Question 1

The patient is getting neomycin for treatment of hepatic encephalopathy.While the patient is receiving this medication,it is especially important that the nurse

Accepted Answer

A)  evaluate renal function studies daily. 
B)  give the medication every 12 hours. 
C)  evaluate liver studies for signs of neomycin-induced damage. 
D)  obtain stool guaiac tests to ensure that pathogens are being destroyed. 
A)  evaluate renal function studies daily. 
B)  give the medication every 12 hours. 
C)  evaluate liver studies for signs of neomycin-induced damage. 
D)  obtain stool guaiac tests to ensure that pathogens are being destroyed. A

Question 2

The nurse is caring for a critically ill patient with respiratory failure who is being treated with mechanical ventilation.As part of the patient's care to prevent stress ulcers,the nurse would provide:

Accepted Answer

A)  vagal stimulation. 
B)  proton pump inhibitors. 
C)  anticholinergic drugs. 
D)  antacids. 
E)  cholinergic drugs. 
A)  vagal stimulation. 
B)  proton pump inhibitors. 
C)  anticholinergic drugs. 
D)  antacids. 
E)  cholinergic drugs. B,C,D

Question 3

The nurse is caring for a patient who is being treated for peptic ulcer disease.Suddenly,the patient yells that the pain has become extreme.The nurse notes that the patient's abdomen is rigid.The nurse should

Accepted Answer

A)  call the provider immediately. 
B)  give the patient pain medication. 
C)  remove the NG tube. 
D)  give the patient an antacid. 
A)  call the provider immediately. 
B)  give the patient pain medication. 
C)  remove the NG tube. 
D)  give the patient an antacid. A

Question 4

When assessing the patient's bowel sounds,the nurse

Accepted Answer

A)  listens to the abdomen after palpation is done. 
B)  places the patient in a relaxed prone position. 
C)  listens to bowel sounds before palpation. 
D)  places a pillow over the patient's knees. 
A)  listens to the abdomen after palpation is done. 
B)  places the patient in a relaxed prone position. 
C)  listens to bowel sounds before palpation. 
D)  places a pillow over the patient's knees.

Question 5

When assessing bowel sounds,the nurse

Accepted Answer

A)  uses the "bell" part of the stethoscope. 
B)  listens at least 15 minutes. 
C)  expects bowel sounds to be regular in rhythm. 
D)  listens for 5 minutes before noting "absent bowel sounds." 
A)  uses the "bell" part of the stethoscope. 
B)  listens at least 15 minutes. 
C)  expects bowel sounds to be regular in rhythm. 
D)  listens for 5 minutes before noting "absent bowel sounds."

Question 6

The nurse is caring for a patient who has had a portacaval shunt placed surgically.The nurse is aware that this procedure

Accepted Answer

A)  improves survival in patients with varices. 
B)  decreases the risk of encephalopathy. 
C)  decreases the incidence of ascites. 
D)  decreases rebleeding. 
A)  improves survival in patients with varices. 
B)  decreases the risk of encephalopathy. 
C)  decreases the incidence of ascites. 
D)  decreases rebleeding.

Question 7

The nurse is to assist the provider in performing bedside endoscopy on a patient.To prevent respiratory complications,the nurse places the patient

Accepted Answer

A)  supine in Trendelenburg position. 
B)  in a left lateral reverse Trendelenburg position. 
C)  flat with the feet elevated. 
D)  in a semi-Fowler's position. 
A)  supine in Trendelenburg position. 
B)  in a left lateral reverse Trendelenburg position. 
C)  flat with the feet elevated. 
D)  in a semi-Fowler's position.

Question 8

The patient is admitted with acute pancreatitis.The nurse should

Accepted Answer

A)  assess pain level because pancreatic pain is unique in character. 
B)  examine laboratory values for low amylase levels. 
C)  expect lipase levels to decrease within 24 hours. 
D)  evaluate C-reactive protein as a gauge of severity. 
A)  assess pain level because pancreatic pain is unique in character. 
B)  examine laboratory values for low amylase levels. 
C)  expect lipase levels to decrease within 24 hours. 
D)  evaluate C-reactive protein as a gauge of severity.

Question 9

The nurse is caring for a patient with a heart rate of 140 beats/min.The provider orders parasympathetic medications to slow down the heart rate.With this type of medication,the nurse should

Accepted Answer

A)  evaluate the patient for symptoms of constipation. 
B)  observe for diarrhea. 
C)  assess mucous membranes for signs of dryness. 
D)  expect decreased bowel sounds. 
A)  evaluate the patient for symptoms of constipation. 
B)  observe for diarrhea. 
C)  assess mucous membranes for signs of dryness. 
D)  expect decreased bowel sounds.

