Nokea
Which assessment is the priority assessment for a patient who will be undergoing intravenous cholangiography?
- A. Patency of the intravenous line
- B. Ensure the patient is fasting prior to the exam
- C. An allergy to the iodine based radiographic dye
- D. Whether or not the patient has signed the consent form
Correct Answer: C
Rationale: If the patient is allergic to the radiographic dye, a potentially life-threatening anaphylactic reaction could occur. Assessing for patency of the intravenous line and ensuring the patient is fasting prior to the exam are important, but these would not likely cause a potentially life-threatening problem. It is crucial to determine if the patient has signed a consent form, but this is would not be life threatening to the patient. There would be legal ramifications for the nurse, health care provider, and facility.
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A patient with cirrhosis of the liver will have which blood test results monitored?
- A. Blood urea nitrogen (BUN)
- B. Platelet counts
- C. Aspartate aminotransferase (AST)
- D. Hemoglobin and Hematocrit (HGB and HCT)
Correct Answer: C
Rationale: The nurse will monitor the patient with cirrhosis for an elevated AST level which would indicate worsening liver function. The BUN monitors kidney function. The platelet count is part of the complete blood count which is not necessary to monitor with cirrhosis. The HGB and HCT monitor for anemia.
The tumor marker that is elevated in patients with pancreatic cancer is
Correct Answer: CA19-9
Rationale: The tumor marker CA19-9 is elevated in the presence of pancreatic cancer.
Which should the nurse expect of a patient with a malabsorption of vitamin K?
- A. Anemia
- B. Excess platelet production
- C. Increased coagulation time
- D. Elevated for infection due to diminished white blood cell count
Correct Answer: C
Rationale: Prothrombin times are increased because malabsorption of vitamin K or inability to produce the clotting factors VII, IX, and X cause the patient to have bleeding tendencies.
Which nursing intervention should be completed immediately after the health care provider has performed a needle liver biopsy?
- A. Assisting to ambulate for the bathroom
- B. Keeping the patient on the right side for a minimum of 2 hours
- C. Taking vital signs every 4 hours
- D. Keeping the patient on the left side for a minimum of 4 hours
Correct Answer: B
Rationale: Keep the patient lying on the right side with a rolled towel against the puncture site for minimum of 2 hours to splint the puncture site. It compresses the liver capsule against the chest wall to decrease the risk of hemorrhage or bile leak. Vital signs are taken every 15 minutes for 30 minutes, then every 30 minutes for 2 hours.
Hepatitis D is usually seen as a coinfection with
Correct Answer: hepatitis B
Rationale: Hepatitis D is usually seen as a coinfection with hepatitis B.