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ATI Learning System PN Medical Surgical Final Quizlet
1. In a client with liver cirrhosis experiencing confusion and disorientation, what condition is most likely causing these symptoms?
- A. Hepatic encephalopathy
- B. Hypoglycemia
- C. Electrolyte imbalance
- D. Dehydration
Correct answer: A
Rationale: Hepatic encephalopathy is the most likely condition causing confusion and disorientation in a client with liver cirrhosis. This condition is a common complication of liver cirrhosis and is characterized by cognitive impairment due to elevated ammonia levels in the blood. The build-up of ammonia affects brain function, leading to symptoms such as confusion, disorientation, and altered consciousness. Hypoglycemia (choice B) may present with confusion but is less likely in a client with liver cirrhosis without a history of diabetes or insulin use. Electrolyte imbalance (choice C) and dehydration (choice D) can contribute to confusion but are not the primary causes in a client with liver cirrhosis experiencing these symptoms.
2. A patient is admitted with a diagnosis of myasthenia gravis. What symptom should the nurse expect to find during the assessment?
- A. Joint pain
- B. Muscle weakness
- C. Loss of sensation
- D. Severe headache
Correct answer: B
Rationale: Myasthenia gravis is a neuromuscular disorder characterized by muscle weakness and fatigue, especially in the voluntary muscles. Patients with myasthenia gravis commonly experience weakness in muscles that control eye movements, facial expressions, chewing, swallowing, and speaking. This weakness typically worsens with activity and improves with rest. Joint pain, loss of sensation, and severe headaches are not typical symptoms of myasthenia gravis. Therefore, the correct answer is muscle weakness (choice B) as it aligns with the characteristic symptom of myasthenia gravis.
3. An adolescent patient seeks care in the emergency department after sharing needles for heroin injection with a friend who has hepatitis B. To provide immediate protection from infection, what medication will the nurse administer?
- A. Corticosteroids
- B. Gamma globulin
- C. Hepatitis B vaccine
- D. Fresh frozen plasma
Correct answer: B
Rationale: In this scenario, the immediate need is to provide passive immunity to the adolescent patient. Gamma globulin contains antibodies against hepatitis B, which can offer immediate protection. The hepatitis B vaccine provides active immunity over time but is not immediate. Fresh frozen plasma and corticosteroids are not indicated for immediate protection against hepatitis B infection. Therefore, the correct choice is Gamma globulin as it can provide immediate passive immunity against hepatitis B.
4. The healthcare provider is caring for a client who has just undergone a thyroidectomy. Which assessment finding requires immediate intervention?
- A. Hoarse voice.
- B. Difficulty swallowing.
- C. Numbness and tingling around the mouth.
- D. Sore throat.
Correct answer: C
Rationale: Numbness and tingling around the mouth can indicate hypocalcemia, a potential complication after thyroidectomy. Hypocalcemia can occur due to inadvertent injury or removal of the parathyroid glands during the thyroidectomy, leading to decreased calcium levels. As a result, the client may experience symptoms such as numbness, tingling, muscle cramps, or spasms. Prompt intervention is necessary to prevent severe complications like tetany or seizures. Therefore, the healthcare provider should address numbness and tingling around the mouth immediately to prevent further deterioration of calcium levels and potential serious outcomes. Choices A, B, and D are not typically associated with immediate post-thyroidectomy complications and can be addressed after ensuring the client's calcium levels are stable.
5. A client with liver cirrhosis is being educated about managing their condition. Which statement by the client indicates a need for further teaching?
- A. I will avoid drinking alcohol
- B. I need to limit my salt intake
- C. I can take acetaminophen for pain
- D. I should eat a balanced diet
Correct answer: C
Rationale: The correct answer is C. Clients with liver cirrhosis should avoid acetaminophen because it can cause further liver damage. Acetaminophen is metabolized in the liver, and in individuals with liver disease, it can lead to liver toxicity. Therefore, clients with liver cirrhosis should use alternative pain medications that do not affect the liver, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or opioids as prescribed by their healthcare provider. Choices A, B, and D are correct statements for managing liver cirrhosis. Avoiding alcohol helps prevent further liver damage, limiting salt intake helps manage fluid retention and complications like ascites, and eating a balanced diet supports overall health and helps prevent malnutrition.
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