Adv Med Surg 4
Lewis, ATI, Evolve(
150 questions with
100% correct
answer s)rated A+
,Adv Med Surg 4 Lewis, ATI, Evolve( 150 questions with 100% correct answer s)rated A+
A patient with hepatitis A is in the acute phase. The nurse plans care for the patient based on
the knowledge that
a. pruritus is a common problem with jaundice in this phase.
b. the patient is most likely to transmit the disease during this phase.
c. gastrointestinal symptoms are not as severe in hepatitis A as they are in hepatitis B.
d. extrahepatic manifestations of glomerulonephritis and polyarteritis are common in this
phase. - correct answer a. pruritus is a common problem with jaundice in this phase.
A patient with acute hepatitis B is being discharged in 2 days. The discharge teaching plan
should include instructions to
a. avoid alcohol for the first 3 weeks.
b. use a condom during sexual intercourse.
c. have family members get an injection of immunoglobulin.
d. follow a low-protein, moderate-carbohydrate, moderate-fat diet. - correct answer b. use a
condom during sexual intercourse.
A patient has been told that she has elevated liver enzymes caused by nonalcoholic fatty liver
disease (NAFLD). The nursing teaching plan should include
a. having genetic testing done.
b. recommending a heart-healthy diet.
c. the necessity to reduce weight rapidly.
d. avoiding alcohol until liver enzymes return to normal. - correct answer b. recommending a
heart-healthy diet.
The patient with advanced cirrhosis asks why his abdomen is so swollen. The nurse's response
is based on the knowledge that
a. a lack of clotting factors promotes the collection of blood in the abdominal cavity.
b. portal hypertension and hypoalbuminemia cause a fluid shift into the peritoneal space.
c. decreased peristalsis in the GI tract contributes to gas formation and distention of the bowel.
d. bile salts in the blood irritate the peritoneal membranes, causing edema and pocketing of
fluid. - correct answer b. portal hypertension and hypoalbuminemia cause a fluid shift into the
peritoneal space.
,Adv Med Surg 4 Lewis, ATI, Evolve( 150 questions with 100% correct answer s)rated A+
In planning care for a patient with metastatic liver cancer, the nurse should include
interventions that
a. focus primarily on symptomatic and comfort measures.
b. reassure the patient that chemotherapy offers a good prognosis.
c. promote the patient's confidence that surgical excision of the tumor will be successful.
d. provide information necessary for the patient to make decisions regarding liver
transplantation. - correct answer a. focus primarily on symptomatic and comfort measures.
Nursing management of the patient with acute pancreatitis includes (select all that apply)
a. checking for signs of hypocalcemia.
b. providing a diet low in carbohydrates.
c. giving insulin based on a sliding scale.
d. observing stools for signs of steatorrhea.
e. monitoring for infection, particularly respiratory tract infection. - correct answer a. checking
for signs of hypocalcemia.
e. monitoring for infection, particularly respiratory tract infection.
A patient with pancreatic cancer is admitted to the hospital for evaluation of possible
treatment options. The patient asks the nurse to explain the Whipple procedure that the
surgeon has described. The explanation includes the information that a Whipple procedure
involves
a. creating a bypass around the obstruction caused by the tumor by joining the gallbladder to
the jejunum.
b. resection of the entire pancreas and the distal portion of the stomach, with anastomosis of
the common bile duct and the stomach into the duodenum.
c. removal of part of the pancreas, part of the stomach, the duodenum, and the gallbladder,
with joining of the pancreatic duct, the common bile duct, and the stomach into the jejunum.
d. radical removal of the pancreas, the duodenum, and the spleen, and attachment of the
stomach to the jejunum, which requires oral supplementation of pancreatic digestive enzymes
and insulin replacement therapy. - correct answer c. removal of part of the pancreas, part of
the stomach, the duodenum, and the gallbladder, with joining of the pancreatic duct, the
common bile duct, and the stomach into the jejunum.
The nursing management of the patient with cholecystitis associated with cholelithiasis is based
on the knowledge that
, Adv Med Surg 4 Lewis, ATI, Evolve( 150 questions with 100% correct answer s)rated A+
a. shock-wave therapy should be tried initially.
b. once gallstones are removed, they tend not to recur.
c. the disorder can be successfully treated with oral bile salts that dissolve gallstones.
d. laparoscopic cholecystectomy is the treatment of choice in most patients who are
symptomatic. - correct answer d. laparoscopic cholecystectomy is the treatment of choice in
most patients who are symptomatic.
Teaching in relation to home management after a laparoscopic cholecystectomy should include
a. keeping the bandages on the puncture sites for 48 hours.
b. reporting any bile-colored drainage or pus from any incision.
c. using over-the-counter antiemetics if nausea and vomiting occur.
d. emptying and measuring the contents of the bile bag from the T tube every day. - correct
answer b. reporting any bile-colored drainage or pus from any incision.
The nurse is caring for a woman recently diagnosed with viral hepatitis A. Which individual
should the nurse refer for an immunoglobulin (IG) injection?
A caregiver who lives in the same household with the patient
A friend who delivers meals to the patient and family each week
A relative with a history of hepatitis A who visits the patient daily
A child living in the home who received the hepatitis A vaccine 3 months ago - correct answer
A caregiver who lives in the same household with the patient
The nurse provides discharge instructions for a 64-yr-old woman with ascites and peripheral
edema related to cirrhosis. Which patient statement indicates teaching was effective?
"Lactulose should be taken every day to prevent constipation."
"It is safe to take acetaminophen up to four times a day for pain."
"Herbs and other spices should be used to season my foods instead of salt."
"I will eat foods high in potassium while taking spironolactone (Aldactone)." - correct answer
"Herbs and other spices should be used to season my foods instead of salt."
The nurse is caring for a 55-yr-old man patient with acute pancreatitis resulting from gallstones.
Which clinical manifestation would the nurse expect?
Hematochezia
Left upper abdominal pain
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