Nursing Elites

1. Sharon has cirrhosis of the liver and develops ascites. What intervention is necessary to decrease the excessive accumulation of serous fluid in her peritoneal cavity?

• A. Restrict fluids
• B. Encourage ambulation
• C. Increase sodium in the diet
• D. Give antacids as prescribed

Correct answer: A

Rationale: Restricting fluids is necessary to decrease the excessive accumulation of serous fluid in the peritoneal cavity for a patient with ascites due to cirrhosis.

2. Which of the following best describes the method of action of medications, such as ranitidine (Zantac), which are used in the treatment of peptic ulcer disease?

• A. Neutralize acid
• B. Reduce acid secretions
• C. Stimulate gastrin release
• D. Protect the mucosal barrier

Correct answer: B

Rationale: Medications like ranitidine (Zantac) are H2 receptor antagonists that reduce acid secretions in the stomach, helping to treat peptic ulcer disease.

3. A nurse is assigned to a 40-year-old client who has a diagnosis of chronic pancreatitis. The nurse reviews the laboratory result, anticipating a laboratory report that indicates a serum amylase level of

• A. 45 units/L
• B. 100 units/L
• C. 300 units/L
• D. 500 units/L

Correct answer: C

Rationale: The normal serum amylase level is 25 to 151 IU/L. With chronic cases of pancreatitis, the rise in serum amylase levels usually does not exceed three times the normal value. In acute pancreatitis, the value may exceed five times the normal value. Options 1 and 2 are within normal limits. Option 3 is an extremely elevated level seen in acute pancreatitis.

4. Which of the following symptoms best describes Murphy’s sign?

• A. Periumbilical ecchymosis exists
• B. On deep palpation and release, pain is elicited
• C. On deep inspiration, pain is elicited and breathing stops
• D. Abdominal muscles are tightened in anticipation of palpation

Correct answer: C

Rationale: Murphy's sign is described as pain elicited on deep inspiration when the examiner's fingers are placed under the right costal margin.

5. When assessing the client with celiac disease, the nurse can expect to find which of the following?

• A. Steatorrhea
• B. Jaundiced sclerae
• C. Clay-colored stools
• D. Widened pulse pressure

Correct answer: A

Rationale: Because celiac disease destroys the absorbing surface of the intestine, fat isn't absorbed but is passed in the stool. Steatorrhea is bulky, fatty stools that have a foul odor. Jaundiced sclerae result from elevated bilirubin levels. Clay-colored stools are seen with biliary disease when bile flow is blocked. Celiac disease doesn't cause a widened pulse pressure.

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