Matt is a 49 y.o. with a hiatal hernia that you are about to counsel. Health care counseling for Matt should include which of the following instructions?

Restrict intake of high-carbohydrate foods.
Increase fluid intake with meals.
Increase fat intake.
Eat three regular meals a day.

Solution

Increase fluid intake with meals.

Increasing fluids helps empty the stomach. A high carb diet isn’t restricted and fat intake shouldn’t be increased.

Type A chronic gastritis can be distinguished from type B by its ability to:

Cause atrophy of the parietal cells.
Affect only the antrum of the stomach.
Thin the lining of the stomach walls.
Decrease gastric secretions.

Solution

Cause atrophy of the parietal cells.

Type A causes changes in parietal cells.

Stephanie, a 28 y.o. accident victim, requires TPN. The rationale for TPN is to provide:

Necessary fluids and electrolytes to the body.
Complete nutrition by the I.V. route.
Tube feedings for nutritional supplementation.
Dietary supplementation with liquid protein given between meals.

Solution

Complete nutrition by the I.V. route.

TPN is given I.V. to provide all the nutrients your patient needs. TPN isn’t a tube feeding nor is it a liquid dietary supplement.

Jason, a 22 y.o. accident victim, requires an NG tube for feeding. What should you immediately do after inserting an NG tube for liquid enteral feedings?

Aspirate for gastric secretions with a syringe.
Begin feeding slowly to prevent cramping.
Get an X-ray of the tip of the tube within 24 hours.
Clamp off the tube until the feedings begin.

Solution

Aspirate for gastric secretions with a syringe.

Aspirating the stomach contents confirms correct placement. If an X-ray is ordered, it should be done immediately, not in 24 hours.

Michael, a 42 y.o. man is admitted to the med-surg floor with a diagnosis of acute pancreatitis. His BP is 136/76, pulse 96, Resps 22 and temp 101. His past history includes hyperlipidemia and alcohol abuse. The doctor prescribes an NG tube. Before inserting the tube, you explain the purpose to patient. Which of the following is a most accurate explanation?

“It empties the stomach of fluids and gas.”
“It prevents spasms at the sphincter of Oddi.”
“It prevents air from forming in the small intestine and large intestine.”
“It removes bile from the gallbladder.”

Solution

“It empties the stomach of fluids and gas.”

An NG tube is inserted into the patient’s stomach to drain fluid and gas.

Stephen is a 62 y.o. patient that has had a liver biopsy. Which of the following groups of signs alert you to a possible pneumothorax?

Dyspnea and reduced or absent breath sounds over the right lung
Tachycardia, hypotension, and cool, clammy skin
Fever, rebound tenderness, and abdominal rigidity
Redness, warmth, and drainage at the biopsy site

Solution

Dyspnea and reduced or absent breath sounds over the right lung

Signs and Symptoms of pneumothorax include dyspnea and decreased or absent breath sounds over the affected lung (right lung).

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

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

Solution

“You’ll need to lie on your right side after the test.”

After a liver biopsy, the patient is placed on the right side to compress the liver and to reduce the risk of bleeding or bile leakage.

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

Eat a low-fiber diet.
Resume heavy lifting in 2 weeks.
Lose weight, if obese.
Resume sexual activity once discomfort is gone.

Solution

Lose weight, if obese.

Because obesity weakens the abdominal muscles, advise weight loss for the patient who has had a hernia repair.

Your goal is to minimize David’s risk of complications after a herniorrhaphy. You instruct the patient to:

Avoid the use of pain medication.
Cough and deep breathe Q2H.
Splint the incision if he can’t avoid sneezing or coughing.
Apply heat to scrotal swelling.

Solution

Splint the incision if he can’t avoid sneezing or coughing.

Teach the pt to avoid activities that increase intra-abdominal pressure such as coughing, sneezing, or straining with a bowel movement.

A patient with Crohn’s disease is admitted after 4 days of diarrhea. Which of the following urine specific gravity values do you expect to find in this patient?

1.005
1.011
1.020
1.030

Solution

1.030

The normal range of specific gravity of urine is 1.010 to 1.025; a value of 1.030 may be seen with dehydration.

UnAttempted

0

Attempted

0

Correct

0

Wrong

0

Complete