The document contains 20 multiple choice questions about the gastrointestinal, renal, and hepatic systems. It provides explanations for each answer that focus on the key aspects of the disease process or nursing care being tested. Some examples covered include evaluating effectiveness of intestinal decompression, assessing a client with cirrhosis for signs of hepatic encephalopathy, and identifying appropriate dietary restrictions for a client taking medications to treat a uric acid kidney stone.
Please note, the MCQs(Multiple choice questions) on this ppt are according to the specifications and syllabus of Specialty Certificate Examination (SCE) in Gastroenterology and the European Section and Board of Gastroenterology and Hepatology Examination (ESBGHE). However, they provide useful knowledge in the relevant subject area in general. Hence, it is recommended you to go through these videos and gather some information to gain success in future medical and surgical field examinations.
https://www.youtube.com/watch?v=7k5kba0TNRM
https://www.youtube.com/watch?v=kcGi5_xm0Uk
https://youtu.be/lSdnQVdLySg
Please note, the MCQs(Multiple choice questions) on this ppt are according to the specifications and syllabus of Specialty Certificate Examination (SCE) in Gastroenterology and the European Section and Board of Gastroenterology and Hepatology Examination (ESBGHE). However, they provide useful knowledge in the relevant subject area in general. Hence, it is recommended you to go through these videos and gather some information to gain success in future medical and surgical field examinations.
https://www.youtube.com/watch?v=1o3JdzgBM9g
https://www.youtube.com/watch?v=7k5kba0TNRM
https://www.youtube.com/watch?v=kcGi5_xm0Uk
Please note, the MCQs(Multiple choice questions) on this ppt are according to the specifications and syllabus of Specialty Certificate Examination (SCE) in Gastroenterology and the European Section and Board of Gastroenterology and Hepatology Examination (ESBGHE). However, they provide useful knowledge in the relevant subject area in general. Hence, it is recommended you to go through these videos and gather some information to gain success in future medical and surgical field examinations.
https://www.youtube.com/watch?v=7k5kba0TNRM
https://www.youtube.com/watch?v=kcGi5_xm0Uk
https://youtu.be/lSdnQVdLySg
Please note, the MCQs(Multiple choice questions) on this ppt are according to the specifications and syllabus of Specialty Certificate Examination (SCE) in Gastroenterology and the European Section and Board of Gastroenterology and Hepatology Examination (ESBGHE). However, they provide useful knowledge in the relevant subject area in general. Hence, it is recommended you to go through these videos and gather some information to gain success in future medical and surgical field examinations.
https://www.youtube.com/watch?v=1o3JdzgBM9g
https://www.youtube.com/watch?v=7k5kba0TNRM
https://www.youtube.com/watch?v=kcGi5_xm0Uk
Please note, the MCQs(Multiple choice questions) on this video are according to the specifications and syllabus of Specialty Certificate Examination (SCE) in Gastroenterology and the European Section and Board of Gastroenterology and Hepatology Examination (ESBGHE). However, they provide useful knowledge in the relevant subject area in general. Hence, it is recommended you to go through these videos and gather some information to gain success in future medical and surgical field examinations.
https://www.youtube.com/watch?v=1o3JdzgBM9g
https://www.youtube.com/watch?v=7k5kba0TNRM
https://www.youtube.com/watch?v=kcGi5_xm0Uk
You can pass your CCNS Exam with our training kits and practice questions answers prepared by industry experts and professionals. For more info please visit here: https://www.certifyguide.com/exam/CCNS/
1. A nurse responds to the cardiac monitor alarm of a patient an.docxmonicafrancis71118
1. A nurse responds to the cardiac monitor alarm of a patient and observes that the patient has atrial flutter. The patient is sitting up in the bed and is responsive. Which of the following actions should the nurse take first?
a. Institute carotid sinus massage
b. Assess the patient for dyspnea
c. Initiate CPR
d. Place the patient Trendelenburg position
2. The night after an exploratory laparotomy, a patient who has a nasogastric tube attached to low suction reports nausea. A nurse should take which of the following action first?
