Azusa Pacific University - UNRS 312 Exam 2, Answers ;all correct.
UNRS 312 Exam2. 1. A 36-year-old male patient in the outpatient clinic is diagnosed with acute hepatitis C (HCV) infection. Which action by the nurse is appropriate? A. Schedule the patient for HCV genotype testing. B. Administer the HCV vaccine and immune globulin. C. Teach the patient about ribavirin (Rebetol) treatment. D. Explain that the infection will resolve over a few months. 2. The nurse administering α-interferon and ribavirin (Rebetol) to a patient with chronic hepatitis C will plan to monitor for ? A. leukopenia. B. hypokalemia. C. polycythemia. D. hypoglycemia. 3. Which information given by a 70-year-old patient during a health history indicates to the nurse that the patient should be screened for hepatitis C? A. The patient had a blood transfusion in 2005. B. The patient used IV drugs about 20 years ago. C. The patient frequently eats in fast-food restaurants. D. The patient traveled to a country with poor sanitation 4. A 55-year-old patient admitted with an abrupt onset of jaundice and nausea has abnormal liver function studies but serologic testing is negative for viral causes of hepatitis. Which question by the nurse is most appropriate? A. "Is there any history of IV drug use? B. "Do you use any over-the-counter drugs?" C. "Are you taking corticosteroids for any reason?" D. "Have you recently traveled to a foreign country?" 5. Which data will the nurse monitor in relation to the 4+ pitting edema assessed in a patient with cirrhosis? A. Hemoglobin B. Temperature C. Activity level D. albumin level 6. Which topic is most important to include in patient teaching for a 41-year-old patient diagnosed with early alcoholic cirrhosis? A. Maintaining good nutrition B. Avoiding alcohol ingestion C. Taking lactulose (Cephulac) D. Using vitamin B supplements 7. A serum potassium level of 3.2 mEq/L (3.2 mmol/L) is reported for a patient with cirrhosis who has scheduled doses of spironolactone (Aldactone) and furosemide (Lasix). due. Which action should the nurse take? A. Administer both drugs. B. Administer the spironolactone. C. Withhold the spironolactone and administer the furosemide. D. Withhold both drugs until discussed with the health care provider 8. Which action should the nurse take to evaluate treatment effectiveness for a patient who has hepatic encephalopathy? A. Request that the patient stand on one foot. B. Ask the patient to extend both arms forward. C. Request that the patient walk with eyes closed. D. Ask the patient to perform the Valsalva maneuver. 9. Which finding indicates to the nurse that lactulose (Cephulac) is effective for a 72-year-old man who has advanced cirrhosis? A. The patient is alert and oriented. B. The patient denies nausea or anorexia. C. The patient's bilirubin level decreases. D. The patient has at least one stool daily. 10. A 53-year-old patient is being treated for bleeding esophageal varices with balloon tamponade. Which nursing action will be included in the plan of care? A. Instruct the patient to cough every hour. B. Monitor the patient for shortness of breath. C. Verify the position of the balloon every 4 hours. D. Deflate the gastric balloon if the patient reports nausea 11. Which nursing action will be included in the plan of care for a patient with cirrhosis who has ascites and 4+ edema of the feet and legs? A. Restrict dietary protein intake. B. Reposition the patient every 4 hours. C. Use a pressure-relieving mattress. D. Perform passive range of motion qid. 12. The health care provider plans a paracentesis for a patient with ascites caused by liver cancer. To prepare the patient for the procedure, the nurse A. places the patient on NPO status. B. assists the patient to lie flat in bed. C. asks the patient to empty the bladder. D. positions the patient on the right side. 13. When assessing a patient who had a liver transplant a week previously, the nurse obtains the following data. Which finding is most important to communicate to the health care provider? A. Dry lips and oral mucosa B. Crackles at both lung bases C. Temperature 100.8° F (38.2° C) D. No bowel movement for 4 days 14. Which of these laboratory test results will be most important for the nurse to monitor when evaluating the effects of therapy for a patient who has acute pancreatitis? A. Calcium B. Bilirubin C. Amylase D. Potassium 15. When obtaining a health history from a patient with acute pancreatitis, the nurse asks the patient specifically about a history of A. alcohol use. B. diabetes mellitus. C. high-protein diet. D. cigarette smoking. 