Nursing Elites

1. Develop a teaching care plan for Angie who is about to undergo a liver biopsy. Which of the following points do you include?

• A. You’ll need to lie on your stomach during the test.
• B. You’ll need to lie on your right side after the test.
• C. During the biopsy you’ll be asked to exhale deeply and hold it.
• D. The biopsy is performed under general anesthesia.

Correct answer: B

Rationale: Instruct the patient to lie on their right side after the biopsy to apply pressure and prevent bleeding.

2. The nurse provides discharge instructions to a patient with hepatitis B. Which of the following statements, if made by the patient, would indicate the need for further instruction?

• A. I can never donate blood.
• B. I can never have unprotected sex.
• C. I cannot share needles.
• D. I should avoid drugs and alcohol.

Correct answer: D

Rationale: The correct answer is D. This patient statement indicates a need for further teaching. The patient should be instructed that, in order to avoid complications, alcohol should be avoided for six months to one year. Illicit drugs and toxic chemicals should also be avoided. Acetaminophen may be taken only when necessary and not beyond the recommended dosage. Choices A, B, and C are correct statements regarding precautions to prevent the spread of hepatitis B and do not indicate a need for further instruction.

3. Rob is a 46 y.o. admitted to the hospital with a suspected diagnosis of Hepatitis B. He’s jaundiced and reports weakness. Which intervention will you include in his care?

• A. Regular exercise.
• B. A low-protein diet.
• C. Allow patient to select his meals.
• D. Rest period after small, frequent meals.

Correct answer: D

Rationale: For a patient with hepatitis B who is jaundiced and reports weakness, providing rest periods after small, frequent meals is important.

4. A client with viral hepatitis states, 'I am so yellow.' The nurse most appropriately would

• A. Assist the client in expressing feelings.
• B. Do most of the activities of daily living for the client.
• C. Provide information to the client only when the client requests it.
• D. Restrict visitors until the jaundice subsides.

Correct answer: A

Rationale: To assist the client in adapting to changes in appearance, the nurse must encourage participation in self-care to foster independence and self-esteem. The nurse should encourage the client to ask questions to clarify misconceptions, learn ways to prevent the spread of hepatitis to reduce fear, and make appropriate decisions. Restricting visitors will reinforce the client’s negative self-esteem.

5. The nurse has given instructions to the client with an ileostomy about foods to eat to thicken the stool. The nurse determines that the client needs further instructions if the client stated to eat which of the following foods to make the stool less watery?

• A. Pasta
• B. Boiled rice
• C. Bran
• D. Low-fat cheese

Correct answer: C

Rationale: Foods that help to thicken the stool of the client with an ileostomy include pasta, boiled rice, and low-fat cheese. Bran is high in dietary fiber and thus will increase the output of watery stool by increasing propulsion through the bowel. Ileostomy output is liquid. Addition or elimination of various foods can help to thicken or loosen this liquid drainage.

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