a. Administer antiemetic medication
b. Determine the patency of the patient’s NG tube
c. Instruct the patient to take deep breaths
d. Asses the patient’s pain level
3. A nurse from medical-surgical unit is asked to work on the orthopedic unit. The medical-surgical nurse has no orthopedic nursing experience. Which client should be assigned to the medical-surgical nurse?
a. a client with a cast for a fractured femur and who has numbness and discoloration of the toes
b. a client with balanced skeletal traction and who needs assistance with morning care
c. a client who had an above-the-knee amputation yesterday and has a temperature of 101.4F degrees
d. a client who had a total hip replacement 2 days ago and needs blood glucose
4. A nurse is caring for four clients and is preparing to do her initial rounds. Which client should the nurse assess first?
a. A patient with diabetes being discharged today
b. A patient with a trach with lots of secretions
c. A patient scheduled for PT this morning
d. A patient with a pressure ulcer that needs a dressing change
5. A nurse enters a room and finds a client lying on the floor. Which action should the nurse perform first?
a. Call for help
b. Determine if the patient is responsive
c. Assist the patient back to bed
d. Ask the patient what happened
6. The nurse plans care for a client in the post-anesthesia care unit. Which assessment should the nurse make first?
a. Respiratory status
b. Level of consciousness
c. Level of pain
d. Reflexes and movement of extremities
7. A nurse in the clinic is reviewing the diet of a 28-year old female who reports several months of intermittent abdominal pain, abdominal bloating, and flatulence. Which is a priority for the nurse to counsel the client to avoid in her diet?
a. Fiber
b. Yogurt
c. Broccoli
d. Simple carbs
8. A nurse in a long term facility is planning care for an elderly client with confusion. Which action should the nurse take first?
a. Sit the patient in the activity chair
b. Apply a vest restraint
c. Apply wrist restraints in the bed
d. Have a staff member sit with the patient for the entire shift
9. The nurse is providing care in the emergency department to the client with chest pain. Which action is most important for the nurse to do first?
a. Start an IV
b. Administer oxygen
c. Administer morphine
d. Start a lidocaine IV drip
10. A nurse arrives on the scene of a multi-motor vehicle accident. The nurse determines that.
Please note, the MCQs(Multiple choice questions) on this ppt are according to the specifications and syllabus of Specialty Certificate Examination (SCE) in Gastroenterology and the European Section and Board of Gastroenterology and Hepatology Examination (ESBGHE). However, they provide useful knowledge in the relevant subject area in general. Hence, it is recommended you to go through these videos and gather some information to gain success in future medical and surgical field examinations.
https://www.youtube.com/watch?v=1o3JdzgBM9g
https://www.youtube.com/watch?v=7k5kba0TNRM
https://www.youtube.com/watch?v=kcGi5_xm0Uk
Please note, the MCQs(Multiple choice questions) on this video are according to the specifications and syllabus of Specialty Certificate Examination (SCE) in Gastroenterology and the European Section and Board of Gastroenterology and Hepatology Examination (ESBGHE). However, they provide useful knowledge in the relevant subject area in general. Hence, it is recommended you to go through these videos and gather some information to gain success in future medical and surgical field examinations.
https://www.youtube.com/watch?v=1o3JdzgBM9g
https://www.youtube.com/watch?v=7k5kba0TNRM
https://www.youtube.com/watch?v=kcGi5_xm0Uk
You can pass your CCNS Exam with our training kits and practice questions answers prepared by industry experts and professionals. For more info please visit here: https://www.certifyguide.com/exam/CCNS/
1. A nurse responds to the cardiac monitor alarm of a patient an.docxmonicafrancis71118
1. A nurse responds to the cardiac monitor alarm of a patient and observes that the patient has atrial flutter. The patient is sitting up in the bed and is responsive. Which of the following actions should the nurse take first?
a. Institute carotid sinus massage
b. Assess the patient for dyspnea
c. Initiate CPR
d. Place the patient Trendelenburg position
2. The night after an exploratory laparotomy, a patient who has a nasogastric tube attached to low suction reports nausea. A nurse should take which of the following action first?