Question 10

Vascular sounds such as bruits,heard in the abdomen during physical assessment,may indicate which of the following?

Accepted Answer

A)  Obstructed portal circulation 
B)  Dilated vessels 
C)  Tortuous vessels 
D)  Constricted vessels 
E)  Presence of an abscess 
A)  Obstructed portal circulation 
B)  Dilated vessels 
C)  Tortuous vessels 
D)  Constricted vessels 
E)  Presence of an abscess

Question 11

The nurse is caring for a patient who has a Sengstaken-Blakemore tube in place.In caring for this patient,the nurse must

Accepted Answer

A)  maintain as little traction as possible. 
B)  apply external traction using a side rail of the bed. 
C)  deflate the gastric balloon before the esophageal balloon. 
D)  deflate the esophageal balloon before the gastric balloon. 
A)  maintain as little traction as possible. 
B)  apply external traction using a side rail of the bed. 
C)  deflate the gastric balloon before the esophageal balloon. 
D)  deflate the esophageal balloon before the gastric balloon.

Question 12

Infection by Helicobacter pylori bacteria is a major cause of

Accepted Answer

A)  duodenal ulcers. 
B)  Cushing's ulcers. 
C)  Curling's ulcers. 
D)  stress ulcers. 
A)  duodenal ulcers. 
B)  Cushing's ulcers. 
C)  Curling's ulcers. 
D)  stress ulcers.

Question 13

The patient is being treated for an H.pylori infection with proton pump inhibitor,metronidazole,and tetracycline but is not responding.The nurse expects that

Accepted Answer

A)  bismuth will be added to the current triple therapy. 
B)  a 6-day course of levofloxacin may be used. 
C)  a second-line therapy is not usually effective. 
D)  the proton pump inhibitor will be changed to a higher dose. 
A)  bismuth will be added to the current triple therapy. 
B)  a 6-day course of levofloxacin may be used. 
C)  a second-line therapy is not usually effective. 
D)  the proton pump inhibitor will be changed to a higher dose.

Question 14

The patient is admitted with end-stage liver disease.The nurse evaluates the patient for which of the following?

Accepted Answer

A)  Hypoglycemia 
B)  Malnutrition 
C)  Ascites 
D)  Hypercoagulation 
E)  Disseminated intravascular coagulation 
A)  Hypoglycemia 
B)  Malnutrition 
C)  Ascites 
D)  Hypercoagulation 
E)  Disseminated intravascular coagulation

Question 15

The nurse is caring for a patient with a Minnesota tube in place when the patient suddenly shows signs of severe pain and respiratory distress.The nurse should

Accepted Answer

A)  cut the gastric balloon lumen and watch for improved symptoms. 
B)  cut the esophageal lumen and watch for improvement. 
C)  cut all three lumens and remove the tube. 
D)  call the provider with an update of the patient's condition. 
A)  cut the gastric balloon lumen and watch for improved symptoms. 
B)  cut the esophageal lumen and watch for improvement. 
C)  cut all three lumens and remove the tube. 
D)  call the provider with an update of the patient's condition.

Question 16

The liver plays a major role in homeostasis by

Accepted Answer

A)  synthesizing factor I but not factor II. 
B)  synthesizing clotting factors without the need for vitamin K. 
C)  removing active clotting factors from the circulation. 
D)  synthesizing factor II but not factor I. 
A)  synthesizing factor I but not factor II. 
B)  synthesizing clotting factors without the need for vitamin K. 
C)  removing active clotting factors from the circulation. 
D)  synthesizing factor II but not factor I.

Question 17

The nurse is caring for a patient with active GI bleeding.Estimated blood loss is 1,000 mL.Which of the following assessments would the nurse expect to find with this amount of blood loss?

Accepted Answer

A)  All vital signs would expect to be normal. 
B)  Oral temperature of 103°. 
C)  Heart rate 125 beats per minute. 
D)  Systolic blood pressure of 120 mm Hg. 
A)  All vital signs would expect to be normal. 
B)  Oral temperature of 103°. 
C)  Heart rate 125 beats per minute. 
D)  Systolic blood pressure of 120 mm Hg.

Question 18

The patient is admitted with acute pancreatitis and is later diagnosed as having a pseudocyst.The nurse realizes that

Accepted Answer

A)  surgery for pseudocysts must be done immediately. 
B)  a cholecystectomy is usually done when pseudocysts are found. 
C)  pseudocysts may resolve spontaneously, so surgery may be delayed. 
D)  pseudocysts require pancreatic resection, removing the entire pancreas. 
A)  surgery for pseudocysts must be done immediately. 
B)  a cholecystectomy is usually done when pseudocysts are found. 
C)  pseudocysts may resolve spontaneously, so surgery may be delayed. 
D)  pseudocysts require pancreatic resection, removing the entire pancreas.

