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Brunner & Suddarth: Test Bank (Chapter 49)

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Brunner & Suddarth: Test Bank (Chapter 49) 1. 1. A nurse is caring for a patient with liver failure and is performing an assessment in the knowledge of the patient's increased risk of bleeding. The nurse recognizes that this risk is related to the patient's inability to synthesize prothrombin in the liver. What factor most likely contributes to this loss of function? A) Alterations in glucose metabolism B) Retention of bile salts C) Inadequate production of albumin by hepatocytes D) Inability of the liver to use vitamin K Ans: D Feedback: Decreased production of several clotting factors may be partially due to defcient absorption of vitamin K from the GI tract. This probably is caused by the inability of liver cells to use vitamin K to make prothrombin. This bleeding risk is unrelated to the roles of glucose, bile salts, or albumin. 2. 2. A nurse is performing an admission assessment of a patient with a diagnosis of cirrhosis. What technique should the nurse use to palpate the patient's liver? A) Place hand under the right lower abdominal quadrant and press down lightly with the other hand. B) Place the left hand over the abdomen and behind the left side at the 11th rib. C) Place hand under right lower rib cage and press down lightly with the other hand. D) Hold hand 90 degrees to right side of the abdomen and push down frmly. Ans: C Feedback: To palpate the liver, the examiner places one hand under the right lower rib cage and presses downward with light pressure with the other hand. The liver is not on the left side or in the right lower abdominal quadrant

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Brunner & Suddarth: Test Bank (Chapter 57)
Study online at https://quizlet.com/_j4sdyf

1. 1. While taking a health histo- C) Candidiasis
ry on a 20-year-old female pa-
tient, the nurse ascertains that Rationale:
this patient is taking micona- Candidiasis is a fungal or yeast infection caused by strains of
zole (Monistat). The nurse is jus- Candida. Miconazole (Monistat) is an antifungal medication
tified in presuming that this pa- used in the treatment of candidiasis. This agent is inserted
tient has what medical condi- into the vagina with an applicator at bedtime and may be ap-
tion? plied to the vulvar area for pruritus. HPV, bacterial vaginosis,
and TSS are not treated by Monistat.
A) Bacterial vaginosis
B) Human papillomavirus
(HPV)
C) Candidiasis
D) Toxic shock syndrome (TSS)

2. 2. A patient with genital her- D) Acyclovir (Zovirax)
pes is having an acute exacer-
bation. What medication would Rationale:
the nurse expect to be ordered Acyclovir (Zovirax) is an antiviral agent that can suppress the
to suppress the symptoms and symptoms of genital herpes and shorten the course of the
shorten the course of the infec- infection. It is effective at reducing the duration of lesions and
tion? preventing recurrences. Clotrimazole is used in the treatment
of yeast infections. Metronidazole is the most effective treat-
A) Clotrimazole (Gyne-Lotrim- ment for trichomoniasis. Podophyllin is used to treat external
in) genital warts. Acyclovir is used in the treatment of genital
B) Metronidazole (Flagyl) herpes.
C) Podophyllin (Podofin)
D) Acyclovir (Zovirax)

3. 3. A patient with trichomoniasis A) Both partners will be treated with metronidazole (Flagyl).
comes to the walk-in clinic. In
developing a care plan for this Rationale:



, Brunner & Suddarth: Test Bank (Chapter 57)
Study online at https://quizlet.com/_j4sdyf

patient the nurse would know The most effective treatment for trichomoniasis is metronida-
to include what as an important zole (Flagyl). Both partners receive a one-time loading dose
aspect of treating this patient? or a smaller dose three times a day for 1 week. In pelvic
inflammatory disease, menstrual difficulties and constipation
'A) Both partners will be treated may occur. Kegel exercises are prescribed to help strengthen
with metronidazole (Flagyl). weakened muscles associated with cystocele and other struc-
B) Constipation and menstrual tural deficits. Hormone therapy does not address the etiology
difficulties may occur. of trichomoniasis.
C) The patient should perform
Kegel exercises 30 to 80 times
daily.
D) Care will involve hormone
therapy to control the pain.

4. 4. A student nurse is doing clin- D) The patient should also be treated for chlamydia.
ical hours at an OB/GYN clinic.
The student is helping to devel- Rationale:
op a plan of care for a patient Because of the high incidence of coinfection with chlamy-
with gonorrhea who has pre- dia and gonorrhea, the patient should also be treated for
sented at the clinic. The student chlamydia. Avoiding the use of tampons is part of the self-
should include which of the fol- care management of a patient with possible toxic shock syn-
lowing in the care plan for this drome (TSS). The patient is not susceptible to incontinence
patient? and there is no indication for the use of oral contraceptives.

A) The patient may benefit from
oral contraceptives.
B) The patient must avoid the
use of tampons.
C) The patient is susceptible to
urinary incontinence.
D) The patient should also be
treated for chlamydia.



, Brunner & Suddarth: Test Bank (Chapter 57)
Study online at https://quizlet.com/_j4sdyf

5. 5. When teaching patients B) Human papillomavirus (HPV)
about the risk factors of cervical
cancer, what would the nurse Rationale:
identify as the most important HPV is the most salient risk factor for cervical cancer, ex-
risk factor? ceeding the risks posed by smoking, late childbearing, and
postmenopausal bleeding.
A) Late childbearing
B) Human papillomavirus
(HPV)
C) Postmenopausal bleeding
D) Tobacco use

6. 6. The nurse is providing preop- D) The bladder must be emptied prior to surgery and a
erative education for a patient catheter may be placed during surgery.
diagnosed with endometrio-
sis. A hysterectomy has been Rationale:
scheduled. What education top- The intestinal tract and the bladder need to be empty before
ic should the nurse be sure to the patient is taken to the OR to prevent contamination and
include for this patient? injury to the bladder or intestinal tract. The patient is informed
that her periods are now over, but she may have a slightly
A) Menstrual periods will con- bloody discharge for a few days. The patient is instructed to
tinue to occur for several avoid straining, lifting, or driving until her surgeon permits
months, some of them heavy. her to resume these activities. The patient's hormonal bal-
B) Normal activity will be per- ance is upset, which usually occurs in reproductive system
mitted within 48 hours follow- disturbances. The patient may experience depression and
ing surgery. heightened emotional sensitivity to people and situations.
C) After a hysterectomy, hor-
mone levels remain largely un-
affected.
D) The bladder must be emp-
tied prior to surgery and a

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