A patient has a gallstone obstructing the biliary duct causing
obstructive jaundice. Lab work shows an increase in
indirect/direct bilirubin? correct answers Direct, conjugated
bilirubin
Post-hepatic jaundice typically occurs due to gallstones. No
issues with liver function, so the liver is as normal conjugating
indirect into direct bilirubin.
A patient has a history of Parkinson's disease and presents to the
ER with suspected intestinal obstruction. They are complaining
of abdominal pain, nausea and vomiting. Their abdomen is
distended. What does the nurse expect for treatment? correct
answers 1. Initial bowel rest and mobility
2. Then NG tube and fluids
3. Possibly surgical interventions
A patient has a new diagnosis for gastritis, inflammation of the
stomach. What is important patient education to provide? Select
all that apply.
a. Avoid alcohol
b. Avoid caffeinated beverages
c. Take medications at least 30 mins prior to meals
d. All of the above correct answers d. All of the above
A patient has a paracentesis performed for management of
ascites. The fluid appears cloudy. What is the nurse concerned
about? correct answers Turbid or cloudy fluid from a
paracentesis indicates infection.
,Normal - translucent yellow
Cancer - pink, bloody, milky
A patient has an infection of H. pylori. They are complaining of
a dull gnawing pain in the mid-epigastric area. What does the
nurse suspect?
a. Peptic ulcer disease
b. GERD
c. Cholecystitis
d. Appendicitis correct answers Peptic ulcer disease is seen in
H. pylori infections - the bacteria decreases the protective mucus
layer in the GI tract.
A patient has been diagnosed with ascites. The provider plans to
start treatment with diuretics. What drug does the nurse expect
to be ordered?
a. furosemide
b. spironolactone
c. mannitol
d. hydrochlorothiazide correct answers b. spironolactone
1st choice diuretic - aldosterone antagonists; spironolactone
2nd - lasix
A patient has been diagnosed with hemolytic jaundice. Liver
function is/is not impaired. Levels of indirect/direct bilirubin are
elevated. What does the nurse expect for the treatment plan?
correct answers Liver function is NOT impaired. Jaundice
, occurs due to an excessive destruction of RBCs. Indirect
bilirubin is elevated.
Treatment for hemolytic jaundice depends on the cause;
corticosteroids, immunosuppressive therapy, splenectomy
A patient is diagnosed with hepatitis C. The nurse is performing
medication reconciliation. It is important to look for medications
that have what effect? What is an important lifestyle
modification to educate patients on? correct answers Look for
medications that effect the liver - any hepatotoxicity.
Advise patients to avoid alcohol as it will potentiate disease
further.
A patient is needing a stomach lavage to empty their stomach
contents. What type of GI tube do you expect to have ordered?
correct answers NGT are used for stomach lavage and short-
term feeding, 48-72 hours.
A patient is on enteral feeds. The nurse assesses clear lung
sounds and a respiratory rate of 14. They ensure the HOB is
elevated during feeds and at least one hour following. What is
the nurse concerned about? correct answers Aspiration
pneumonia
A patient is on intermittent enteral feedings. What should the
nurse measure prior to hanging the next bag of enteral feed?
correct answers Gastric residual volume (GVR); if it is 2x more
than the rate the nurse should notify the provider