16. Which data obtained by the nurse during the assessment of a patient with cirrhosis will be of most concern? A. The patient's hands flap back and forth when the arms are extended. B. The patient has ascites and a 2-kg weight gain from the previous day. C. The patient's skin has multiple spider-shaped blood vessels on the abdomen. D. The patient complains of right upper-quadrant pain with abdominal palpation. 17. When taking the BP of a patient with severe acute pancreatitis, the nurse notices carpal spasm of the patient's hand. Which action should the nurse take next? A. Ask the patient about any arm pain. B. Retake the patient's blood pressure. C. Check the calcium level on the chart. D. Notify the health care provider immediately. 18. Which nursing action will be included in the plan of care for a patient who has recently been diagnosed with asymptomatic nonalcoholic fatty liver disease (NAFLD)? A. Teach symptoms of variceal bleeding. B. Discuss the need to increase caloric intake. C. Review the patient's current medication list. D. Draw blood for hepatitis serology testing. 19. During change-of-shift report, the nurse learns about the following four patients. Which patient requires the most rapid assessment? A. 50-year-old with chronic pancreatitis who has gnawing abdominal pain B. 48-year-old who has compensated cirrhosis and is complaining of anorexia C. 45-year-old with cirrhosis and severe ascites who has an oral temperature of 102° F (38.8° D. 56-year-old who is recovering from a laparoscopic cholecystectomy and has severe shoulder pain 20. Which goal has the highest priority in the plan of care for a 26-year-old homeless patient admitted with viral hepatitis who has severe anorexia and fatigue? A. Increase activity level. B. Maintain adequate nutrition. C. Establish a stable environment. D. Identify sources of hepatitis exposure. 21. A patient with cirrhosis who has been vomiting blood is admitted to the emergency department. Which action should the nurse take first? A. Insert a large-gauge IV catheter. B. Draw blood for coagulation studies. C. Check BP, heart rate, and respirations. D. Place the patient in the supine position. 22. For a patient with cirrhosis, which of the following nursing actions can the registered nurse (RN) delegate to unlicensed assistive personnel (UAP)? A. Assessing the patient for jaundice B. Providing oral hygiene after a meal C. Palpating the abdomen for distention D. Assisting the patient to choose the diet 23. A 23-year-old has been admitted with acute liver failure. Which assessment data are most important for the nurse to communicate to the health care provider? A. Asterixis and lethargy B. Jaundiced sclera and skin C. Elevated total bilirubin level D. Liver 3 cm below costal margin 24. A 36-year-old female patient is receiving treatment for chronic hepatitis C with pegylated interferon (PEG-Intron, Pegasys), ribavirin (Rebetol), and telaprevir (Incivek). Which finding is most important to communicate to the health care provider? A. Weight loss of 2 lb (1 kg) B. Positive urine pregnancy test C. Hemoglobin level of 10.4 g/dL D. Complaints of nausea and anorexia 25. After the insertion of an arteriovenous graft (AVG) in the right forearm, a 54-year-old patient complains of pain and coldness of the right fingers. Which action should the nurse take? A. Teach the patient about normal AVG function. B. Remind the patient to take a daily low-dose aspirin tablet. C. Report the patient's symptoms to the health care provider. D. Elevate the patient's arm on pillows to above the heart level. 26. Which statement by a 62-year-old patient with stage 5 chronic kidney disease (CKD) indicates that the nurse's teaching about management of CKD has been effective? A. I need to get most of my protein from low-fat dairy products." B. "I will increase my intake of fruits and vegetables to 5 per day." C. "I will measure my urinary output each day to help calculate the amount I can drink." D. "I need to take erythropoietin to boost my immune system and help prevent infection." 