the patient described in the preceding question has a positive h pylori antibody blood test she is compliant with the medical regimen you prescribe al

ATI LPN

Adult Medical Surgical ATI

1. The patient described in the preceding question has a positive H. pylori antibody blood test. She is compliant with the medical regimen you prescribe. Although her symptoms initially respond, she returns to see you six months later with the same symptoms. Which of the following statements is correct?

A. She is at low risk for reinfection with H. pylori
B. A positive serum IgG indicates that eradication of H. pylori was successful
C. The urease breath test is an ideal test to document failure of eradication
D. Dyspepsia typically worsens with H. pylori eradication

Correct answer: C

Rationale: Reinfection with H. pylori is rare, and the persistence of infection usually indicates poor compliance with the medical regimen or antibiotic resistance. The serum IgG may remain positive indefinitely and cannot be used to determine failure of eradication; however, a decrease in quantitative IgG levels has been utilized to indicate treatment success. If available, either the stool antigen or urease breath test is ideal to document treatment failure due to their high sensitivity, specificity, and ease of performance. The relationship between dyspepsia and H. pylori is controversial, but generally, dyspepsia does not typically improve with H. pylori eradication.

2. Why is a low-protein diet recommended for a patient with renal failure?

A. To prevent fluid overload
B. To reduce nitrogenous waste
C. To maintain electrolyte balance
D. To prevent hyperglycemia

Correct answer: B

Rationale: A low-protein diet is crucial for patients with renal failure to reduce the generation of nitrogenous waste products like urea and creatinine, which the compromised kidneys struggle to eliminate effectively. By limiting protein intake, the production of these waste products is decreased, lessening the burden on the kidneys and helping to manage the progression of renal failure. Choices A, C, and D are incorrect because a low-protein diet primarily aims to reduce the workload on the kidneys by decreasing the production of nitrogenous waste, not to prevent fluid overload, maintain electrolyte balance, or prevent hyperglycemia.

3. A client with long-standing obesity has been prescribed phentermine/topiramate-ER. What statement by the client suggests that further health education is necessary?

A. I'm so relieved to start this medication. I really don't like having to exercise or change what I eat.
B. It's hard to believe that there are actually medications that can treat obesity.
C. I'm a bit nervous to start this medication because I know I'll need blood tests sometimes.
D. I'm going to have to do some rearranging of my finances to make sure I can afford this medication.

Correct answer: A

Rationale: Choice A suggests the need for further health education as the client expresses a reluctance to exercise or change dietary habits, indicating a lack of understanding about the importance of lifestyle modifications in conjunction with medication for effective weight management. It is important for the client to comprehend that a holistic approach, including lifestyle changes, is crucial for successful obesity treatment and long-term health benefits.

4. The nurse is administering sevelamer (RenaGel) during lunch to a client with end-stage renal disease (ESRD). The client asks the nurse to bring the medication later. The nurse should describe which action of RenaGel as an explanation for taking it with meals?

A. Prevents indigestion associated with the ingestion of spicy foods.
B. Binds with phosphorus in foods and prevents absorption.
C. Promotes stomach emptying and prevents gastric reflux.
D. Buffers hydrochloric acid and prevents gastric erosion.

Correct answer: B

Rationale: Sevelamer (RenaGel) binds with phosphorus in foods and prevents its absorption. By taking RenaGel with meals, the binding of phosphorus helps to reduce the phosphorus load absorbed from food, thus aiding in the management of hyperphosphatemia in clients with ESRD.