Nokea
Which action will the nurse take to prepare a patient for an endoscopic retrograde cholangiopancreatography (ERCP)?
- A. Confirm that a recent chest x-ray is on file.
- B. Confirm the presence of a consent form.
- C. Warn patient that the procedure will take about 3 hours.
- D. Confirm the presence of a prothrombin time/INR.
- E. Withhold food and drink for 4 hours.
Correct Answer: B,D
Rationale: Before the ERCP, the patient will be held NPO for 8 hours. It is necessary that a consent form be signed as well as evidence of a prothrombin time INR.
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The disease that is on the increase because of the growing obesity population and is associated with coronary artery disease and use of corticosteroids is
Correct Answer: nonalcoholic fatty liver disease (NAFLD)
Rationale: NAFLD is a disease that is on the rise due to the increasing population of obese persons. The disease is also associated with CAD and the use of corticosteroids.
The patient's cirrhosis of the liver has also caused a dilation of the veins of the lower esophagus secondary to portal hypertension, resulting in the development of which complication?
- A. esophageal varices.
- B. diverticulosis.
- C. Crohn disease.
- D. esophageal reflux (GERD).
Correct Answer: A
Rationale: Esophageal varices (a complex of longitudinal, tortuous veins at the lower end of the esophagus) enlarge and become edematous as the result of portal hypertension.
What is the challenge in encouraging coughing and deep breathing for a postoperative patient who had an open cholecystectomy?
- A. High placement of incision
- B. Excessive nausea
- C. Weakened abdominal muscles
- D. Poor oxygenation
Correct Answer: A
Rationale: The high placement of the incision of the cholecystectomy makes the patient reluctant to cough. Splinting the incision is beneficial.
Which medical intervention and management system controls the bleeding of esophageal varices?
- A. Transfusions
- B. Sengstaken-Blakemore (S/B) tube
- C. Band ligation
- D. Cryotherapy
- E. Portacaval shunt
- F. Large doses of vitamin B12
Correct Answer: B,C,E
Rationale: Band ligation, insertion of the tube, and various shunting surgeries are helpful in stopping the hemorrhage. Transfusions, cryotherapy, and water-soluble vitamins are not beneficial.
Which should the nurse explain is the major purpose of the Sengstaken-Blakemore tube (S/B tube)?
- A. Decompress the stomach.
- B. Control esophageal varices bleeding.
- C. A route for tube feedings.
- D. Obtain specimen for gastric analyzing.
Correct Answer: B
Rationale: The major purpose of the S/B tube is to control bleeding by pressure against the vessels in the esophagus. The two balloons of the tube are inflated to put direct pressure on the esophagus and are anchored by the inflated balloon in the stomach. The tube can suction blood from the stomach as well.