Nokea
Which is an essential nursing measure to prevent injury to the patient who is to receive a paracentesis?
- A. Have patient sign a permit.
- B. Pad side rails.
- C. Check for allergy to contrast media or to shellfish.
- D. Have patient void immediately before procedure.
Correct Answer: D
Rationale: To prevent the puncturing of the bladder, the patient must void immediately before the procedure. A permit is required but it is not a safety precaution for the patient. There is no contrast media used in a paracentesis.
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Which patient statement indicates that the patient requires additional teaching about an endoscopic retrograde cholangiopancreatography?
- A. Right after the test, I want breakfast with black coffee.'
- B. The instrument will be put down my throat.'
- C. I haven't had anything to eat or drink since 9 p.m. last night.'
- D. My doctor said I could have medicine to relax me before the test.'
Correct Answer: A
Rationale: After the procedure, keep the patient at nothing by mouth status (NPO) until the gag reflex returns.
The nurse explains that the use of cyclosporine as an immunosuppressant has been successful in the reduction of rejection of liver transplants because the drug has which benefit?
- A. increases the rate of the regeneration of liver cells.
- B. can overcome complications presented by hepatitis C.
- C. increases blood supply to transplant.
- D. does not suppress bone marrow.
Correct Answer: D
Rationale: Cyclosporine is an immunosuppressant that does not cause bone marrow suppression nor does it impede healing.
Which will the nurse point out as a significant advantage of the laparoscopic cholecystectomy?
- A. Slightly more invasive, but there is less pain
- B. Can be performed on all patients of any age
- C. Can be performed even when there are large stones present in the bile duct
- D. Less invasive procedure
Correct Answer: D
Rationale: The laparoscopic cholecystectomy is less invasive and causes less pain and a quick recovery. If there are large stones present, a sphincterotomy is done before the laparoscopic cholecystectomy. Persons with bleeding tendencies, pathologic conditions of the abdomen, stones in the bile duct, and extensive adhesions are not good candidates.
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.
Which is a classic location and radiation of the pain associated with cholecystitis?
- A. Substernal, radiating to the left shoulder and arm
- B. Epigastric, radiating to the back
- C. Right upper abdomen, radiating to the back or right scapula
- D. Left upper abdomen, radiating to the jaw and neck
Correct Answer: C
Rationale: It localizes in the right upper quadrant epigastric region. The pain radiates around the mid torso to the right scapular area.