Nursing Elites

1. A patient with chronic alcohol abuse is admitted with liver failure. You closely monitor the patient’s blood pressure because of which change that is associated with the liver failure?

• A. Hypoalbuminemia
• B. Increased capillary permeability
• C. Abnormal peripheral vasodilation
• D. Excess rennin release from the kidneys

Correct answer: C

Rationale: Abnormal peripheral vasodilation is a change associated with liver failure that requires close monitoring of the patient's blood pressure.

2. The nurse provides medication instructions to a client with peptic ulcer disease. Which statement, if made by the client, indicates best understanding of the medication therapy?

• A. The cimetidine (Tagamet) will cause me to produce less stomach acid.
• B. Sucralfate (Carafate) will change the fluid in my stomach.
• C. Antacids will coat my stomach.
• D. Omeprazole (Prilosec) will coat the ulcer and help it heal.

Correct answer: A

Rationale: Cimetidine (Tagamet) a Histamine H2 receptor antagonist, will decrease the secretion of gastric acid. Sucralfate (Carafate) promotes healing by coating the ulcer. Antacids neutralize acid in the stomach. Omeprazole (Prilosec) inhibits gastric acid secretion.

3. A client with a peptic ulcer is scheduled for a vagotomy. The client asks the nurse about the purpose of this procedure. The nurse tells the client that the procedure:

• A. Decreases food absorption in the stomach
• B. Heals the gastric mucosa
• C. Halts stress reactions
• D. Reduces the stimulus to acid secretions

Correct answer: D

Rationale: A vagotomy reduces the stimulus to acid secretions by cutting the vagus nerve, which innervates the stomach.

4. The client being treated for esophageal varices has a Sengstaken-Blakemore tube inserted to control the bleeding. The most important assessment is for the nurse to:

• A. Check that the hemostat is on the bedside
• B. Monitor IV fluids for the shift
• C. Regularly assess respiratory status
• D. Check that the balloon is deflated on a regular basis

Correct answer: C

Rationale: Regularly assessing respiratory status is crucial when a Sengstaken-Blakemore tube is inserted to control bleeding in esophageal varices.

5. A client with a peptic ulcer reports epigastric pain that frequently awakens her at night, a feeling of fullness in the abdomen, and a feeling of anxiety about her health. Based on this information, which nursing diagnosis would be most appropriate?

• A. Imbalanced Nutrition: Less than Body Requirements related to anorexia.
• B. Disturbed Sleep Pattern related to epigastric pain
• C. Ineffective Coping related to exacerbation of duodenal ulcer
• D. Activity Intolerance related to abdominal pain

Correct answer: B

Rationale: Disturbed Sleep Pattern related to epigastric pain is appropriate because the client reports pain that frequently awakens her at night.

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