemic symptoms due to the release of bioactive substances.
2. Metastasis to the liver can lead to the production of systemic symptoms like flushing and diarrhea.
3. This systemic symptom production is a characteristic feature of carcinoid tumors.
4. Choice B accurately describes the biologic nature of carcinoid tumors in relation to systemic symptoms.
Summary of why other choices are incorrect:
A: Carcinoid tumors can be malignant and produce systemic symptoms, so they are not always benign.
C: Carcinoid tumors originating in the appendix are typically associated with a more favorable prognosis.
D: Jejunal ulceration due to gastrin elaboration is more commonly seen in gastrinomas, not carcinoid tumors.
The nurse is teaching a patient with diabetes about foot care. Which statement by the patient indicates that further teaching is needed?
- A. "I should wash my feet daily with warm water and mild soap."
- B. "I should inspect my feet daily for blisters, redness, or cuts."
- C. "I can use heating pads to warm my feet if they are cold."
- D. "I should trim my toenails straight across."
Correct Answer: C
Rationale: Correct Answer: C - "I can use heating pads to warm my feet if they are cold."
Rationale:
1. Using heating pads can cause burns or injuries due to reduced sensation in diabetic feet.
2. Patients with diabetes should avoid direct heat on their feet.
3. Optimal foot care for diabetics includes inspecting feet, washing with mild soap, and trimming nails correctly.
Summary:
A: Correct - Washing feet daily is recommended.
B: Correct - Inspecting feet daily is essential for early detection of issues.
C: Incorrect - Using heating pads can be harmful to diabetic feet.
D: Correct - Trimming toenails straight across is an appropriate practice.
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.
What problem should the nurse assess the patient for if the patient was on prolonged antibiotic therapy?
- A. Coagulation problems
- B. Impaired absorption of amino acids
- C. Elevated serum ammonia levels
- D. Increased mucus and bicarbonate secretion
Correct Answer: C
Rationale: The correct answer is C: Elevated serum ammonia levels. Prolonged antibiotic therapy can lead to disruption of normal gut flora, causing overgrowth of ammonia-producing bacteria. Elevated serum ammonia levels can indicate hepatic encephalopathy, a serious condition that requires immediate intervention. Coagulation problems (A) are more commonly associated with liver disease or vitamin deficiencies. Impaired absorption of amino acids (B) is typically seen in conditions like celiac disease or gastrointestinal disorders, not specifically related to prolonged antibiotic use. Increased mucus and bicarbonate secretion (D) are not directly related to prolonged antibiotic therapy, but rather to respiratory or gastrointestinal conditions.
In planning the post-operative care for a morbidly obese client, how can the expertise of the LPN/LVN best be applied?
- A. Obtain an oversized blood pressure cuff and a large-size bed.
- B. Set up a reinforced trapeze bar.
- C. Assist in the planning of bathing, turning, and ambulation.
- D. Design alternatives for routine tasks such as daily weights.
Correct Answer: C
Rationale: The correct answer is C because LPN/LVNs can assist in planning bathing, turning, and ambulation for a morbidly obese client. This is crucial in preventing complications such as pressure ulcers, deep vein thrombosis, and respiratory issues. LPN/LVNs can provide physical support and guidance to ensure the client's safety and comfort during these activities.
Choice A is incorrect because obtaining oversized equipment is not the primary role of LPN/LVNs. Choice B is also incorrect as setting up a reinforced trapeze bar is more of a facility management task. Choice D is incorrect as designing alternatives for routine tasks is not within the scope of practice for LPN/LVNs.