youre caring for betty with liver cirrhosis which of the following assessment findings leads you to suspect hepatic encephalopathy in her
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Nursing Elites

ATI RN

ATI Gastrointestinal System Test

1. You’re caring for Betty with liver cirrhosis. Which of the following assessment findings leads you to suspect hepatic encephalopathy in her?

Correct answer: A

Rationale: Asterixis, a flapping tremor of the hands, is a sign of hepatic encephalopathy.

2. The client with cirrhosis has ascites and excess fluid volume. Which measure will the nurse include in the plan of care for this client?

Correct answer: B

Rationale: Excess fluid volume, related to the accumulation of fluid in the peritoneal and dependent areas of the body, can occur in the client with cirrhosis. Fluids should be restricted, including fluids given in medications and meals. Sodium restriction also aids in reducing fluid volume excess.

3. Janice is waiting for discharge instructions after her herniorrhaphy. Which of the following instructions do you include?

Correct answer: C

Rationale: Advise the patient to lose weight if obese to reduce the risk of complications after herniorrhaphy.

4. A client with suspected gastric cancer undergoes an endoscopy of the stomach. Which of the following assessments made after the procedure would indicate the development of a potential complication?

Correct answer: C

Rationale: A sudden increase in temperature after an endoscopy can indicate a potential complication, such as perforation.

5. Elmer is scheduled for a proctoscopy and has an I.V. The doctor wrote an order for 5mg of I.V. diazepam(Valium). Which order is correct regarding diazepam?

Correct answer: A

Rationale: The correct method for administering I.V. diazepam is to give it in the I.V. port closest to the vein.

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