a. Administer antiemetic medication
b. Determine the patency of the patient’s NG tube
c. Instruct the patient to take deep breaths
d. Asses the patient’s pain level
3. A nurse from medical-surgical unit is asked to work on the orthopedic unit. The medical-surgical nurse has no orthopedic nursing experience. Which client should be assigned to the medical-surgical nurse?
a. a client with a cast for a fractured femur and who has numbness and discoloration of the toes
b. a client with balanced skeletal traction and who needs assistance with morning care
c. a client who had an above-the-knee amputation yesterday and has a temperature of 101.4F degrees
d. a client who had a total hip replacement 2 days ago and needs blood glucose
4. A nurse is caring for four clients and is preparing to do her initial rounds. Which client should the nurse assess first?
a. A patient with diabetes being discharged today
b. A patient with a trach with lots of secretions
c. A patient scheduled for PT this morning
d. A patient with a pressure ulcer that needs a dressing change
5. A nurse enters a room and finds a client lying on the floor. Which action should the nurse perform first?
a. Call for help
b. Determine if the patient is responsive
c. Assist the patient back to bed
d. Ask the patient what happened
6. The nurse plans care for a client in the post-anesthesia care unit. Which assessment should the nurse make first?
a. Respiratory status
b. Level of consciousness
c. Level of pain
d. Reflexes and movement of extremities
7. A nurse in the clinic is reviewing the diet of a 28-year old female who reports several months of intermittent abdominal pain, abdominal bloating, and flatulence. Which is a priority for the nurse to counsel the client to avoid in her diet?
a. Fiber
b. Yogurt
c. Broccoli
d. Simple carbs
8. A nurse in a long term facility is planning care for an elderly client with confusion. Which action should the nurse take first?
a. Sit the patient in the activity chair
b. Apply a vest restraint
c. Apply wrist restraints in the bed
d. Have a staff member sit with the patient for the entire shift
9. The nurse is providing care in the emergency department to the client with chest pain. Which action is most important for the nurse to do first?
a. Start an IV
b. Administer oxygen
c. Administer morphine
d. Start a lidocaine IV drip
10. A nurse arrives on the scene of a multi-motor vehicle accident. The nurse determines that.
Please note, the MCQs(Multiple choice questions) on this ppt are according to the specifications and syllabus of Specialty Certificate Examination (SCE) in Gastroenterology and the European Section and Board of Gastroenterology and Hepatology Examination (ESBGHE). However, they provide useful knowledge in the relevant subject area in general. Hence, it is recommended you to go through these videos and gather some information to gain success in future medical and surgical field examinations.
https://www.youtube.com/watch?v=1o3JdzgBM9g
https://www.youtube.com/watch?v=7k5kba0TNRM
https://www.youtube.com/watch?v=kcGi5_xm0Uk
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
2. Question 1
The physician orders intestinal decompression with
a Cantor tube for a client with an intestinal
obstruction. In order to determine effectiveness of
intestinal decompression the nurse should evaluate
the client to determine if:
A.Fluid and gas have been removed from the
intestine
B.The client has had a bowel movement.
C.The client’s urinary output is adequate
D.The client can sit up without pain.
3. Answer
Answer A:
Intestinal decompression is accomplished with a
Cantor, Harris, or Miller-Abbott tube. These 6-10
foot tubes are passed into the small intestine to
the obstruction. They remove accumulated fluid
and gas, relieving the pressure.
4. Question 2
The client with an intestinal obstruction
continues to have acute pain even though the
nasogastric tube is patent and draining. Which
action by the nurse would be most appropriate?
A.Reassure the client that the nasogastric tube
is functioning.
B.Assess the client for a rigid abdomen
C.Administer an opioid as ordered.
D.Reposition the client on the left side.
5. Answer
Answer B. The client’s pain may be indicative of
peritonitis, and the nurse should assess for signs
and symptoms, such as a rigid abdomen,
elevated temperature, and increasing pain.
