D440 OA PRACTICE ASSESSMENT
GRADED A+ WITH RATIONALES
1. Which intervention will the nurse implement for a client
hospitalized with acute pancreatisis? - ANSWER-- Administer
analgesics
- Teach relaxation exercises
- monitor cardiac rate & rhythm
- provide antiemetics
Rationale:
Analgesics, histamine-receptor antagonists, and proton pump
inhibitors may be administered to decrease gastrointestinal
activity and the secretion of pancreatic enzymes. Relaxation
will decrease the metabolic rate, which will decrease
gastrointestinal activity, including the secretion of pancreatic
enzymes. Monitoring cardiac rate and rhythm is necessary to
assess for hypokalemia and fluid volume changes. Antiemetics
will be administered to help reduce nausea and vomiting. The
client would be kept nothing by mouth to decrease
gastrointestinal activity and the secretion of pancreatic
enzymes and therefore would not have a high-fat diet order.
Once PO nutrition is resumed the diet would include high-
carbohydrate and protein, but low-fat. Walking increases the
metabolic rate, which will increase gastrointestinal activity,
including the secretion of pancreatic enzymes. Hypocalcemia,
not hypercalcemia, occurs because of calcium and fatty acids
combining during fat necrosis. The client with acute
pancreatitis is at risk for inadequate nutrition and will be
weighed daily.
2. Which food selection by a client with celiac disease indicates
the nurse's dietary teaching was successful? SATA
A) Green beans
B) Baked potato
, C) Egg noodles
D) Turkey sandwich
E) Baked salmon
F) Whole-wheat cereal
G) Fried eggs
H) Whole milk - ANSWER-Green beans, baked potato, baked
salmon, fried eggs, whole milk
Rationale: Noodles, bread in the turkey sandwich, and whole-
wheat cereal are high in gluten, and clients on gluten-free
diets should avoid these products. Celiac clients are to avoid
gluten found in wheat, oats, and barley.
3. Which nursing action is appropriate when providing care to a
hospitalized infant who is diagnosed with failure to thrive
(FTT) due to inadequate caloric intake? SATA
a) Consulting with social work
b) Monitoring for sensitivity to cow's milk
c) Assessing juice consumption
d) Teaching the parents how to prepare formula
e) Evaluating for severe allergies
f) Examining the EHR for diagnosis of cystic fibrosis
g) Analyzing eating patterns and diet for signs of celiac disease
h) Reviewing laboratory data related to thyroid function -
ANSWER-- Consulting with social work
- Assessing juice consumption
- Teaching the parents how to prepare formula
Rationale: Poor infant growth with a diagnosis of FTT due to
inadequate caloric intake requires the nurse to consult with
social work to determine if the family is living in poverty;
assess the infant's juice consumption (too much juice and not
enough formula often causes inadequate caloric intake); and
teach the parents how to properly prepare formula (too much
water decreases the amount of calories). A sensitivity to cow's
GRADED A+ WITH RATIONALES
1. Which intervention will the nurse implement for a client
hospitalized with acute pancreatisis? - ANSWER-- Administer
analgesics
- Teach relaxation exercises
- monitor cardiac rate & rhythm
- provide antiemetics
Rationale:
Analgesics, histamine-receptor antagonists, and proton pump
inhibitors may be administered to decrease gastrointestinal
activity and the secretion of pancreatic enzymes. Relaxation
will decrease the metabolic rate, which will decrease
gastrointestinal activity, including the secretion of pancreatic
enzymes. Monitoring cardiac rate and rhythm is necessary to
assess for hypokalemia and fluid volume changes. Antiemetics
will be administered to help reduce nausea and vomiting. The
client would be kept nothing by mouth to decrease
gastrointestinal activity and the secretion of pancreatic
enzymes and therefore would not have a high-fat diet order.
Once PO nutrition is resumed the diet would include high-
carbohydrate and protein, but low-fat. Walking increases the
metabolic rate, which will increase gastrointestinal activity,
including the secretion of pancreatic enzymes. Hypocalcemia,
not hypercalcemia, occurs because of calcium and fatty acids
combining during fat necrosis. The client with acute
pancreatitis is at risk for inadequate nutrition and will be
weighed daily.
2. Which food selection by a client with celiac disease indicates
the nurse's dietary teaching was successful? SATA
A) Green beans
B) Baked potato
, C) Egg noodles
D) Turkey sandwich
E) Baked salmon
F) Whole-wheat cereal
G) Fried eggs
H) Whole milk - ANSWER-Green beans, baked potato, baked
salmon, fried eggs, whole milk
Rationale: Noodles, bread in the turkey sandwich, and whole-
wheat cereal are high in gluten, and clients on gluten-free
diets should avoid these products. Celiac clients are to avoid
gluten found in wheat, oats, and barley.
3. Which nursing action is appropriate when providing care to a
hospitalized infant who is diagnosed with failure to thrive
(FTT) due to inadequate caloric intake? SATA
a) Consulting with social work
b) Monitoring for sensitivity to cow's milk
c) Assessing juice consumption
d) Teaching the parents how to prepare formula
e) Evaluating for severe allergies
f) Examining the EHR for diagnosis of cystic fibrosis
g) Analyzing eating patterns and diet for signs of celiac disease
h) Reviewing laboratory data related to thyroid function -
ANSWER-- Consulting with social work
- Assessing juice consumption
- Teaching the parents how to prepare formula
Rationale: Poor infant growth with a diagnosis of FTT due to
inadequate caloric intake requires the nurse to consult with
social work to determine if the family is living in poverty;
assess the infant's juice consumption (too much juice and not
enough formula often causes inadequate caloric intake); and
teach the parents how to properly prepare formula (too much
water decreases the amount of calories). A sensitivity to cow's
