MCA 2 - Med-surg - Review Exam 1
Questions and Answers
The family of a patient newly diagnosed with hepatitis A asks the
nurse what they can do to prevent becoming ill. Which response by
the nurse is most appropriate?
"You will need to be tested first; then treatment can be
determined."
"The hepatitis vaccine will provide immunity from this and future
exposures."
"There is nothing you can do since the patient was infectious before
admission."
"An immunoglobulin injection will be given to prevent infection or
limit symptoms." -
correct answer ✅"An immunoglobulin injection will be given to
prevent infection or limit symptoms."
Rationale: Immunoglobulin provides temporary (1 to 2 months)
passive immunity and is effective for preventing hepatitis A if given
within 2 weeks after exposure. It may not prevent infection in all
persons, but it will at least modify the illness to a subclinical
infection. The hepatitis vaccine is only used for preexposure
prophylaxis.
A patient with sudden pain in the left upper quadrant radiating to
the back and vomiting was diagnosed with acute pancreatitis.
,MCA 2 - Med-surg - Review Exam 1
Questions and Answers
Which intervention should the nurse include in the patient's plan of
care?
Immediately start enteral feeding to prevent malnutrition.
Insert an NG and maintain NPO status to allow pancreas to rest.
Initiate early prophylactic antibiotic therapy to prevent infection.
Administer acetaminophen (Tylenol) every 4 hours for pain relief. -
correct answer ✅Insert an NG and maintain NPO status to allow
pancreas to rest.
Rationale: Initial treatment with acute pancreatitis will include an
NG tube if there is vomiting and being NPO to decrease pancreatic
enzyme stimulation and allow the pancreas to rest and heal. Fluid
will be administered to treat or prevent shock. The pain will be
treated with IV morphine because of the NPO status. Enteral
feedings will only be used for the patient with severe acute
pancreatitis in whom oral intake is not resumed. Antibiotic therapy
is only needed with acute necrotizing pancreatitis and signs of
infection.
The patient with suspected pancreatic cancer is having many
diagnostic studies done. Which test can be used to establish the
diagnosis of pancreatic cancer and for monitoring the response to
treatment?
,MCA 2 - Med-surg - Review Exam 1
Questions and Answers
Spiral CT scan
A PET/CT scan
Abdominal ultrasound
Cancer-associated antigen 19-9 -
correct answer ✅Cancer-associated antigen 19-9
Rationale: The cancer-associated antigen 19-9 (CA 19-9) is the
tumor marker used for the diagnosis of pancreatic cancer and
monitoring the response to treatment. Although a spiral CT scan
may be the initial study done and provides information on
metastasis and vascular involvement, this test and the positron
emission tomography (PET)/CT scan or abdominal ultrasonography
does not provide additional information.
When teaching the patient with acute hepatitis C (HCV), which
statement demonstrates understanding of the disease process?
"I will use care when kissing my wife to prevent giving it to her."
"I will need to take adefovir (Hepsera) to prevent chronic HCV."
"Now that I have had HCV, I will have immunity and not get it
again."
"I will need to be monitored for chronic HCV and other liver
problems." -
, MCA 2 - Med-surg - Review Exam 1
Questions and Answers
correct answer ✅"I will need to be monitored for chronic HCV and
other liver problems."
Rationale: Many patients who acquire HCV develop chronic
infection, which may lead to cirrhosis or liver cancer. HCV is not
transmitted via saliva but by blood exposures such as sharing
needles and high-risk sexual activity. The treatment for acute viral
hepatitis focuses on resting the body and adequate nutrition for
liver regeneration. Adefovir (Hepsera) is taken for severe hepatitis B
(HBV) with liver failure. HCV is treated with oral direct-acting
antivirals (DAAs). Immunity with HCV does not occur as it does with
HAV and HBV, so the patient may be reinfected with another type
of HCV.
When caring for a patient with a biliary obstruction, the nurse will
anticipate administering which vitamin supplements? (Select all
that apply.)
