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Which should the nurse avoid contamination from to prevent the transmission of hepatitis A?
- A. Food or water
- B. Blood transfusion
- C. Needles
- D. Sexual contact
Correct Answer: A
Rationale: Hepatitis A virus is transmitted when a person puts something in his or her mouth that is contaminated with fecal material (called fecal-oral transmission). Teach patients the importance of good hand washing after the bathroom or changing a diaper, as well as proper food preparation, to prevent the spread of hepatitis A.
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The patient with cirrhosis has an albumin of 2.8 g/dL. The nurse is aware that normal is 3.5 to 5 g/dL. Based on these findings, which would the nurse expect the patient to exhibit?
- A. Jaundice
- B. Edema
- C. Copious urine output
- D. Pallor
Correct Answer: B
Rationale: Low serum albumin levels result also from excessive loss of albumin into urine or into third-space volumes, causing ascites or edema.
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.
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.
When caring for an extremely jaundiced patient with cirrhosis, which does the nurse expect to see included in the plan of care?
- A. Encouraging consumption of a high-fat diet
- B. Skin care to relieve pruritus
- C. Offering foods rich in fat-soluble vitamins
- D. Meticulous foot care
Correct Answer: B
Rationale: Jaundice causes pruritus and can lead to skin lesions and pressure injury.
Dietary teaching for a patient who is treated conservatively for cholecystitis is necessary to keep the patient comfortable. Which food should be avoided?
- A. Peanut butter
- B. Grilled chicken
- C. Rice and pasta
- D. Bananas, apples, oranges
- E. Whole milk
- F. Glazed chocolate doughnuts
Correct Answer: A,E,F
Rationale: Peanut butter, nuts, chocolate, whole milk, fried foods, and cream and other fatty foods should be avoided.