Reassuring the client is important, but accurate
assessment of the client is essential. The full
assessment should occur before pain relief
measures are employed. Repositioning the
client to the left side will not resolve the pain.
6. Question 3
A client has advanced cirrhosis of the liver. The client’s spouse
asks the nurse why his abdomen is swollen, making it very
difficult for him to fasten his pants. How should the nurse
respond to provide the most accurate explanation of the
disease process?
A.“He must have been eating too many foods with salt in
them. Salt pulls water with it.”
B.“The swelling in his ankles must have moved up closer to his
heart so the fluid circulates better.”
C.“He must have forgotten to take his daily water pill.”
D.“Blood is not able to flow readily through the liver now, and
the liver cannot make protein to keep fluid inside the blood
vessels.”
7. Answer
Answer D:
Portal hypertension and hypoalbuminemia as a
result of cirrhosis cause a fluid shift into the
peritoneal space causing ascites. Although
diuretics promote the excretion of excess fluid,
occasionally forgetting or omitting a dose will
not yield the ascites found in cirrhosis of the
liver.
8. Question 4
A client with cirrhosis begins to develop ascites.
Spironolactone (Aldactone) is prescribed to
treat the ascites. The nurse should monitor the
client closely for which of the following drug-
related adverse effects?
A.Constipation
B.Hyperkalemia
C.Irregular pulse
D.Dysuria
9. Answer
Answer B:
Spironolactone (Aldactone) is a potassium-
sparing diuretic; therefore, clients should be
monitored closely for hyperkalemia. Other
common adverse effects include abdominal
cramping, diarrhea, dizziness, headache, and
rash.
10. Question 5
Which of the following interventions should the
nurse anticipate incorporating into the client’s
plan of care when hepatic encephalopathy
initially develops?
A.Inserting a NG tube
B.Restricting fluids to 1000 mL/day
C.Administering IV salt-poor albumin
D.Implementing a low-protein diet
11. Answer
Answer D. When hepatic encephalopathy
develops, measures are taken to reduce
ammonia formation. Protein is restricted in the
diet. Fluid restriction and salt-poor albumin are
incorporated into the treatment of ascites, but
not hepatic encephalopathy.
12. Question 6
A client has been admitted to the ED with acute
renal failure. What should the nurse do? Select
all that apply:
A.Take vital signs
B.Establish an IV access site
C.Call the admitting physician for orders.
D.Contact the hemodialysis unit.
13. Answer
Answers A, B, C:
The nurse should assess the vital signs because
the pulse and respirations will be elevated.
Establishing a site for IV therapy will become
important because fluids will be administered IV
in addition to orally. The physician will need to
be contacted for further orders; there is no need
to contact the hemodialysis unit.
14. Question 7
The client with acute renal failure asks the nurse
for a snack. Because the client’s potassium level
is elevated, which of the following snacks is
most appropriate?
A.A gelatin dessert
B.Yogurt
C.An orange
D.Peanuts
15. Answer
Answer A:
Gelatin desserts contain little or no potassium
and can be served to a client on potassium-
restricted diet. Foods high in potassium include
bran and whole grains; most dried, raw, and
frozen fruits and vegetables; most milk and milk
products; chocolate, nuts, raisins, coconut and
strong brewed coffee.
16. Question 8
Which of the following abnormal blood values
would not be improved by dialysis treatment?
A.Elevated serum creatinine level
B.Hyperkalemia
C.Decrease hemoglobin concentration
D.Hypernatremia
17. Answer
Answer C: Dialysis has no effect on anemia.
Because some red blood cells are injured during
the procedure, dialysis aggravates a low
hemoglobin concentration. Dialysis will clear
metabolic waste products from the body and
correct electrolyte imbalances.
18. Question 9
Which of the following symptoms would most
likely indicate that the client has pyelonephritis?
A.Ascites
B.Costovertebral angle (CVA) tenderness
C.Polyuria
D.Nausea and vomiting
19. Answer
Answer B:
Common symptoms of pyelonephritis include
CVA tenderness, burning on urination, urinary
urgency or frequency, chills, fever, and fatigue.
