Exam Med Surg 120 with well answered questions

Exam Med Surg 120 with well answered |\ |\ |\ |\ |\ |\ |\




questions


To palpate the liver, the nurse
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a. presses slowly and firmly over the right costal margin with one
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hand and withdraws the fingers quickly after the liver edge is
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felt.
b. places one hand on top of the other and uses the upper
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fingers to apply pressure and the bottom fingers to feel for the
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liver edge. |\




c. places one hand under the patient's lower ribs and presses the
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left lower rib cage forward, palpating below the costal margin
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with the other hand.
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d. places one hand on the patient's back and presses upward and
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inward with the other hand below the patient's right costal
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margin. - CORRECT ANSWERS ✔✔D. |\ |\ |\ |\ |\




Rationale: The liver is normally not palpable below the costal
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margin, the nurse needs to push inward below the right costal
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margin while lifting the patient's back slightly with the left hand.
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The other methods will not allow palpation of the liver.
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When caring for a patient following a needle biopsy of the liver at
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the bedside, the nurse should
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a. elevate the head of the bed to facilitate breathing.
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b. check the patient's post-biopsy coagulation studies.
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c. place the patient on the right side with the bed flat.
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,d. put pressure on the biopsy site using a sandbag. - CORRECT
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ANSWERS ✔✔C. |\ |\




Rationale: After a biopsy, the patient lies on the right side with
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the bed flat to splint the biopsy site. Coagulation studies are
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checked prior to the biopsy. A sandbag does not exert adequate
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pressure to splint the site. |\ |\ |\ |\




The RN and NA are caring for a patient who has just returned to
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the nursing unit after an esophagogastroduodenoscopy (EGD).
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Which nursing action being done by the NA requires that the RN
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intervene?
a. The NA positions the patient on the right side.
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b. The NA checks the temperature every 30 minutes.
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c. The NA offers the patient a glass of water.
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d. The NA swabs the patient's mouth with cold water. - CORRECT
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ANSWERS ✔✔C |\




Rationale: Immediately after EGD, the patient will have a
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decreased gag reflex and is at risk for aspiration. The other
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actions by the NA are appropriate.
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When a patient has a history of a total gastrectomy, the nurse
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will monitor for clinical manifestations of
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a. dehydration.
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b. elevated total cholesterol.
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c. cobalamin (vitamin B12) deficiency.
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d. constipation. - CORRECT ANSWERS ✔✔C
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Rationale: The patient with a total gastrectomy does not secrete
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intrinsic factor, which is needed for cobalamin (vitamin B12)
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, absorption. Because the stomach absorbs only small amounts of
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water and nutrients, the patient is not at higher risk for
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dehydration, elevated cholesterol, or constipation |\ |\ |\ |\




A patient who is receiving chemotherapy develops a Candida
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albicans oral infection. The nurse will anticipate the need for
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a. hydrogen peroxide rinses.
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b. administration of nystatin (Mycostatin) oral tablets.
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c. the use of antiviral agents.
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d. referral to a dentist for professional tooth cleaning. - CORRECT
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ANSWERS ✔✔B. |\ |\




Rationale: Candida albicans is treated with an antifungal such as
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nystatin.


A 67-year-old patient tells the nurse, "I have problems with
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constipation now that I am older, so I use a suppository every|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\


morning." The most appropriate nursing action at this time is to
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a. encourage the patient to drink at least 3000 ml of fluid a day.
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b. inform the patient that a daily bowel movement is not
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necessary.
c. perform a focused nursing assessment to identify risk factors
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for constipation.
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d. suggest that the patient increase dietary intake of foods that
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are high in fiber. - CORRECT ANSWERS ✔✔C.
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Rationale: The nurse's initial action should be further assessment
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of the patient for risk factors for constipation and for usual bowel
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pattern. The other actions may be appropriate but will be based
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on the assessment.
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