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?

Encourage eating three large meals daily.

Provide a high carbohydrate diet.

Include high protein snacks.

Administer acetaminophen for pain.

Answer and Explanation

The Correct Answer is B

Rationale:
A. Clients with hepatitis often experience anorexia and nausea. Small, frequent meals are better tolerated than three large meals.
B. Carbohydrates are the primary source of calories in clients with hepatitis. They help spare protein and allow the liver to rest and heal. This is the recommended dietary intervention.
C. Protein should be limited in clients with severe hepatitis, especially if liver function is impaired, because excess protein can worsen encephalopathy.
D. Acetaminophen is hepatotoxic and should be avoided in clients with hepatitis due to the risk of further liver damage.

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Correct Answer is B

Explanation

Rationale:

A. Restlessness can occur with electrolyte imbalances or hypoxia, but it is not a hallmark of low albumin or protein malnutrition.

B. Low serum albumin and total protein decrease plasma oncotic pressure, allowing fluid to shift from the vascular space into interstitial tissues, leading to peripheral and sometimes generalized edema (anasarca).

C. Pallor is more indicative of anemia, which may coexist but is not a direct effect of hypoalbuminemia.

D. Confusion can result from electrolyte disturbances, hypoxia, or hepatic encephalopathy, but it is not a direct manifestation of low albumin.

A. Increased serum calcium B. Decreased serum lipase C. Decreased WBC D. Increased serum amylase

Correct Answer is D

Explanation

Rationale:
A. Serum calcium levels are often decreased in acute pancreatitis due to fat saponification, not increased.

B. Serum lipase is typically elevated, not decreased, in acute pancreatitis, and is often more specific than amylase for pancreatic injury.

C. WBC count usually increases due to inflammation and possible infection; a decreased WBC is not expected.

D. Increased serum amylase is a hallmark laboratory finding in acute pancreatitis. Amylase is released from damaged pancreatic cells into the bloodstream. Levels typically rise within 6–12 hours of onset of symptoms and remain elevated for 3–5 days. Monitoring amylase, along with lipase (which remains elevated longer), helps confirm the diagnosis and assess the severity of pancreatic inflammation. Elevated amylase, in the context of abdominal pain radiating to the back, nausea, and vomiting, supports the provider’s suspicion of acute pancreatitis.

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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?

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Naxlex Comprehensive Predictor Exams

An older adult patient who is malnourished presents to the emergency department with a serum albumin that is low with total protein that is also low. Which clinical manifestation should the nurse expect?

Correct Answer is B

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?

Correct Answer is D

Explanation

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