Question 19

The patient has a hemoglobin of 8.5 g/dL and hematocrit of 27%.The nurse administers 2 units of packed red blood cells to the patient and repeats the lab work a few hours later.The new hemoglobin and hematocrit would be expected to be

Accepted Answer

A)  hemoglobin 7.5 g/dL and hematocrit 25%. 
B)  hemoglobin 9.5 g/dL and hematocrit 29%. 
C)  hemoglobin 10.5 g/dL and hematocrit 32%. 
D)  hemoglobin 12.5 g/dL and hematocrit 36%. 
A)  hemoglobin 7.5 g/dL and hematocrit 25%. 
B)  hemoglobin 9.5 g/dL and hematocrit 29%. 
C)  hemoglobin 10.5 g/dL and hematocrit 32%. 
D)  hemoglobin 12.5 g/dL and hematocrit 36%.

Question 20

The liver detoxifies the blood by

Accepted Answer

A)  converting fat-soluble compounds to water-soluble compounds. 
B)  converting water-soluble compounds to fat-soluble compounds. 
C)  excreting fat-soluble compounds in feces. 
D)  metabolizing inactive toxic substances to active forms. 
A)  converting fat-soluble compounds to water-soluble compounds. 
B)  converting water-soluble compounds to fat-soluble compounds. 
C)  excreting fat-soluble compounds in feces. 
D)  metabolizing inactive toxic substances to active forms.

Exam 18: Gastrointestinal Alterations

The patient is getting neomycin for treatment of hepatic encephalopathy.While the patient is receiving this medication,it is especially important that the nurse

The nurse is caring for a critically ill patient with respiratory failure who is being treated with mechanical ventilation.As part of the patient's care to prevent stress ulcers,the nurse would provide:

The nurse is caring for a patient who is being treated for peptic ulcer disease.Suddenly,the patient yells that the pain has become extreme.The nurse notes that the patient's abdomen is rigid.The nurse should

When assessing the patient's bowel sounds,the nurse

When assessing bowel sounds,the nurse

The nurse is caring for a patient who has had a portacaval shunt placed surgically.The nurse is aware that this procedure

The nurse is to assist the provider in performing bedside endoscopy on a patient.To prevent respiratory complications,the nurse places the patient

The patient is admitted with acute pancreatitis.The nurse should

The nurse is caring for a patient with a heart rate of 140 beats/min.The provider orders parasympathetic medications to slow down the heart rate.With this type of medication,the nurse should

Vascular sounds such as bruits,heard in the abdomen during physical assessment,may indicate which of the following?

The nurse is caring for a patient who has a Sengstaken-Blakemore tube in place.In caring for this patient,the nurse must

Infection by Helicobacter pylori bacteria is a major cause of

The patient is being treated for an H.pylori infection with proton pump inhibitor,metronidazole,and tetracycline but is not responding.The nurse expects that

The patient is admitted with end-stage liver disease.The nurse evaluates the patient for which of the following?

The nurse is caring for a patient with a Minnesota tube in place when the patient suddenly shows signs of severe pain and respiratory distress.The nurse should

The liver plays a major role in homeostasis by

The nurse is caring for a patient with active GI bleeding.Estimated blood loss is 1,000 mL.Which of the following assessments would the nurse expect to find with this amount of blood loss?

The patient is admitted with acute pancreatitis and is later diagnosed as having a pseudocyst.The nurse realizes that

The patient has a hemoglobin of 8.5 g/dL and hematocrit of 27%.The nurse administers 2 units of packed red blood cells to the patient and repeats the lab work a few hours later.The new hemoglobin and hematocrit would be expected to be

The liver detoxifies the blood by

Overview of Critical Care Nursing

Patient and Family Response to the Critical Care Experience

Ethical and Legal Issues in Critical Care Nursing

End-Of-Life Care and Palliative Care in Critical Care Settings

Comfort and Sedation

Nutritional Support

Dysrhythmia Interpretation and Management

Hemodynamic Monitoring

Ventilatory Assistance

Rapid Response Teams and Code Management

Organ Donation

Shock,sepsis,and Multiple Organ Dysfunction Syndrome

Cardiovascular Alterations

Nervous System Alterations

Acute Respiratory Failure

Acute Kidney Injury

Hematological and Immune Disorders

Endocrine Alterations

Trauma and Surgical Management

Burns

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