Question

40. A patient with hepatitis is experiencing pruritis and jaundice. Which location is best to evaluate jaundice? a. Oral mucus membrane b. Nail bed C Conjunctiva d. Sclera 41. The nurse will ask a 64-year-old patient being admitted with acute pancreatitis specifically about a history of a. Smoking marijuana on the weekends b. Drinking protein shakes c. Smoking a pack per day of cigarettes d. Drinking 6 cans of beer every evening 42. A patient that has experienced hypotension after coronary artery bypass surgery is at risk of developing acute kidney injury. Which of the following assessment findings would support this diagnosis? a. Urine output of 150 for 6 hours b. Painless hematuria loc. Presence of rebound tenderness d. Painful urination 43. Which laboratory finding in the client with chronic renal failure would indicate to the nurse the desired effect of erythropoetin (Epogen). a) .Decreased serum creatinine b) Increased hematocrit (HCT) c) Increased white blood cell count (WBC) d) Increased platelet count 44. A client considering peritoneal versus hemodialysis asks the nurse to explain the advantages of peritoneal dialysis. Which of the following statements by the nurse is accurate? a) "You can perform this at home, sometimes even while you sleep." b) "You can use the dialysis catheter as soon as it is inserted." c) "It is the preferred method of dialysis for removing toxins quickly." d) "Anyone can be a candidate for peritoneal dialysis. quickly." 45. A patient with end stage renal disease has had an AV fistula placed in his right forearm for hemodialysis. The nurse knows which of the following must be avoided to keep the fistula patent? (Select all that apply) a. No blood draws in Rarm b. No IV insertion in Rarm C. No manual BP in Rarm d. No pulse oximetry in Rarm e. No restraints on the Rarm

Answer 1

40. Answer: Sclera.

Due to the hepatitis infection the liver gets impaired so it cannot eliminate the bilirubin out.Hence serum bilirubin level gets increased it results in yellow discoloration .With hepatitis it due to high amount of bilirubin it shows the discoloration in the sclera.

other options: Oral mucous membrane,nail bed and conjuctiva. it also shows the discoloration in these regions in normal jaundice but here the jaundice is due to the hepatitis so the bilirubin level gets comparatively high with normal jaundice hence it shows discoloration even in the sclera.Hence it should be first inspected.

41.Answer:Drinking 6 cans of beer every evening.

Alcohol is the cause for acute pancreatitis.The Pancreas have three types of cells that function it by these cells.The alcohol cause damage to the pancreatic cells thus it impair its function resulting in Acute pancreatitis.

Smoking and marijuana is also can be the cause but not have that much evident as a cause.

Protein shakes not cause pancreatitis.

42.Answer:Urine output of 150 for 6 hours.

Acute kidney injury makes the kidney impair hence it cannot seperate the waste particles from the blood that is it cannot produce urine and results in decreased urine output that is oliguria.Hence for acute kidney it is assessed by oliguria.

Painful urination ,rebound tenderness and painless hematuria are not always occurring in acute kidney injury.It occurs in other kidney disorders.Not that much important as oliguria.

43.Answer: Increased hematocrit

Chronic kidney disease can cause poor erythropoisis hence the hemoglobin level can gets reduced results in anemia.it can also by blood loss during the dialysis.So epogen is given to correct anemia.So the desired effect is increased hematocrit.

To acknowledge the treatment of anemia the parameter to check that the anemia is cured is hematocrit.So the other three options not a parameter to check anemia.

44.Answer: You can perform this at home even when you are in sleep

Peritoneal dialysis is using the peritoneal layer for filter function.It uses the client's peritoneal layer itself.Hence it is performed at anywhere and anytime.

So can be performed at home even while sleep

The tube is inserted into the abdomen one week before to the start of dialysis process.Provide one week time time for wound healing.So option b is not possible.You cannot start with dialysis immediately after tube insertion.

It is also for removing toxins but comparatively hemodialysis have quick excretion.So option C is not correct.

Option D is wrong.It is possible only for the patients with good abdominal and peritoneal condition.

45.We should not pressure the limb containing AV fistula.Pressurizing the area can create the block or embolism.So the activities of pressuring should be avoided.Manual BP checking cause pressure , Drawing blood and Iv lines can cause sometimes the blood clots.Restraints cause pressure in the limb.Pulse oximetry not create any pressure.

Answer:

Drawing blood, inserting IV lines,Checking manual blood pressure and restraints are should be avoided.