Ascites, polyuria, and nausea and vomiting are
not indicative of pyelonephritis.
20. Question 10
After completion of peritoneal dialysis, the
nurse should expect the client to exhibit which
of the following characteristics?
A.Hematuria
B.Weight loss
C.Hypertension
D.Increased urine output
21. Answer
Answer B:
Weight loss is expected because of the removal
of fluid. The client’s weight before and after
dialysis is one measure of the effectiveness of
treatment. Blood pressure usually decreases
because of the removal of fluid. Hematuria
would not occur after completion of peritoneal
dialysis. Dialysis only minimally affects the
damaged kidneys’ ability to manufacture urine.
22. Question 11
The nurse is doing an admission assessment on
a client with a history of duodenal ulcer. To
determine whether the problem is currently
active, the nurse should assess the client for
which symptom(s) of duodenal ulcer?
A.Weight loss
B.Nausea and vomiting
C.Pain relieved by food intake
D.Pain radiating down the right arm
23. Answer
Answer C: A frequent symptom of duodenal
ulcer is pain that is relieved food intake. These
clients generally describe the pain as a burning,
heavy, sharp, or “hungry” pain that often
localizes in the midepigastric area. The client
with duodenal ulcers usually does not
experience weight loss or nausea and vomiting.
These symptoms are more typical in the client
with a gastric ulcer.
24. Question 12
A client with a peptic ulcer is diagnosed with a Helicobacter pylori
infection. The nurse is teaching the client about the medications
prescribed, including clarithromycin (Biaxin), esomeprazole (Nexium),
and amoxicillin (Amoxil). Which statement by the client indicates the
best understanding of the medication regimen?
A.“My ulcer will heal because these medications will kill the bacteria.”
B.These medications are only taken when I have pain from my ulcer.”
C.“The medications will kill the bacteria and stop the act acid
production.
D.“These medications will coat the ulcer and decrease the acid
production in my stomach.”
25. Answer
Answer C: Triple therapy for Helicobacter pylori
infection usually includes two antibacterial
drugs and a proton pump inhibitor
Clarithromycin and amoxicillin are
antibacterials. Esomeprozole is a proton pump
inhibitor. These medications will kill the bacteria
and decrease acid production.
26. Question 13
The client with chronic renal failure returns to
the nursing unit following a hemodialysis
treatment. On assessment, the nurse notes that
the client’s temperature 100.2 F. Which of the
following is the appropriate nursing action?
A.Monitor the client
B.Notify the physician
C.Elevate the head of the bed
D.Medicate the client for nausea.
27. Answer
Answer A:
The client may have an elevated temperature
following dialysis because the dialysis machine
warms the blood slightly. If the temperature is
elevated excessively and remains elevated,
sepsis would be suspected and a blood sample
would be obtained as prescribed for culture and
sensitivity determinations.
28. Question 14
The nurse is reviewing the record of a client with
a diagnosis of cirrhosis and notes that there is
documentation of the presence of asterixis. How
should the nurse assess for its presence?
A.Dorsiflex the client’s foot.
B.Measure the abdominal girth.
C.Ask the client to extend the arms.
D.Instruct the client to lean forward.
29. Answer
Answer C:
Asterixis is irregular flapping movements of the
fingers and wrists when the hands and arms are
outstretched, with the palms down, wrists bent
up, and fingers spread. Asterixis is the most
common and reliable sign and the hepatic
encephalopathy is developing. Options 1, 2, and
4 are incorrect.
30. Question 15
The client with a gastric ulcer has a prescription
for sucralfate (Carafate), 1 g by mouth 4 times
daily. The nurse schedules the medication for
which times?
A.With meals and at bedtime.
B.Every 6 hours around the clock.
C.One hour after meals and at bed time.
D.One hour before meals and at bedtime.
