A nurse is preparing to administer a dose of lactulose to a client who has cirrhosis. The client states, "I don't need this medication. I am not constipated." The nurse should explain that in clients who have cirrhosis, lactulose is used to decrease levels of which of the following components in the bloodstream?

Potassium

Ammonia

Bicarbonate

Glucose

Answer and Explanation

The Correct Answer is B

Choice A rationale
Potassium levels are not directly affected by lactulose. While cirrhosis can lead to imbalances in electrolytes, including potassium, lactulose is not used to manage potassium levels in the bloodstream.

Choice B rationale
Ammonia is produced by the breakdown of proteins in the intestines and is normally processed by the liver. In cirrhosis, the liver's ability to convert ammonia to urea is impaired, leading to increased levels in the blood. Lactulose helps reduce blood ammonia levels by converting it into ammonium, which is then excreted.

Choice C rationale
Bicarbonate levels are related to the body's pH balance and are not the target of lactulose treatment. Cirrhosis does not typically result in bicarbonate imbalances that would be treated with lactulose.

Choice D rationale
Glucose levels are managed by insulin and other metabolic processes, not lactulose. While cirrhosis can affect overall metabolism, lactulose does not have a direct effect on blood glucose levels.

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Correct Answer is D

Explanation

Choice A rationale
Chest pain that is relieved with eating or drinking water is not typically indicative of a complication from a peptic ulcer. This symptom may be related to conditions like gastroesophageal reflux disease (GERD).

Choice B rationale
Burning epigastric pain after eating is a common symptom of a peptic ulcer and, while uncomfortable, does not usually require an urgent change in the plan of care unless it significantly worsens or is accompanied by other concerning symptoms.

Choice C rationale
Back pain after eating can be associated with a peptic ulcer if the ulcer is located at the back of the stomach or the pain radiates; however, it does not typically warrant an urgent change in care without other symptoms.

Choice D rationale
A rigid abdomen and vomiting following indigestion can indicate a perforated ulcer, which is a medical emergency. This requires immediate intervention and possibly surgical consultation, thus warranting an urgent change in the nursing plan of care.

A. "This medication will need to be stored at room temperature." B. "This medication is being given because your kidneys are not properly producing erythropoietin." C. "This medication will delay your need for dialysis as long as you take it." D. "This medication will help prevent your AV fistula from clotting."

Correct Answer is B

Explanation

Choice A rationale
Storing the medication at room temperature is a practical instruction but does not explain the therapeutic purpose of the medication, which is essential for patient understanding.

Choice B rationale
Epoetin alfa (Procrit) is used to treat anemia associated with chronic kidney disease by supplementing erythropoietin, a hormone the damaged kidneys can no longer produce effectively. This is the most informative statement for the patient's understanding of the medication's purpose.

Choice C rationale
While epoetin alfa can improve anemia and potentially improve quality of life, it does not directly delay the need for dialysis, which is determined by overall kidney function and not solely by the presence of anemia.

Choice D rationale
Epoetin alfa does not have a role in preventing AV fistula clotting. It is specifically used to stimulate red blood cell production and has no direct effect on clotting mechanisms.

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Naxlex Comprehensive Predictor Exams

A 72-year-old patient was admitted with epigastric pain caused by a peptic ulcer. Which patient assessment warrants an urgent change in the nursing plan of care?

Correct Answer is D

Explanation

A 55-year-old patient with end-stage kidney disease (ESKD) is scheduled to receive a prescribed dose of epoetin alfa (Procrit). Which statement should the nurse include in her teaching about this medication?

Correct Answer is B

Explanation

A nurse is caring for a client in the outpatient cardiologist's office. The client is alert and oriented. Lung sounds with crackles are heard bilaterally. Dyspnea is observed on exertion, and heart sounds reveal an S3 gallop. Which of the following findings is the nurse most likely to expect?

Which laboratory finding indicates the resolution of a patient's acute pancreatitis?

A nurse is developing a plan of care for a client who has a new ileal conduit. Which of the following should the nurse include as risks for the client? (Select all that apply.)

A nurse is providing teaching on common symptoms of glomerulonephritis. What assessment findings are consistent with this diagnosis? (Select all that apply.)

A patient is admitted with esophageal varices and portal hypertension. Which underlying cause of these conditions would the nurse suspect?

A nurse is giving a presentation to a community group about preventing atherosclerosis. Which of the following should the nurse include as modifiable risk factors for this disorder? (Select all that apply.)

A nurse is caring for a school-age child who has acute glomerulonephritis with peripheral edema and is producing 35 mL of urine per hour. The nurse should place the client on which of the following diets?

A nurse is admitting a client who has pyelonephritis. Which of the following manifestations should the nurse expect to be present during the assessment? (Select all that apply.)