A nurse is caring for a newly admitted client.

Exhibits
A nurse notes the client's condition and initiates the following action. Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress

Answer and Explanation

The Correct Answer is []

Rationale:

Potential Condition: The client with cirrhosis shows elevated ammonia (236 mcg/dL), confusion, agitation, and disorientation, which are classic findings of hepatic encephalopathy.
Actions to Take:
- Lactulose is given to lower ammonia levels by promoting its excretion through the stool.
- Assessing for asterixis (flapping tremor of the hands) is key in identifying worsening encephalopathy.
Parameters to Monitor:
- Neurologic status (orientation, cognition, responsiveness) should be monitored closely to evaluate improvement or deterioration.
- Safety measures are essential because confusion and agitation increase the client’s risk for falls and injury.

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Correct Answer is A

Explanation

Rationale:
A. Hypertonic solutions, like TPN with 25% dextrose, can irritate peripheral veins and cause phlebitis. Administering them through a central line allows rapid dilution in a large volume of blood, reducing vein irritation and promoting safe infusion.
B. Blood glucose monitoring is not dependent on the line type; it is done via peripheral blood samples.
C. The infusion rate is determined by the prescribed therapy, not by whether a central line is used.
D. Central lines do not decrease the risk of infection; in fact, they carry a higher risk of central line–associated bloodstream infections compared with peripheral lines.

A. Thirty minutes before breakfast B. With a bedtime snack C. During the evening meal D. Thirty minutes after lunch

Correct Answer is A

Explanation

Rationale:

A. Lansoprazole is a proton pump inhibitor (PPI) that works best when given before meals, ideally 30–60 minutes prior to the first meal of the day, to maximize inhibition of gastric acid secretion.

B. Taking lansoprazole at night does not optimize its effect because acid production is highest in the morning.

C. Administering with food reduces absorption and efficacy of the medication.

D. PPIs should be taken before the meal, not after, to ensure maximum acid suppression.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A student asks the nurse why a peripherally inserted central catheter is needed for a patient receiving parenteral nutrition with 25% dextrose. Which response by the nurse is accurate?

Correct Answer is A

Explanation

A client is prescribed lansoprazole 15 mg PO once a day. At which of the following times should the nurse administer the medication?

Correct Answer is A

Explanation

A nurse admits a client to the emergency department who reports nausea and vomiting that worsens when he lies down. Antacids do not help. The provider suspects acute pancreatitis. Which of the following laboratory test results should the nurse expect to see?

A nurse on the day shift is preparing to change a client's total parenteral nutrition (TPN) solution, but the new TPN solution has not arrived from the pharmacy. The client receives additional IV fat emulsion during the night shift. Which of the following actions should the nurse take?

What is the primary cause of refeeding syndrome in TPN patients?

A nurse is providing care for a client who had a laparoscopic cholecystectomy. Which of the following is an appropriate nursing action?

Which of the following are contraindications for administering a tap water enerna? (Select all that apply)

A nurse is teaching a client who has a hiatal hernia about dietary recommendations. Which of the following client statements indicates an understanding of the teaching? (Select all that apply.)

A nurse is planning care for a client who has viral hepatitis. Which of the following actions should the nurse include in the plan of care?

A nurse is caring for a client who has diverticular disease. When palpating the client's abdomen, in which of the following locations should the nurse expect the client to report abdominal pain?