Nur Medical Surg 203 ECPI UNIVERSITY
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Free Nur Medical Surg 203 ECPI UNIVERSITY Questions
Immediately following a liver biopsy, the client becomes dyspneic, the pulse increases to 100, and no breath sounds can be heard on the affected side. What should the nurse suspect?
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Pleural effusion
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Hemorrhage of the liver
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Pneumothorax
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Peritonitis
Explanation
The Correct Answer is:
C. Pneumothorax
Detailed Explanation:
A pneumothorax can occur as a complication of a liver biopsy when the needle inadvertently punctures the pleura or lung tissue. The sudden onset of dyspnea, tachycardia, and absence of breath sounds on the affected side indicates air has entered the pleural space, collapsing the lung. This is a medical emergency requiring prompt assessment, notification of the healthcare provider, and preparation for possible chest tube insertion to re-expand the lung and restore ventilation.
A nurse is collecting data from a client who has pancreatitis. Which of the following findings should the nurse identify as a manifestation of pancreatitis?
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Gray-blue discoloration of the skin around the umbilicus
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Generalized cyanosis
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Hyperactive bowel sounds
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Wheezing in the lower lung fields
Explanation
The Correct Answer is:
A. Gray-blue discoloration of the skin around the umbilicus
Detailed Explanation:
A gray-blue discoloration around the umbilicus, known as Cullen’s sign, is a classic indicator of acute pancreatitis. It results from internal bleeding caused by pancreatic enzyme leakage that leads to subcutaneous tissue discoloration. This finding signals severe disease and possible hemorrhagic pancreatitis, requiring urgent medical attention. Other signs may include epigastric pain radiating to the back, nausea, vomiting, and elevated serum amylase and lipase levels. Immediate supportive care and close monitoring are critical for recovery.
A nurse is assessing a client with cirrhosis and notes the presence of caput medusae. This finding is best described as:
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Yellow discoloration of the skin
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Enlarged lymph nodes
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Distended veins around the umbilicus
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Dark tarry stools
Explanation
The Correct Answer is:
C. Distended veins around the umbilicus
Detailed Explanation:
Caput medusae refers to distended, tortuous veins radiating from the umbilicus, resembling a medusa’s head of snakes. It is a sign of portal hypertension, a common complication of cirrhosis. Increased pressure in the portal venous system causes blood to flow through collateral vessels, including superficial abdominal veins, leading to this visible pattern. The finding indicates advanced liver disease and impaired hepatic circulation, often accompanied by ascites, splenomegaly, and other manifestations of portal hypertension.
It has been determined that a client with hepatitis has contracted the infection from contaminated food. Which type of hepatitis is this client most likely experiencing?
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Hepatitis C
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Hepatitis A
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Hepatitis D
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Hepatitis B
Explanation
The Correct Answer is:
B. Hepatitis A
Detailed Explanation:
Hepatitis A is most commonly transmitted through the fecal–oral route, often from ingesting food or water contaminated with the virus. Outbreaks are typically linked to poor sanitation or improper hand hygiene during food preparation. Unlike hepatitis B and C, which are spread through blood and body fluids, hepatitis A does not cause chronic liver disease and usually resolves on its own. Preventive measures include proper handwashing, safe food handling, and vaccination against the hepatitis A virus.
A patient has been told they need to have a blood test called an A1c to check for diabetes. Which of the following should the nurse explain the test measures?
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The test measures the average levels of the glucose in your blood for the last 6 months.
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Cheyne-Stokes
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The test measures the average levels of the glucose in your blood for the last 3 months.
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The test measures the average levels of the glucose in your blood for the last 10 days.
Explanation
The Correct Answer is:
C. The test measures the average levels of the glucose in your blood for the last 3 months.
Detailed Explanation:
The A1c test, also known as glycosylated hemoglobin, measures the percentage of hemoglobin molecules in the blood that have glucose attached to them. Because red blood cells live about 120 days (3 months), this test reflects the average blood glucose level over that time period, helping to monitor long-term glucose control in diabetic and prediabetic patients.
