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Which blood test results would confirm a diagnosis of appendicitis?
- A. WBC of 13,000
- B. RBC of 4.5 million
- C. Platelet count of 300,000
- D. Positive heterophil antibody test
Correct Answer: A
Rationale: An elevated WBC count (e.g., 13,000) indicates inflammation, supporting an appendicitis diagnosis. Normal RBC and platelet counts are not specific, and a heterophil antibody test is for infectious mononucleosis.
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Which priority teaching information should the nurse discuss with the client to help prevent contracting hepatitis B?
- A. Explain the importance of good hand washing.
- B. Recommend the client take the hepatitis B vaccine.
- C. Tell the client not to ingest unsanitary food or water.
- D. Discuss how to implement Standard Precautions.
Correct Answer: B
Rationale: The hepatitis B vaccine is the most effective way to prevent hepatitis B, a bloodborne virus. Handwashing and food safety are less relevant, and Standard Precautions are for healthcare settings.
The nurse is preparing to administer amitriptyline 10 mg orally to the client diagnosed with IBS. The client asks, “Why am I receiving this? I don’t feel depressed.” Which response by the nurse is best?
- A. “The medication is working. People with chronic diseases typically also suffer from depression.”
- B. “People with IBS have difficulty returning to sleep after waking to the bathroom. It will help you get adequate rest.”
- C. “The anticholinergic side effects of the drug will help to prevent bowel irritability and constipation.”
- D. “Tricyclic antidepressants reduce abdominal pain by affecting the communication system from the bowel to the brain.”
Correct Answer: D
Rationale: A. Not all clients with chronic diseases suffer from depression. The response does not address the primary reason for the use of a TCA such as amitriptyline (Elavil) in IBS. B. A common response to TCAs is sedation; however, this medication is not given for this reason. C. TCAs do have anticholinergic side effects and can cause (not prevent) constipation. Clients with IBS can have constipation or diarrhea. D. Evidence supports that TCAs can reduce abdominal pain, and this benefit is unrelated to whether or not the client is being treated for depression.
The nurse is caring for a client diagnosed with rule-out peptic ulcer disease. Which test confirms this diagnosis?
- A. Esophagogastroduodenoscopy.
- B. Magnetic resonance imaging (MRI).
- C. Occult blood test.
- D. Gastric acid stimulation.
Correct Answer: A
Rationale: Esophagogastroduodenoscopy (EGD) directly visualizes the gastric mucosa to confirm the presence of ulcers, making it the gold standard for diagnosing peptic ulcer disease. MRI is not used, occult blood tests are nonspecific, and gastric acid stimulation assesses acid production, not ulcers.
Which diagnostic test should the nurse monitor for the client diagnosed with severe anorexia nervosa?
- A. Liver function tests.
- B. Kidney function tests.
- C. Cardiac function tests.
- D. Bone density scan.
Correct Answer: C
Rationale: Cardiac function tests (e.g., ECG) monitor for arrhythmias or heart failure, common in severe anorexia due to electrolyte imbalances and starvation. Liver, kidney, and bone tests are less urgent.
The client is diagnosed with esophageal diverticula. Which lifestyle modification should be taught by the nurse?
- A. Raise the foot of the bed to 45 degrees to increase peristalsis.
- B. Eat the evening meal at least two (2) hours prior to bed.
- C. Eat a low-fat, low-cholesterol, high-fiber diet.
- D. Wear an abdominal binder to strengthen the abdominal muscles.
Correct Answer: B
Rationale: Eating at least two hours before bed prevents food pooling in the diverticula, reducing regurgitation risk. Raising the bed foot, specific diets, and binders are not standard.