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The physician is assessing renal function in a client with severe pancreatitis. Which laboratory finding would be the best indicator of a problem in this area? A. Alkaline phosphatase 20U/L B. Hemoglobin 14.6 g/dl C. BUN 28 mg/dl D. Creatinine 2.3 mg/dl

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An 85-year-old client with diverticulitis has been vomiting and febrile for 12 hours. Where is the best location to assess skin turgor on this client? A. Dorsal hand B. Feet C. Back of the arm D. Sternum

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The nurse is caring for a client with pancreatitis experiencing the process of lipolysis of the pancreas. Which assessment would be a priority because of the pathophysiology of lipolysis? A. Checking for tetany-like movements B. Assessing breath sounds C. Obtaining vital signs D. Palpating pedal pulses

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A client scheduled for a Nissen repair for a hiatal hernia is being instructed preoperatively to use the incentive spirometer. Which statement indicates to the nurse that the client understands the teaching? A. These exercises will help to decrease my pain. B. I should use this device once a day. C. If I use this device, it will help in preventing pneumonia. D. I should do these breathing techniques while lying down flat in bed.

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A nurse receives a report on a client three days postoperative abdominal surgery that includes four saturated dressing changes in eight hours. On assessment of this client, dehiscence and evisceration of the wound are noted. After applying a sterile, moistened 4x-4, what is the nurses next action? A. Place the client in the dorsal recumbent position. B. Notify the physician. C. Wrap an Ace bandage around the abdomen. D. Use a wheelchair to transport the client to the treatment room.

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The nurse is caring for a client with a nasogastric tube in place. Assessment of the aspirate reveals a pH of 2.0. Which is the appropriate action? A. Document the finding. B. Notify the physician.

C. Remove the NG tube and replace it. D. Turn the client side lying and reassess the aspirate. 7. A client diagnosed with an ulcer has been placed on tetracycline due to a positive helicobacter pyloric test result. Which food choice, when taken with the drug, could decrease its effectiveness? A. Cabbage B. Yogurt C. Bran cereal D. Bananas 8. A client with hepatitis C is scheduled for a liver biopsy. Which data, noted in the clients record, would receive priority? A. Prothrombin time of 56 seconds B. BUN of 22 mg/dl C. Hematocrit 42% D. Potassium 4.0 mEq/L 9. A client is being admitted with a diagnosis of possible pancreatitis. Which of the following is the best support for this diagnosis? A. Pain is in the left upper quadrant of the abdomen B. Client reports steatorrhea for the last three days C. A serum amylase level of 366 U/L D. Assessed diminished bowel sounds 10. A client with diverticulitis has received nutritional discharge instructions for a high-fiber diet. Which menu selection by the client would reinforce that the teaching was effective? A. Spaghetti with meatballs and toast B. Baked chicken and macaroni with cheese C. Broccoli chicken stir fry and brown rice D. Broiled liver and dinner roll

Answer Rationales
1. Answer D is correct. Creatinine is the most specific laboratory test for renal functioning; normal is 0.51.5mg/dl. Answers A and B do not relate to the kidney, so they are incorrect. Answer C can be abnormal with kidney function but is not as specific as the creatinine, so its incorrect. Answer D is correct. This is the best area to check in the elderly due to loss of skin elasticity that occurs with aging. Answers A, B, and C are all influenced by loss of elasticity more than the sternum, so they are incorrect. Answer A is correct. Hypocalcemia is a specific manifestation of clients with pancreatitis and

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lipolysis, and tetany is a major characteristic of low calcium levels. Answers B, C, and D are all pertinent assessments but are not priorities with the pathophysiology of lipolysis, so they are incorrect. 4. Answer C is correct. Incentive spirometrys purpose is to prevent or treat ate lectasis, which can lead to pneumonia. Answer A is a false statement, so it is incorrect. Answer B is incorrect because the timing is not as often as it should be. Answer D is wrong because it is best done sitting upright. Answer B is correct. After the saline dressing is applied, the doctor should be notified for probable repair. Answer A is wrong because low Fowlers position should be used. Answer C will not help, so its incorrect. Answer D is inappropriate at this time, so its incorrect. Answer A is correct. This finding is within normal range for gastric aspirate of 0 4. Answers B, C, and D would not be appropriate or necessary due to the no rmal reading, so theyre incorrect. Answer B is correct. Milk and dairy products can reduce the effectiveness of the drug when taken at the same time. Answers A, C, and D would not affect the drug, so the yre incorrect. Answer A is correct. An abnormal prothrombin time would receive priority due to the risk of hemorrhage with a liver biopsy. Answers B, C, and D are all normal values and dont relate to the procedures risks, so theyre incorrect. Answer C is correct. The clients amylase level is elevated above the normal level of 200 U/L. This measurement is the most accurate indicator of pancreatitis and the most objective and specific. The answers in A, B, and D are also clinical manifestations of pancreatitis, but are not as specific as the laboratory value, so they are incorrect choices. Answer C is correct. This diet has the highest amount of fiber. Answers A, B, and D have low amounts of fiber, so theyre incorrect.

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