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The Nurse Is Assessing A Client With Acute Pancreatitis. Which Finding Requires The Most Immediate
Intervention By The Nurse?
A.
The Client's Amylase Level Is Three Times Higher Than The Normal Level.
B.
The Client Has A Carpal Spasm When Taking A Blood Pressure.
C.
On A 1 To 10 Scale, The Client Tells The Nurse That Her Epigastric Pain Is At 7.
D.
The Client States That She Will Continue To Drink Alcohol After Going Home.
CORRECT ANS>>> B
The Nurse Is Assessing A Client With Acute Pancreatitis. Which Finding Requires The Most Immediate
Intervention By The Nurse?
FEEDBACK: A Positive Trousseau Sign Indicates Hypocalcemia And Always Requires Further Assessment
And Intervention, Regardless Of The Cause (40% To 75% Of Those With Acute Pancreatitis Experience
Hypocalcemia, Which Can Have Serious, Systemic Effects). A Key Diagnostic Finding Of Pancreatitis Is
Serum Amylase And Lipase Levels That Are Two To Five Times Higher Than The Normal Value. Severe
Boring Pain Is An Expected Symptom For This Diagnosis, But Dealing With The Hypocalcemia Is A Priority
Over Administering An Analgesic. Long-Term Planning And Teaching Do Not Have The Same Immediate
Importance As A Positive Trousseau Sign.
A 55-Year-Old Male Client Has Been Admitted To The Hospital With A Medical Diagnosis Of Chronic
Obstructive Pulmonary Disease (Copd). Which Risk Factor Is The Most Significant In The Development Of
This Client's Copd?
A.
The Client's Father Was Diagnosed With Copd In His 50s.
B.
A Close Family Member Contracted Tuberculosis Last Year.
, C.
The Client Smokes One To Two Packs Of Cigarettes Per Day.
D.
The Client Has Been 40 Pounds Overweight For 15 Years.
CORRECT ANS>>> C
FEEDBACK: Smoking, Considered To Be A Modifiable Risk Factor, Is The Most Significant Risk Factor For
The Development Of Copd. The Exact Mechanism Of Genetic And Hereditary Implications For The
Development Of Copd Is Still Under Investigation, Although Exposure To Similar Predisposing Factors
(E.G., Smoking Or Inhaling Secondhand Smoke) May Increase The Likelihood Of Copd Incidence Among
Family Members. Options B And D Do Not Exceed The Risks Associated With Cigarette Smoking In The
Development Of Copd.
In Assessing A Client Diagnosed With Primary Aldosteronism, The Nurse Expects The Laboratory Test
Results To Indicate A Decreased Serum Level Of Which Substance?
A.
Sodium
B.
Phosphate
C.
Potassium
D.
Glucose
CORRECT ANS>>> C
FEEDBACK: Clients With Primary Aldosteronism Exhibit A Profound Decline In Serum Levels Of
Potassium; Hypokalemia; Hypertension Is The Most Prominent And Universal Sign. The Serum Sodium
Level Is Normal Or Elevated, Depending On The Amount Of Water Resorbed With The Sodium. Option B
Is Influenced By Parathyroid Hormone (Pth). Option D Is Not Affected By Primary Aldosteronism.