TRIAL VINODHINI

The nurse is caring for a client with acute pancreatitis. While obtaining the client's blood pressure, the nurse notes a carpal spasm. The nurse should obtain a blood specimen to check the client's serum

• Calcium level
• Albumin level
• Troponin T level
• Potassium level

Answer explanation

Trousseau and Chvostek signs are linked with hypocalcemia, often seen in pancreatitis. Calcium should be checked and corrected to avoid complications like tetany and arrhythmias.

Which group of food selections would be appropriate for a client on a full liquid diet 3 days after bariatric surgery?

• Apple juice, mashed potatoes, and chocolate pudding
• Chicken broth, low-fat cheese omelet, and strawberry ice cream
• Creamy wheat cereal, blended cream of chicken soup, and a protein shake
• Low-fat vanilla yogurt, smooth peanut butter, and vegetable juice

Answer explanation

Post-bariatric surgery, the full liquid diet should include high-protein, low-sugar items like cream soups and protein shakes. Avoid overstretching the pouch and dumping syndrome.

The nurse is caring for a client with liver cirrhosis. Which of the following assessment findings would warrant immediate follow-up?

• Black, tarry stool
• Bright red-streaked stool
• Light gray clay-colored stool
• Small, dry, rocky stool

Answer explanation

Black, tarry stools (melena) may indicate upper GI bleeding, which can be life-threatening in cirrhotic patients due to bleeding varices.

The nurse understands that which of these body substances are modes of transmission for hepatitis B? Select all that apply.

• Blood
• Feces
• Semen
• Urine
• Vaginal secretions

Answer explanation

Hepatitis B is transmitted through blood, semen, and vaginal secretions. It is not transmitted through feces or urine.

The nurse is caring for a client who had an endoscopic procedure yesterday to stop upper gastrointestinal bleeding and who started a clear liquid diet today. Which of the following foods would be appropriate to offer to this client? Select all that apply.

• Apple juice
• Chicken broth
• Cranberry juice
• Cream of chicken soup
• Unsweetened tea

Answer explanation

Clear liquids without red dye (to avoid confusion with bleeding) are recommended. Apple juice, broth, and tea are appropriate; cranberry juice and ice cream are not suitable for a clear liquid diet.

The nurse is talking with a client who is scheduled for a screening colonoscopy. The client asks, 'What should I know about this procedure?' What information should the nurse include? Select all that apply.

• The procedure is not painful, and you will be sedated.
• Your abdomen should feel firm and distended after the procedure.
• You will need to avoid consuming red liquids prior to the procedure.
• Colonoscopies are performed to screen for colon cancer and colon polyps.
• You will be given laxatives before the procedure to completely empty your colon.

Answer explanation

Colonoscopy clients should know they'll be sedated, avoid red liquids, take laxatives for prep, and that the procedure screens for colon cancer/polyps. Firm, distended abdomen is a warning sign.

The nurse admits a client with cirrhosis who has an upper gastrointestinal bleed from suspected gastroesophageal varices. Which new prescription should the nurse question?

• Administer pantoprazole IV piggyback every 12 hours
• Initiate continuous octreotide IV infusion
• Insert and maintain a nasogastric tube
• Maintain NPO status except for PO medications

Answer explanation

NG tube insertion may traumatize and rupture varices causing hemorrhage. All other orders are appropriate in UGIB management.

A client diagnosed with cirrhosis is experiencing pruritus. Which strategies are appropriate for the nurse to teach the client to promote comfort and skin integrity? Select all that apply.

• Maintain short fingernails to minimize excoriating the skin
• Take a bath or shower in hot water to alleviate itching sensations
• Take prescribed cholestyramine 1 hour after other medications
• Use a moisturizing cream on unbroken skin daily
• Wear wool gloves and tight stockings to avoid scratching

Answer explanation

Clients should avoid hot baths, use moisturizers, take bile acid sequestrants appropriately, and avoid irritating materials like wool.

The nurse is caring for a client with celiac disease who started a gluten-free diet 4 weeks ago. The client reports continuation of symptoms. Which of the following responses would be most appropriate for the nurse to make?

• I can request a referral to the dietitian.
• Tell me what you had to eat yesterday.
• You may not be following your diet correctly.
• You will need to read food labels more carefully.

Answer explanation

The best response involves assessment. Asking about food intake helps identify gluten exposure before offering conclusions or referrals.

The nurse is caring for a client who has undergone a colonoscopy. Which client assessment finding should most concern the nurse?

• Abdominal cramping
• Frequent, watery stools
• Positive rebound tenderness
• Recurring flatus

Answer explanation

Rebound tenderness may signal perforation, a serious complication. Other listed findings are expected post-procedure symptoms.