A nurse is evaluating a client admitted to the emergency unit.

Exhibits
Which nursing interventions are appropriate for managing a patient with cirrhosis experiencing fluid volume excess?

Advise strict bed rest

Encourage high-sodium diet

Administer diuretics as prescribed

Monitor abdominal girth daily

Answer and Explanation

The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"A"}}

Rationale

Advise strict bed rest → Contraindicated
Strict bed rest is not necessary unless the patient is severely compromised; mobility is encouraged to prevent complications.
Encourage high-sodium diet → Contraindicated
A low-sodium diet is essential to reduce fluid retention and ascites; high sodium worsens edema.
Administer diuretics as prescribed → Anticipated
Diuretics (e.g., spironolactone, furosemide) help reduce ascites and edema.
Monitor abdominal girth daily → Anticipated
Helps track fluid accumulation and assess effectiveness of interventions.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is D

Explanation

Rationale:

A. Tachycardia may occur secondary to hypotension, but it is a secondary concern, not the primary pharmacological issue.

B. Paracentesis does not directly affect blood glucose levels.

C. While changes in bowel habits may occur with fluid shifts, they are not the primary concern after paracentesis.

D. Removal of large volumes of ascitic fluid can lead to intravascular volume depletion, resulting in hypotension. Monitoring blood pressure before, during, and after the procedure is essential, and volume replacement may be required to maintain hemodynamic stability.

A. Increased AST levels B. Decreased albumin levels C. High prothrombin time D. Elevated serum bilirubin

Correct Answer is B

Explanation

Rationale:

A. Elevated AST indicates hepatocellular injury, but it does not directly reflect fluid volume status.

B. In liver cirrhosis, the liver produces less albumin, leading to reduced plasma oncotic pressure. Low albumin allows fluid to leak into interstitial spaces, causing ascites, edema, and overall fluid volume excess.

C. Prolonged PT reflects impaired clotting factor synthesis in cirrhosis, not fluid status.

D. High bilirubin indicates impaired bile excretion and liver dysfunction, but it is not a direct marker of fluid overload.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A nurse is evaluating a client admitted to the emergency unit. Exhibits Which nursing interventions are appropriate for managing a patient with cirrhosis experiencing fluid volume excess?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What is the main pharmacological concern after performing a paracentesis?

Correct Answer is D

Explanation

Which of the following laboratory findings is most indicative of fluid volume excess in a client with liver cirrhosis?

Correct Answer is B

Explanation

Which electrolyte imbalance is most commonly associated with refeeding syndrome?

A nurse in a provider's office is caring for a client. Exhibits Select the 3 findings from the client's medical record that increase their risk for peptic ulcer disease (PUD).

A nurse is caring for a client who has ulcerative colitis and is teaching the client about the common link with Crohn's disease. Which of the following information should the nurse include?

A client is admitted to the emergency room with a respiratory rate of 7/min. Arterial blood gases (ABG) reveal the following values. Which of the following is an appropriate analysis of the ABGs? pH 7.22 PaCO2 68 mm Hg Base excess-2 PaO2 78 mm Hg Saturation 80% Bicarbonate 26 mEq/L

Which type of enema is typically used to relieve constipation by instilling and retaining fluid for a short period before expelling?

A nurse is caring for a client in the gastroenterology unit. Exhibits Select the key indicators of improvement when evaluating the effectiveness of paracentesis in clients with cirrhosis

A nurse is assessing a client who has an obstruction of the common bile duct resulting from chronic cholecystitis. Which of the following findings should the nurse expect?

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 evaluating a client admitted to the emergency unit.

Exhibits
Which nursing interventions are appropriate for managing a patient with cirrhosis experiencing fluid volume excess?