Nur Medical Surg 203 ECPI UNIVERSITY
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Free Nur Medical Surg 203 ECPI UNIVERSITY Questions
Which laboratory values would you use to assess liver function?
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BUN, creatinine, GFR
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ALT, AST, ammonia
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CBC, BMP, ABGs
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Amylase, lipase, WBC
Explanation
The Correct Answer is:
B. ALT, AST, ammonia
Detailed Explanation:
Liver function is primarily assessed using enzymes and byproducts that reflect hepatic cell integrity and metabolic performance. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are key enzymes released when hepatocytes are damaged, making them sensitive markers of liver injury. Ammonia levels rise when the liver fails to convert ammonia to urea, indicating impaired detoxification. Together, these values help evaluate inflammation, necrosis, or hepatic failure, guiding diagnosis and treatment decisions.
What is the priority intervention for a patient with esophageal varices who is vomiting blood?
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Administer beta blockers
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Maintain airway and stabilize circulation
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Perform paracentesis
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Administer vitamin K
Explanation
The Correct Answer is:
B. Maintain airway and stabilize circulation
Detailed Explanation:
When a patient with esophageal varices is vomiting blood, the priority is to maintain the airway and stabilize circulation. Massive hematemesis can obstruct the airway and lead to aspiration or hypovolemic shock. The nurse should position the patient to protect the airway, provide oxygen, start large-bore IV lines for fluid and blood replacement, and monitor vital signs closely. Once the airway and circulation are stabilized, medications like beta blockers or procedures may follow to control bleeding.
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 preparing to administer 0.9% sodium chloride (NS) 100 mL IV to infuse over 4 hr. The drip factor of the manual IV tubing is 60 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number.)
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15 gtt/min
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25 gtt/min
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50 gtt/min
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60 gtt/min
Explanation
The Correct Answer is:
B. 25 gtt/min
Detailed Explanation:
To determine the flow rate (gtt/min), use the formula:
Flow rate = (Volume × Drip factor) ÷ Time (in minutes)
= (100 mL × 60 gtt/mL) ÷ (4 hr × 60 min)
= 6000 ÷ 240
= 25 gtt/min
The nurse should regulate the IV to deliver 25 drops per minute to ensure the solution infuses evenly over 4 hours, maintaining proper hydration and avoiding fluid overload.
A patient is diagnosed with the type of diabetes in which the plasma beta cells fail to respond to insulin. Which type of diabetes is this patient experiencing?
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Gestational diabetes
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Type 1 diabetes mellitus
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Type 2 diabetes mellitus
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Impaired glucose intolerance
Explanation
The Correct Answer is:
C. Type 2 diabetes mellitus
Detailed Explanation:
Type 2 diabetes mellitus is characterized by insulin resistance, meaning the body’s cells fail to respond properly to insulin produced by pancreatic beta cells. Over time, the pancreas compensates by producing more insulin, but eventually, beta cells become exhausted, and insulin production decreases. This leads to elevated blood glucose levels. Type 2 diabetes is commonly associated with obesity, sedentary lifestyle, and genetics, and it is managed through diet, exercise, oral hypoglycemics, and sometimes insulin therapy.
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.
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.
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.
Which of the following respiratory assessments are found in a patient with DKA?
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Kussmaul
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Cheyne-Stokes
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Tachypnea
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Bradypnea
Explanation
The Correct Answer is:
A. Kussmaul
Detailed Explanation:
In diabetic ketoacidosis (DKA), the body produces excess ketones leading to metabolic acidosis. To compensate, the respiratory system increases the rate and depth of breathing to blow off carbon dioxide (an acid), resulting in Kussmaul respirations—deep, labored, and rapid breathing. This compensatory mechanism helps reduce acidosis by lowering carbon dioxide levels and temporarily stabilizing blood pH.
The nurse is providing education to the patient about a low-fat diet. The nurse suspects the patient needs additional education when he states:
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"I can eat baked fish."
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"I can eat chicken that has been broiled."
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"I'll start to eat more roasted turkey for dinner."
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"I can still eat a hamburger and fries when I go out with friends."
Explanation
The Correct Answer is:
D. "I can still eat a hamburger and fries when I go out with friends."
Detailed Explanation:
A hamburger and fries are high in saturated fats and trans fats, which contradict the principles of a low-fat diet. Consuming such foods can elevate cholesterol levels and increase the risk of cardiovascular disease. Patients should instead choose lean meats (like chicken, turkey, or fish) prepared by baking, broiling, or roasting, and pair them with vegetables or whole grains. Education should emphasize limiting fried and processed foods to maintain heart and liver health.
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