31. Answer
Answer D: Sucralfate is a gastric protectant. The
medication should be scheduled for
administration 1 hour before meals and at
bedtime. The medication is timed to allow it to
form a protective covering over the ulcer before
food intake stimulates gastric acid production
and mechanical irritation. The other options are
incorrect.
32. Question 16
The nurse is caring for a male client with
cirrhosis. Which assessment findings indicate
that the client has deficient vitamin K absorption
caused by this hepatic disease?
A. Dyspnea and fatigue
B. Ascites and orthopnea
C. Purpura and petechiae
D. Gynecomastia and testicular atrophy
•
33. Answer
Answer C. A hepatic disorder, such as cirrhosis,
may disrupt the liver’s normal use of vitamin K
to produce prothrombin (a clotting factor).
Consequently, the nurse should monitor the
client for signs of bleeding, including purpura
and petechiae. Dyspnea and fatigue suggest
anemia. Ascites and orthopnea are unrelated to
vitamin K absorption. Gynecomastia and
testicular atrophy result from decreased
estrogen metabolism by the diseased liver.
34. Question 17
A female client is admitted for treatment of chronic
kidney disease (CKD). Nurse Juliet knows that this
disorder increases the client’s risk of:
A. Water and sodium retention secondary to a severe
decrease in the glomerular filtration rate.
B. A decreased serum phosphate level secondary to
kidney failure.
C. An increased serum calcium level secondary to
kidney failure.
D. Metabolic alkalosis secondary to retention of
hydrogen ions.
35. Answer
Answer A. A client with CKD is at risk for fluid
imbalance — fluid retention if the kidneys fail to
produce urine. Electrolyte imbalances associated with
this disorder result from the kidneys’ inability to
excrete phosphorus; such imbalances may lead to
hyperphosphatemia with reciprocal hypocalcemia. CKD
may cause metabolic acidosis, not metabolic alkalosis,
secondary to inability of the kidneys to excrete
hydrogen ions.
36. Question 18
A female client with acute renal failure is undergoing
dialysis for the first time. The nurse in charge monitors
the client closely for dialysis equilibrium syndrome, a
complication that is most common during the first few
dialysis sessions. Typically, dialysis equilibrium
syndrome causes:
A. confusion, headache, and seizures.
B. acute bone pain and confusion.
C. weakness, tingling, and cardiac arrhythmias.
D. hypotension, tachycardia, and tachypnea.
37. Answer
Answer A. Dialysis equilibrium syndrome causes
confusion, a decreasing level of consciousness,
headache, and seizures. These findings, which
may last several days, probably result from a
relative excess of interstitial or intracellular
solutes caused by rapid solute removal from the
blood.
38. Question 19
The client who has a history of gout also is
diagnosed with nephrolithiasis and the stones
are determined to be of uric acid type. The
nurse gives the client instructions in which foods
to limit, including:
A. milk
B. liver
C. apples
D. carrots
39. Answer B. The client with uric acid stones should
avoid foods containing high amounts of purines.
This includes limiting or avoiding organ meats
such as liver, brain, heart, kidney, and
sweetbreads. Other foods to avoid include
herring, sardines, anchovies, meat extracts,
consommés, and gravies.
40. Question 20
A client has been diagnosed with urolothiasis in
the right ureter. The nurse would expect the
client to describe the pain (renal colic) as:
A. located in the upper right epigastric area,
radiating to the shoulder or back
B. occurring 2 to 3 hours after meal
C. intermittent in the right upper abdominal
quadrant, radiating to the groin
D. worsening with the ingestion of food
41. Answer
Answer C. Renal colic is generally associated with acute
obstruction of a ureter and resulting ureteral spasm. As the
stone moves along the ureter, the pain can be excruciating,
is intermittent in character, and is located in the flank and
upper abdominal quadrant of the affected side. It is caused
by the spasm of the ureter and anoxia of the ureter wall
from the pressure of the stone. The pain follows the
anterior course of the ureter down to the suprapubic area
and radiates to the external genitalia (groin). Options A, B,
and D describe pain characteristic of gastrointestinal
problems (cholecystitis, duodenal and gastric ulcers,
respectively).