Unit 2 QUIZ Flashcards
A client is suspected of having the onset of alcoholic liver disease. The nurse should be
assessing for which of the following manifestations related to the necrosis of liver cells?
Select one:
a. Tremors of the hands
b. Long muscle group atrophy
c. Rapid onset of jaundice
d. Development of multiple skin nodules
C. Rapid onset of jaundice
Alcoholic hepatitis is the intermediate stage between fatty changes and cirrhosis and is characterized by inflammation and necrosis of liver cells. The condition is always serious and sometimes fatal. The cardinal sign of alcoholic hepatitis is rapid onset of jaundice. Hand tremors are not specific to alcoholic hepatitis. Long muscle group atrophy can occur but is not the primary sign. Development of nodules is not caused by alcoholic hepatitis.
A client is admitted with late manifestations of cirrhosis. Which of the following clinical
manifestations confirm this diagnosis? Select all that apply.
Select one or more:
a. Splenomegaly with bleeding tendencies
b. Hepatomegaly felt on deep palpation
c. GI bleeding related to esophageal varices
d. Acute renal failure with electrolyte imbalances
e. Diffuse liver fibrosis with large, palpable lumps
A) Splenomegaly with bleeding tendencies
B) Hepatomegaly felt on deep palpation
C) GI bleeding related to esophageal varices
A client's medication contains 650 mg per ounce. What percentage of this dosage does 375 mg represent? Select one: a. 59.8 b. 60.6 c. 57.7 d. 56.7
C. 57.7
A new mother required an episiotomy during the birth of her baby. Two days after delivery, the patient is in need of a laxative. What will be the most effective drug for the nurse to administer? Select one: a. Docusate (Colace) b. Castor oil (Neolid) c. Magnesium sulfate (epsom salts) D. Cascara
Ans: A
Feedback:
Docusate is a stool softener that will make expulsion of stool easier in a traumatized body area following an episiotomy. Care must be taken to choose a mild laxative that will not enter breast milk and not affect the newborn if the mother is nursing. Docusate is the drug of choice from this list because it is mild and will produce a soft stool and decrease the need to strain. The other options would not be appropriate because they do not soften the stool and are harsher laxatives that can enter breast milk.
An adult patient is prescribed cimetidine (Tagamet). A nurse will instruct the patient
that an appropriate dosage and frequency of cimetidine is what?
Select one:
a. 300 mg PO at bedtime
b. 800 mg PO at bedtime
c. 20 mg PO b.i.d
d. 150 mg PO b.i.d
B. 800 mg PO at bedtime
The nurse administers psyllium hydrophilic mucilloid (Metamucil) expecting it to have
what action?
Select one:
a. Has antibacterial properties
b. Promotes reabsorption of water into large bowel
c. Slows peristalsis
d. Adds bulk to the stool
Ans:
D
Feedback:
Metamucil is a natural substance that forms a gelatin-like bulk of the intestinal contents. This agent stimulates local activity. It is considered milder and less irritating than many other bulk stimulants. Patients must use caution and take it with plenty of water because Metamucil absorbs large amounts of water and produces stools of gelatin-like consistency. It does not slow peristalsis, promote water reabsorption, or have antibacterial properties.
A patient has received a prescription for nabilone (Cesamet) for treatment of nausea.
The nurse is aware that this medication is used for what reason?
Select one:
a. The patient has a substance abuse problem
b. The patient is under age 18.
c. The patient is experiencing motion sickness.
d. The patient has not responded to other medications.
Ans:
D
Feedback:
Nabilone is a miscellaneous agent that is developed from the active ingredient of marijuana. It is used to treat nausea and vomiting related to cancer chemotherapy and is used only after the patient has not responded to other antiemetic medications. It should not be used in patients under 18 and because it is derived from marijuana it would not be appropriate to use for a patient with a history of substance abuse.
A patient with a duodenal ulcer is receiving sucralfate for short-term treatment. What
will the nurse advise the patient to avoid?
