Tiêu đề KEY - R12 NP3.docx ✅

D. Strengthening contractions of the heart Answer: B Ratio: Nitroglycerin dilates coronary arteries, improves collateral blood flow to ischemic areas within myocardium. IV form of this drug produces peripheral vasodilation. Therapeutic Effect: Decreases myocardial oxygen demand. Reduces left ventricular preload, afterload. Source: Saunders Nursing Drug Handbook 2019, pg. 1868 Situation: Disturbances in the gastrointestinal tract, such as nausea or cramps, can disrupt digestion and cause discomfort. These issues often require attention to diet and sometimes medical treatment to restore normal function. 56. Razell, who had a total gastrectomy, is given instructions on measure to prevent the developing of dumping syndrome. Which of the following statements, if made by the patient, would indicate a correct understanding of the instructions? A. "I will have a bedtime snack." B. "I will rest one hour before each meal." C. "I will avoid concentrated sugar." D. “I will include high-carbohydrate foods in my diet” Answer: C Ratio: Dumping syndrome is a condition in which food, especially food high in carbohydrates, moves from your stomach into your small bowel too quickly after you eat (Rapid gastric emptying). Concentrated sugars/simple sugars like table sugar (sucrose) & fruits (fructose) is avoided. 57. Which of the following laboratory values should Nurse Razell expect to be elevated in a patient who has pancreatitis? A. Red blood cell count B. Blood urea nitrogen C. Glycosylated hemoglobin D. Serum amylase Answer: D Ratio: Pancreatitis is inflammation of the pancreas. Presence of digestive enzymes (serum amylase, serum lipase) in the blood indicates inflammation of the pancreatic tissue causing its leakage. 58. Which of the following statements, if made by Jam who has had a cholecystectomy, would indicate a correct understanding of dietary instructions? A. "I should limit my intake of citrus products.” B. "I must avoid carbonated beverages.” C. "I will Increase high-fiber foods in my diet" D. "I can eat whatever I can tolerate” Answer: D Ratio: There are usually no special dietary instructions in patients who had cholecystectomy other than to maintain a nutritious diet and avoid excessive fats. 59. The nurse should expect to prepare a patient who has bleeding esophageal varices for which of these procedures initially? A. Nasogastric tube feeding B. Normal saline lavage C. Electro cauterization D. X-ray Answer: D Ratio: To stop the bleeding and prevent hemorrhagic shock, the first procedure to be done in patients with bleeding esophageal varices is Balloon Tamponade. The placement of the balloon is confirmed via x-ray 60. Nurse Tres is caring for a patient with acute Hepatitis B. To which of the following measures should she give priority when caring for her patient? A. Using disposable dishes and cutlery for the patient B. Placing the patient in a private room C. Promoting bed rest D. Limiting fluid intake Answer: C. See photo below.

66. Nurse Neil knew that the initial diagnosis of pancreatitis is confirmed if the client's blood shows a significant in elevation which of the following serum values? A. Amylase B. Calcium C. Potassium D. Trypsin Answer: A Ratio: Pancreatitis is inflammation of the pancreas. Elevated presence of digestive enzymes (serum amylase, serum lipase) in the blood indicates inflammation of the pancreatic tissue causing its leakage. 67. In a client with acute pancreatitis, Nurse Neil should anticipate observing the following signs and symptoms: A. Diarrhea B. Jaundice C. Hypertension D. Ascites Answer: D 68. Nurse Neil reviews the client's latest laboratory results. What findings would indicate a diagnosis of acute pancreatitis? A. Hyperglycemia B. Leukopenia C. Thrombocytopenia D. Hyperkalemia Answer: A Ratio: Serum glucose is increased because of impaired excretion of insulin d/t pancreatic injury 69. Nurse Neil reviews initial plan for a client with pancreatitis would most likely focus on which of the following as a priority? A. Resting the gastrointestinal tract B. Ensuring adequate nutrition C. Maintaining fluid and electrolyte balance D. Preventing the development of an infection Answer: A Ratio: Question is asking about the initial plan. Initial plan is to put the patient in NPO to rest the GIT, prevent stimulation of pancreas and prevent further painful distention in the patient. 70. Nurse Neil knows that if a client is diagnosed with acute pancreatitis, he should carefully monitor the client for which of the following complications? A. Congestive heart failure B. Duodenal Ulcer C. Cirrhosis D. Pneumonia Answer: D Ratio: The patient with acute pancreatitis is prone to complications associated with the respiratory system. Pneumonia, atelectasis, and pleural effusion are examples of respiratory complications that can develop as a result of pancreatic enzyme exudate. Pancreatitis does not cause heart failure, ulcer formation, or cirrhosis. Situation: Nurse Anne, an infectious control nurse, is caring for a client with Pulmonary Tuberculosis. 71. Which client has special risk factors that warrant testing for tuberculosis? A. 45-year-old Caucasian man who has been homeless for 2 years B. 15-year-old Caucasian woman with asthma C. 72-year-old woman who is a recent immigrant from Russia D. 50-year-old Iowa farmer Answer: A Ratio: One of the risk factors for TB is any person without adequate health care (the homeless, impoverished; minorities, particularly children under age 15 and young adults between ages 15 and 44) Source: Brunner & Suddarth’s Textbook of Medical-Surgical Nursing, Twelfth Ed., pg.567