A nurse is caring for a client who has acute pancreatitis. After treating the client’s pain, which of the following should the nurse address as the priority intervention?
Withhold oral fluids and food.
Auscultate the client’s lungs.
Provide oral hygiene.
Assist the client to a side-lying position.
The Correct Answer is A
Choice A reason: Withhold oral fluids and food
Withholding oral fluids and food (NPO status) is a critical intervention for clients with acute pancreatitis. This helps to rest the pancreas by reducing the stimulation of pancreatic enzyme secretion, which can exacerbate inflammation and pain. Maintaining NPO status is essential to prevent further pancreatic damage and to allow the pancreas to heal.
Choice B reason: Auscultate the client’s lungs
While auscultating the lungs is an important part of the overall assessment, it is not the immediate priority after pain management in acute pancreatitis. Respiratory complications can occur, but the primary focus should be on managing the pancreatic inflammation and preventing further damage.
Choice C reason: Provide oral hygiene
Providing oral hygiene is important for overall patient care, especially when the client is NPO. However, it is not the priority intervention immediately after pain management. The primary concern is to prevent further pancreatic stimulation and manage the inflammation.
Choice D reason: Assist the client to a side-lying position
Assisting the client to a side-lying position can help with comfort and may be beneficial in managing pain. However, it is not the priority intervention. The main focus should be on preventing further pancreatic stimulation by withholding oral intake.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","D"]
Explanation
Choice A reason: Using a kitchen spoon to administer the medication is not recommended. Kitchen spoons can vary in size and may not provide an accurate dose. It is important to use a proper measuring device, such as an oral syringe or a medication cup, to ensure the correct dosage.
Choice B reason: Written information about the medication is crucial for the parents or caregivers. This information should include the name of the medication, the dosage, the frequency of administration, and any special instructions. Providing written information helps ensure that the medication is administered correctly and consistently.
Choice C reason: The reason why the child is taking the medication should be clearly explained to the parents or caregivers. Understanding the purpose of the medication helps ensure compliance and allows them to monitor the child’s response to the treatment.
Choice D reason: The adverse effects of the medication should be discussed with the parents or caregivers. Knowing the potential side effects allows them to recognize and respond to any adverse reactions promptly. This information is essential for the safe administration of the medication.
Choice E reason: Stopping the medication when the child feels better is incorrect. Antibiotics should be taken for the full prescribed course, even if the child starts to feel better before the medication is finished. Stopping the medication early can lead to incomplete treatment of the infection and contribute to antibiotic resistance.
Correct Answer is B
Explanation
Choice A reason: Increasing age is a non-modifiable risk factor for cardiovascular disease. As people age, their risk of developing cardiovascular conditions naturally increases due to changes in the heart and blood vessels. However, age cannot be altered or controlled, making it a non-modifiable factor.
Choice B reason: Cigarette smoking is a significant modifiable risk factor for cardiovascular disease. Smoking damages the lining of the arteries, leading to atherosclerosis (narrowing and hardening of the arteries), which can result in heart attacks and strokes. Quitting smoking can significantly reduce the risk of cardiovascular disease, making it a key focus in prevention programs.
Choice C reason: Family history of cardiac disease is another non-modifiable risk factor. Genetics play a crucial role in the predisposition to cardiovascular diseases. If a close family member has had heart disease, the risk is higher. While this factor cannot be changed, awareness can lead to more proactive management of other modifiable risks.
Choice D reason: Diagnosis of diabetes mellitus is a complex risk factor. While having diabetes itself is not modifiable, the management of diabetes through lifestyle changes, medication, and monitoring can significantly reduce the risk of cardiovascular complications. Proper control of blood glucose levels, diet, and exercise are crucial in mitigating this risk.
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