A nurse is contributing to the plan of care for a client who has acute pancreatitis. Which of the following interventions should the nurse include?

Monitor peripheral pulses every 8 hr.

Ambulate the client three times daily.

Maintain NPO status.

Measure urine output every 4 hr.

Answer and Explanation

The Correct Answer is C

Choice A rationale
Monitoring peripheral pulses every 8 hours is not a specific intervention for a client who has acute pancreatitis. While it is important to monitor peripheral pulses as part of overall patient assessment, it does not directly address the needs of a patient with acute pancreatitis.
Choice B rationale
Ambulating the client three times daily is not a specific intervention for a client who has acute pancreatitis. While physical activity is generally beneficial for overall health, it does not directly address the needs of a patient with acute pancreatitis, especially during an acute attack.
Choice C rationale
Maintaining NPO (nothing by mouth) status is a common intervention for a client who has acute pancreatitis. This allows the pancreas to rest and recover, reducing inflammation and pain.
Choice D rationale
Measuring urine output every 4 hours is not a specific intervention for a client who has acute pancreatitis. While it is important to monitor urine output as part of overall patient assessment, it does not directly address the needs of a patient with acute pancreatitis.

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Correct Answer is B

Explanation

Choice A rationale
It is a good practice to change the batteries in smoke detectors annually to ensure they are working properly. This statement does not indicate a need for further instruction.
Choice B rationale
Using a walker when going upstairs can be dangerous due to the risk of falls. It is recommended that individuals use handrails or assistance when navigating stairs, not a walker. This statement indicates that the client needs further instruction.
Choice C rationale
Leaving a night light on can help prevent falls by providing visibility during the night. This statement does not indicate a need for further instruction.
Choice D rationale

Installing grab bars in the bathroom, especially near the toilet and in the shower, can provide support and prevent falls. This statement does not indicate a need for further instruction.

A. Urea levels B. Helicobacter pylori antibodies C. Gastrin levels D. Pepsinogen levels . .

Correct Answer is A

Explanation

Choice A rationale
The UREA breath test is used to detect Helicobacter pylori (H. pylori), a type of bacteria that may infect the stomach and is a main cause of ulcers in both the stomach and duodenum (the first part of the small intestine).
H. pylori produces an enzyme called urease, which breaks urea down into ammonia and carbon dioxide. During the test, a tablet containing urea is swallowed and the amount of exhaled carbon dioxide is measured. This indicates the presence of H. pylori in the stomach. Therefore, the UREA breath test measures urea levels to determine if H. pylori is present.

Choice B rationale
While it is true that the presence of Helicobacter pylori antibodies in the blood can indicate an
H. pylori infection, this is typically detected using a blood test, not a UREA breath test. The UREA breath test specifically measures the amount of carbon dioxide in your breath after you drink a special solution containing urea.
H. pylori bacteria break down urea into carbon dioxide, and excess carbon dioxide in your breath is a sign of an H. pylori infection. Therefore, while Helicobacter pylori antibodies can indicate an H. pylori infection, they are not the lab value that the UREA breath test measures to determine if H. pylori is present.
Choice C rationale
Gastrin levels are not measured in a UREA breath test. Gastrin is a hormone that stimulates the production of gastric acid, which helps the stomach digest food. While gastrin levels can be elevated in individuals with certain conditions, such as gastrinomas or Zollinger-Ellison syndrome, they are not directly related to H. pylori infections or measured in a UREA breath test.
Choice D rationale
Pepsinogen levels are not measured in a UREA breath test. Pepsinogen is a precursor enzyme (zymogen) produced by the gastric chief cells, and it is converted to the enzyme pepsin in the presence of stomach acid. While pepsinogen levels can be used to assess certain conditions, such as atrophic gastritis, they are not directly related to H. pylori infections or measured in a UREA breath test.

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