Nursing Elites

1. Which of the following nursing interventions should have the highest priority during the first hour after the admission of a client with cholecystitis who is experiencing pain, nausea, and vomiting?

• A. Administering pain medication.
• B. Completing the admission history.
• C. Maintaining hydration.
• D. Teaching about planned diagnostic tests.

Correct answer: A

Rationale: Administering pain medication would have the highest priority during the first hour after the client's admission. Pain relief is essential to address the client's immediate discomfort and distress. Completing the admission history, maintaining hydration, and teaching about planned diagnostic tests are important aspects of care but can be addressed after addressing the client's pain and stabilizing their condition.

2. Ralph has a history of alcohol abuse and has acute pancreatitis. Which lab value is most likely to be elevated?

• A. Calcium
• B. Glucose
• C. Magnesium
• D. Potassium

Correct answer: B

Rationale: In a patient with acute pancreatitis and a history of alcohol abuse, glucose levels are most likely to be elevated.

3. A client with which of the following conditions may be likely to develop rectal cancer?

• A. Adenomatous polyps
• B. Diverticulitis
• C. Hemorrhoids
• D. Peptic ulcer disease

Correct answer: A

Rationale: Adenomatous polyps are a known risk factor for the development of rectal cancer.

4. Lactulose (Chronulac) is prescribed for a client with a diagnosis of hepatic encephalopathy. The nurse would determine that this medication has had a therapeutic effect if which of the following is noted?

• A. Increased red blood cell count
• B. Decreased serum ammonia level
• C. Increased protein level
• D. Decreased white blood cell level

Correct answer: B

Rationale: Lactulose is prescribed for the client with hepatic encephalopathy to reduce bacterial breakdown of protein in the bowel. The medication creates an acidic environment in the bowel and causes the ammonia to leave the bloodstream and enter the colon. Ammonia then becomes trapped in the bowel. Lactulose also has a laxative effect that allows for the elimination of the ammonia.

5. When preparing the client with hepatitis A for extended convalescence, the nurse teaches the client about problems that may occur. The nurse knows that the client has understood the teaching when he says that he is most likely to have difficulty:

• A. Controlling abdominal pain.
• B. Maintaining a regular bowel elimination pattern.
• C. Preventing respiratory complications.
• D. Maintaining a positive, optimistic outlook.

Correct answer: D

Rationale: Convalescence after hepatitis A may take weeks or even months. Boredom and depression are common problems that the client should anticipate. Abdominal pain is not usually a symptom of hepatitis A. Maintaining a regular bowel elimination pattern is not usually a problem with hepatitis. Problems preventing respiratory complications are unlikely. To support healing, activity is strictly limited but bed rest is not prescribed.

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