27. Sodium polystyrene sulfonate (Kayexalate) is ordered for a patient with hyperkalemia. Before administering the medication, the nurse should assess the A. bowel sounds. B. blood glucose. C. blood urea nitrogen (BUN). D. level of consciousness (LOC). 28. Which menu choice by the patient who is receiving hemodialysis indicates that the nurse's teaching has been successful? A. Split-pea soup, English muffin, and nonfat milk B. Oatmeal with cream, half a banana, and herbal tea C. Poached eggs, whole-wheat toast, and apple juice D. Cheese sandwich, tomato soup, and cranberry juice 29. Before administration of calcium carbonate (Caltrate) to a patient with chronic kidney disease (CKD), the nurse should check laboratory results for A. potassium level. B. total cholesterol. C. serum phosphate. D. serum creatinine. 30. A patient will need vascular access for hemodialysis. Which statement by the nurse accurately describes an advantage of a fistula over a graft? A. A fistula is much less likely to clot. B. A fistula increases patient mobility. C. A fistula can accommodate larger needles. D. A fistula can be used sooner after surgery. 31. When caring for a patient with a left arm arteriovenous fistula, which action will the nurse include in the plan of care to maintain the patency of the fistula? A. Auscultate for a bruit at the fistula site. B. Assess the quality of the left radial pulse. C. Compare blood pressures in the left and right arms. D. Irrigate the fistula site with saline every 8 to 12 hours 32. A 64-year-old male patient who has had progressive chronic kidney disease (CKD) for several years has just begun regular hemodialysis. Which information about diet will the nurse include in patient teaching? A. Increased calories are needed because glucose is lost during hemodialysis. B. Unlimited fluids are allowed because retained fluid is removed during dialysis. C. . More protein is allowed because urea and creatinine are removed by dialysis. D. Dietary potassium is not restricted because the level is normalized by dialysis. 33. Which action by a 70-year-old patient who is using peritoneal dialysis (PD) indicates that the nurse should provide more teaching about PD? A. The patient leaves the catheter exit site without a dressing. B. The patient plans 30 to 60 minutes for a dialysate exchange. C. The patient cleans the catheter while taking a bath each day. D. The patient slows the inflow rate when experiencing abdominal pain. 34. Which information in a patient's history indicates to the nurse that the patient is not an appropriate candidate for kidney transplantation? A. The patient has type 1 diabetes. B. The patient has metastatic lung cancer. C. The patient has a history of chronic hepatitis C infection. D. The patient is infected with the human immunodeficiency viruss 35. Which assessment finding may indicate that a patient is experiencing adverse effects to a corticosteroid prescribed after kidney transplantation? A. Postural hypotension B. Recurrent tachycardia C. Knee and hip joint pain D. Increased serum Creatinine 36. A 62-year-old female patient has been hospitalized for 8 days with acute kidney injury (AKI) caused by dehydration. Which information will be most important for the nurse to report to the health care provider? A. The creatinine level is 3.0 mg/dL. B. Urine output over an 8-hour period is 2500 mL. C. The blood urea nitrogen (BUN) level is 67 mg/dL. D. The glomerular filtration rate is <30 mL/min/1.73m2. 37. A 42-year-old patient admitted with acute kidney injury due to dehydration has oliguria, anemia, and hyperkalemia. Which prescribed actions should the nurse take first? A. Insert a urinary retention catheter. B. Place the patient on a cardiac monitor. C. Administer epoetin alfa (Epogen, Procrit). D. Give sodium polystyrene sulfonate (Kayexalate) 38. 25-year-old male patient has been admitted with a severe crushing injury after an industrial accident. Which laboratory result will be most important to report to the health care provider? A. Serum creatinine level 2.1 mg/dL B. Serum potassium level 6.5 mEq/L C. White blood cell count 11,500/µL D. Blood urea nitrogen (BUN) 56 mg/dL 39. In a patient with acute kidney injury (AKI) who requires hemodialysis, a temporary vascular access is obtained by placing a catheter in the left femoral vein. Which intervention will be included in the plan of care? A. Place the patient on bed rest. B. Start continuous pulse oximetry. C. Discontinue the retention catheter. D. Restrict the patient's oral protein intake. 