Vitamin A
Vitamin B
Vitamin D
Vitamin E
Questions and Answers
The family of a patient newly diagnosed with hepatitis A asks the
nurse what they can do to prevent becoming ill. Which response by
the nurse is most appropriate?
"You will need to be tested first; then treatment can be
determined."
"The hepatitis vaccine will provide immunity from this and future
exposures."
"There is nothing you can do since the patient was infectious before
admission."
"An immunoglobulin injection will be given to prevent infection or
limit symptoms." -
correct answer ✅"An immunoglobulin injection will be given to
prevent infection or limit symptoms."
Rationale: Immunoglobulin provides temporary (1 to 2 months)
passive immunity and is effective for preventing hepatitis A if given
within 2 weeks after exposure. It may not prevent infection in all
persons, but it will at least modify the illness to a subclinical
infection. The hepatitis vaccine is only used for preexposure
prophylaxis.
A patient with sudden pain in the left upper quadrant radiating to
the back and vomiting was diagnosed with acute pancreatitis.
,MCA 2 - Med-surg - Review Exam 1
Questions and Answers
Which intervention should the nurse include in the patient's plan of
care?
Immediately start enteral feeding to prevent malnutrition.
Insert an NG and maintain NPO status to allow pancreas to rest.
Initiate early prophylactic antibiotic therapy to prevent infection.
Administer acetaminophen (Tylenol) every 4 hours for pain relief. -
correct answer ✅Insert an NG and maintain NPO status to allow
pancreas to rest.
Rationale: Initial treatment with acute pancreatitis will include an
NG tube if there is vomiting and being NPO to decrease pancreatic
enzyme stimulation and allow the pancreas to rest and heal. Fluid
will be administered to treat or prevent shock. The pain will be
treated with IV morphine because of the NPO status. Enteral
feedings will only be used for the patient with severe acute
pancreatitis in whom oral intake is not resumed. Antibiotic therapy
is only needed with acute necrotizing pancreatitis and signs of
infection.
The patient with suspected pancreatic cancer is having many
diagnostic studies done. Which test can be used to establish the
diagnosis of pancreatic cancer and for monitoring the response to
treatment?
,MCA 2 - Med-surg - Review Exam 1
Questions and Answers
Spiral CT scan
A PET/CT scan
Abdominal ultrasound
Cancer-associated antigen 19-9 -
correct answer ✅Cancer-associated antigen 19-9
Rationale: The cancer-associated antigen 19-9 (CA 19-9) is the
tumor marker used for the diagnosis of pancreatic cancer and
monitoring the response to treatment. Although a spiral CT scan
may be the initial study done and provides information on
metastasis and vascular involvement, this test and the positron
emission tomography (PET)/CT scan or abdominal ultrasonography
does not provide additional information.
When teaching the patient with acute hepatitis C (HCV), which
statement demonstrates understanding of the disease process?
"I will use care when kissing my wife to prevent giving it to her."
"I will need to take adefovir (Hepsera) to prevent chronic HCV."
"Now that I have had HCV, I will have immunity and not get it
again."
"I will need to be monitored for chronic HCV and other liver
problems." -
, MCA 2 - Med-surg - Review Exam 1
Questions and Answers
correct answer ✅"I will need to be monitored for chronic HCV and
other liver problems."
Rationale: Many patients who acquire HCV develop chronic
infection, which may lead to cirrhosis or liver cancer. HCV is not
transmitted via saliva but by blood exposures such as sharing
needles and high-risk sexual activity. The treatment for acute viral
hepatitis focuses on resting the body and adequate nutrition for
liver regeneration. Adefovir (Hepsera) is taken for severe hepatitis B
(HBV) with liver failure. HCV is treated with oral direct-acting
antivirals (DAAs). Immunity with HCV does not occur as it does with
HAV and HBV, so the patient may be reinfected with another type
of HCV.
When caring for a patient with a biliary obstruction, the nurse will
anticipate administering which vitamin supplements? (Select all
that apply.)
Vitamin A
Vitamin B
Vitamin D
Vitamin E