Select one:
a. Tums
b. Aluminum salts
c. Milk of Magnesia
d. Proton pump inhibitors
Ans:
B
Feedback:
If aluminum salts (AlternaGEL) are taken concurrently with sucralfate, a risk of high aluminum levels and related aluminum toxicity exists. The combination of sucralfate and aluminum salts should be avoided or used with extreme caution. Adverse reactions with sucralfate are not associated with Milk of magnesia, Tums, or proton pump inhibitors
A laboratory report listed the following four results: bilirubin (0.2), creatinine (1.46),
creatinine (0.09), and albumin (0.75). Identify the smallest amount.
Select one:
a. 1.46
b. 0.2
c. 0.09
d. 0.75
c. 0.09
A cancer patient is in the outpatient department to receive chemotherapy. The nurse administers prochlorperazine (Compazine) prophylactically before the infusion. What will the nurse’s teaching for this patient include?
Select one:
a. Avoid driving or any dangerous activities if dizziness or drowsiness occurs.
b. Check blood pressure at home on a regular basis.
c. Cover the head in extreme of temperatures.
d. Take extra precautions to avoid heat stroke.
Ans:
A
Feedback:
Prochlorperazine is an antiemetic that can cause dizziness and drowsiness. A patient who is taking it should be advised not to drive or undertake dangerous activities if these adverse effects occur. The drug does not cause heat loss or inability to sweat that may lead to heat stroke. This drug should not affect blood pressure, so there is no need to test for it.
The nurse administers ranitidine (Zantac) cautiously to patients with evidence of what conditions? Select one: a. Pulmonary disease b. Migraine headaches C. Renal disease d. Diabetes mellitus
Ans:
C
Feedback:
All histamine-2 antagonists are eliminated through the kidneys; dosages need to be reduced in patients with renal impairment. No caution is necessary with Zantac therapy in people with diabetes, pulmonary disease, or migraine headaches.
A 66-year-old woman has been diagnosed with diverticular disease based on her recent
complaints and the results of a computed tomography (CT) scan. Which of the client’s
following statements demonstrates an accurate understanding of this diagnosis?
Select one:
a. “I suppose I should try to eat a bit more fiber in my diet.”
b. “I think this might have happened because I’ve used enemas and laxatives too much.”
c. “From now on, I’m going to stick to an organic diet and start taking more supplements.”
d. “I’ve always struggled with heartburn and indigestion, and I guess I shouldn’t have
ignored those warning signs.”
A: I suppose I should try to eat more fiber and become a bit more active
Which of the following clients should the nurse observe most closely for the signs and
symptoms of paralytic ileus?
Select one:
a. An obese client who refuses to ambulate because he complains of shortness of breath
b. A client with a long-standing diagnosis of irritable bowel syndrome
c. A client who is first day postoperative following gallbladder surgery
d. A client whose acute diarrhea has necessitated the use of antidiarrheal medications
C: A client who is first day postoperative following gallbladder surgery
The nurse administers lubiprostone (Amitiza) to the patient with irritable bowel
syndrome and anticipates what therapeutic action from the drug?
Select one:
a. Adding bulk to the fecal matter to ease the process of stooling
b. Stimulate the bowel by increasing innervation
c. Irritation of the inner lining of the bowel to increase bowel motility
d. Secretion of chloride-rich intestinal fluid leading to increased motility
Ans:
D
Feedback:
Lubiprostone is a locally acting chloride channel activator that increases the secretion of a chloride-rich intestinal fluid without changing sodium or potassium levels. Increasing the intestinal fluid leads to increased motility. It does not add bulk, irritate the inner lining, or innervate the bowel.
The client has right upper quadrant pain caused by acute choledocholithiasis. The health care provider suspects the common bile duct is obstructed, based on which of the flowing lab values? Select one: a. Albumin 2.0 g/dL (low) b. Amylase 150 units/L (high) c. Serum calcium level 1.75 mmol/L (low) d. Bilirubin 256 umol/L (high)
d. Bilirubin 256 umol/L (high)