40. A 55-year-old patient with end-stage kidney disease (ESKD) is scheduled to receive a prescribed dose of epoetin alfa (Procrit). Which information should the nurse report to the health care provider before giving the medication? A. Creatinine 1.6 mg/dL B. Oxygen saturation 89% C. Hemoglobin level 13 g/dL D. Blood pressure 98/56 mm Hg 41. A patient has arrived for a scheduled hemodialysis session. Which nursing action is most appropriate for the registered nurse (RN) to delegate to a dialysis technician? A. Teach the patient about fluid restrictions. B. Check blood pressure before starting dialysis. C. Assess for causes of an increase in predialysis weight. D. Determine the ultrafiltration rate for the hemodialysis. 42. Two hours after a kidney transplant, the nurse obtains all of the following data when assessing the patient. Which information is most important to communicate to the health care provider? A. The urine output is 900 to 1100 mL/hr. B. The blood urea nitrogen (BUN) and creatinine levels are elevated. C. The patient's central venous pressure (CVP) is decreased. D. The patient has level 8 (on a 10-point scale) incisional pain. 43. A female patient with chronic kidney disease (CKD) is receiving peritoneal dialysis with 2 L inflows. Which information should the nurse report immediately to the health care provider? A. The patient has an outflow volume of 1800 mL. B. The patient's peritoneal effluent appears cloudy. C. The patient has abdominal pain during the inflow phase. D. The patient's abdomen appears bloated after the inflow 44. A licensed practical/vocational nurse (LPN/LVN) is caring for a patient with stage 2 chronic kidney disease. Which observation by the RN requires an intervention? A. The LPN/LVN administers the erythropoietin subcutaneously. B. The LPN/LVN assists the patient to ambulate out in the hallway. C. The LPN/LVN administers the iron supplement and phosphate binder with lunch. D. The LPN/LVN carries a tray containing low-protein foods into the patient's room 45. The nurse is titrating the IV fluid infusion rate immediately after a patient has had kidney transplantation. Which parameter will be most important for the nurse to consider? A. Heart rate B. Urine output C. Creatinine clearance D. Blood urea nitrogen (BUN) level 46. A patient complains of leg cramps during hemodialysis. The nurse should first A. reposition the patient. B. massage the patient's legs. C. give acetaminophen (Tylenol). D. infuse a bolus of normal saline. 47. During routine hemodialysis, the 68-year-old patient complains of nausea and dizziness. Which action should the nurse take first? A. Slow down the rate of dialysis. B. Check patient's blood pressure (BP). C. Review the hematocrit (Hct) level. D. Give prescribed PRN antiemetic drugs. 48. After an unimmunized individual is exposed to hepatitis B through a needle-stick injury, which actions will the nurse plan to take (select all that apply)? A. Administer hepatitis B vaccine. B. Test for antibodies to hepatitis B. C. Teach about α-interferon therapy. D. Give hepatitis B immune globulin. 49. Which information will be included when the nurse is teaching self-management to a patient who is receiving peritoneal dialysis (select all that apply)? A. . Avoid commercial salt substitutes. B. Drink 1500 to 2000 mL of fluids daily. C. Take phosphate-binders with each meal. D. Choose high-protein foods for most meals. E. Have several servings of dairy products daily.
École, étude et sujet
- Établissement
- Azusa Pacific University
- Cours
- UNRS 312 (UNRS312)
Infos sur le Document
- Publié le
- 22 février 2021
- Nombre de pages
- 6
- Écrit en
- 2020/2021
- Type
- Examen
- Contient
- Questions et réponses
Sujets
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azusa pacific university unrs 312 exam2
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1 a 36 year old male patient in the outpatient clinic is diagnosed with acute hepatitis c hcv infection which action by the nurse is appropriate
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2 the n
