A nurse is planning care for a client who has cirrhosis of the liver. Which of the following actions should the nurse include in the plan? (Select all that apply.)

Encourage weight lifting during physical therapy

Measure the client's abdominal girth.

Administer warfarin.

Administer furosemide.

Implement a low-sodium diet.

Answer and Explanation

Correct Answer : B,D,E

A. Encourage weight lifting during physical therapy:

Encouraging weight lifting or strenuous physical activities might not be advisable for individuals with advanced cirrhosis. Engaging in intense physical activity could potentially strain the liver or increase the risk of injury or bleeding, which is already heightened in individuals with cirrhosis.

B. Measure the client's abdominal girth:

Monitoring the client's abdominal girth is essential because cirrhosis can lead to the accumulation of fluid in the abdomen, known as ascites. Changes in abdominal girth can indicate the progression or resolution of ascites, guiding treatment and interventions.

C. Administer warfarin:

Administering warfarin, an anticoagulant, might not be ideal in cirrhosis due to the increased risk of bleeding. Liver dysfunction in cirrhosis can impair the production of clotting factors, increasing the risk of bleeding complications.

D. Administer furosemide:

Furosemide, a diuretic, can be utilized in managing ascites by promoting the elimination of excess fluid. However, its use requires careful monitoring, considering the electrolyte balance and potential adverse effects, especially in individuals with liver impairment.

E. Implement a low-sodium diet:

A low-sodium diet is crucial in managing cirrhosis-related complications, particularly ascites and edema. Sodium restriction helps reduce fluid retention, lessening the burden on the liver and alleviating symptoms associated with fluid accumulation.

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 C

Explanation

A. Dyspepsia:

Dyspepsia refers to discomfort or pain in the upper abdomen, often described as indigestion. It is a common symptom of peptic ulcer disease but is not as urgent as the manifestation described in option C.

B. Epigastric discomfort:

Epigastric discomfort is a common symptom of peptic ulcer disease, but the priority is to identify more severe complications, such as bleeding.

C. Hematemesis:

This is the correct answer. Hematemesis refers to the vomiting of blood, which is a serious and potentially life-threatening complication of peptic ulcer disease. It indicates active bleeding in the upper gastrointestinal tract and requires prompt medical attention.

D. Epigastric pain:

Epigastric pain is similar to epigastric discomfort and is a common symptom of peptic ulcer disease. However, the priority in the given options is to identify the more severe complication of hematemesis.

A. Administer medications B. Supply nutrients via tube feedings C. Decompress the stomach D. D. Determine the pH of the gastric secretions

Correct Answer is C

Explanation

A. Administer medications:

While nasogastric tubes can be used to administer medications, this is not the primary rationale for their use in pyloric obstruction. The primary goal is often decompression.

B. Supply nutrients via tube feedings:

Providing nutrients via tube feedings is not the primary purpose in the context of a pyloric obstruction. Decompression is more relevant in this scenario.

C. Decompress the stomach:

Decompressing the stomach is a common use of nasogastric tubes in the context of pyloric obstruction. The tube helps to remove excess air and gastric contents, relieving pressure in the stomach.

D. Determine the pH of the gastric secretions:

While determining the pH of gastric secretions is a possible use, it is not the primary rationale for nasogastric tube placement in pyloric obstruction. The primary goal is often to relieve obstruction and decompress the stomach.

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 planning care for a client who has cirrhosis of the liver. Which of the following actions should the nurse include in the plan? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client diagnosed with peptic ulcer disease. Which of the following findings should the nurse identify as the priority?

Correct Answer is C

Explanation

A nurse is teaching a client who has a prescription of a nasogastric tube (NG) to treat a pyloric obstruction. Which of the following rationales for the use of the nasogastric tube should the nurse include in the teaching?

Correct Answer is C

Explanation

A nurse is preparing dietary instructions for a client who has episodes of billary colic from chronic cholecystitis. Which of the following instructions should the nurse include in the teaching plan?

A nurse is caring for a client who is receiving total parenteral nutrition via a peripherally inserted central catheter (PICC). When assessing the client, the nurse notes edema of the client's arm above the PICC insertion site. Which of the following actions should the nurse take first?

A nurse is caring for a client who has gastrointestinal bleeding. Which of the following actions should the nurse take first?

A nurse is teaching an older adult client diagnosed with diabetes mellitus about preventing the long-term complications of retinopathy and nephropathy. Which of the following instructions should the nurse include?

A nurse is performing gastric lavage on a client using a large-bore NG tube. Which of the following actions should the nurse take?

A nurse is developing a teaching plan for a client who has an Ileostomy and will require stoma care. Which of the following Information should the nurse include?

A nurse is teaching a client diagnosed with hepatitis A about preventing transmission of the virus. Which of the following strategies should the nurse include in the teaching?