A nurse is caring for a client post-cholecystectomy with a T-tube in place. Which nursing action is appropriate?
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Keep the drainage bag above the level of the abdomen
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Clamp the T-tube 2 hours before and after meals
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Encourage a high-fat diet to stimulate bile flow
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Assess and record the color and amount of drainage
Explanation
The Correct Answer is:
D. Assess and record the color and amount of drainage
Detailed Explanation:
After a cholecystectomy, a T-tube is inserted to maintain bile drainage and allow the common bile duct to heal. The nurse should assess and accurately record the color, consistency, and amount of bile drainage to monitor for complications such as obstruction or infection. Normal bile drainage is greenish-yellow and gradually decreases over time. The drainage bag should remain below the abdomen to prevent backflow, and the diet should be low in fat until bile flow normalizes.
Insulin is most rapidly absorbed into the:
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Abdomen
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Legs
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Arms
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Buttocks
Explanation
The Correct Answer is:
A. Abdomen
Detailed Explanation:
The abdomen provides the fastest and most consistent absorption site for insulin due to its rich blood supply and thinner subcutaneous tissue compared to other areas. This makes it the preferred injection site, especially for rapid-acting or short-acting insulin. Rotation of injection sites within the same region is recommended to prevent lipodystrophy and maintain consistent absorption rates. In contrast, insulin injected into the thighs, arms, or buttocks absorbs more slowly.
A nurse finds a patient who has type 1 diabetes mellitus lying in bed, sweating, tachycardic, and reports feeling light-headed and shaky. Which complication should the nurse expect?
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Hyperglycemia
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Ketoacidosis
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Hypoglycemia
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Nephropathy
Explanation
The Correct Answer is:
C. Hypoglycemia
Detailed Explanation:
The patient’s symptoms—sweating, tachycardia, shakiness, and light-headedness—are classic signs of hypoglycemia, a blood glucose level typically below 70 mg/dL. Low glucose triggers an adrenergic response as the body releases epinephrine to raise blood sugar, producing these symptoms. Immediate treatment involves giving a fast-acting carbohydrate such as glucose tablets or juice to prevent progression to confusion, seizures, or loss of consciousness. Early recognition and prompt intervention are critical to prevent severe neurological complications.
A nurse is reinforcing teaching with a client who reports right shoulder pain following a laparoscopic cholecystectomy. Which of the following statements should the nurse make?
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"The pain results from lying in one position too long during surgery."
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"The pain is caused from the nitrous dioxide injected into the abdomen."
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"The pain will dissipate if you ambulate frequently."
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"The pain occurs as a residual pain from cholecystitis."
Explanation
The Correct Answer is:
C. "The pain will dissipate if you ambulate frequently."
Detailed Explanation:
After a laparoscopic cholecystectomy, right shoulder pain commonly occurs due to carbon dioxide (CO₂) gas used to insufflate the abdomen during surgery. The gas irritates the phrenic nerve, causing referred pain to the shoulder. The most effective relief is early and frequent ambulation, which helps the body absorb and expel the remaining CO₂ through respiration. This pain is temporary and usually resolves within 24–48 hours as the gas is reabsorbed.
A nurse is reinforcing dietary teaching to a client with diabetes. Which meal choice is most appropriate?
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Donuts and orange juice
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Grilled salmon, brown rice, and steamed broccoli
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Fried chicken, mashed potatoes, and sweet tea
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Pepperoni pizza and soda
Explanation
The Correct Answer is:
B. Grilled salmon, brown rice, and steamed broccoli
Detailed Explanation:
The meal of grilled salmon, brown rice, and steamed broccoli provides a balanced mix of lean protein, complex carbohydrates, and fiber—ideal for blood glucose control in diabetes. Salmon offers healthy omega-3 fats that support cardiovascular health, brown rice provides slow-releasing carbohydrates that prevent glucose spikes, and broccoli adds essential vitamins and fiber for digestion and satiety. This combination promotes stable blood sugar levels and overall metabolic health in diabetic patients.
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