The nurse is preparing to administer spironolactone (Aldactone) and furosemide (Lasix) at 0900 to a client diagnosed with ascites. Review of 0600 laboratory results shows serum sodium 130 mEq/L (136-145 mEq/L) and potassium 3.1 mEq/L (3.5-5.0 mEq/L). Which action should the nurse take first?

Request a dietary consult

Order a 2 gram sodium restriction diet

Initiate a fluid restriction

Hold the spironolactone and furosemide

Answer and Explanation

The Correct Answer is D

A) Requesting a dietary consult is useful but not the most immediate action needed.

B)   Ordering a 2 gram sodium restriction diet is important but not addressing the immediate issue of electrolyte imbalance.
C)   Fluid restriction may be considered but not before addressing the electrolyte issues.
D)   Holding the spironolactone and furosemide is the correct action, as administering these could exacerbate the existing hypokalemia and hyponatremia, increasing the risk of adverse effects.

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Correct Answer is C

Explanation

A) Pancrelipase may be prescribed to aid in digestion in chronic pancreatitis but is not typically used in the acute phase.
B) While ambulation may be encouraged as tolerated, it is not a specific prescription for acute pancreatitis.
C) Pantoprazole, a proton pump inhibitor, is often prescribed in acute pancreatitis to reduce gastric acid secretion, thereby reducing pancreatic stimulation and promoting healing.
D) In acute pancreatitis, dietary intake is typically restricted initially, often starting with nothing by mouth (NPO) and progressing to a clear liquid diet as tolerated; a low-residue diet is usually introduced at a later stage.

A. Prothrombin time (PT) B. Serum albumin C. Serum ammonia D. Troponin E. Serum lipase

Correct Answer is ["A","B","C"]

Explanation

A) PT is prolonged in cirrhosis due to impaired synthesis of clotting factors by the liver, making it important to monitor for bleeding risk.
B) Serum albumin levels decrease in cirrhosis due to impaired liver function, reflecting the client's nutritional status and liver synthetic function.
C) Elevated serum ammonia levels can indicate hepatic encephalopathy, a complication of cirrhosis characterized by altered mental status.
D) Troponin is not typically evaluated in cirrhosis assessment; it is a cardiac marker used to assess for myocardial infarction.
E) Serum lipase is not typically evaluated in cirrhosis assessment; it is a pancreatic enzyme used to diagnose pancreatitis.

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The nurse is preparing to administer spironolactone (Aldactone) and furosemide (Lasix) at 0900 to a client diagnosed with ascites. Review of 0600 laboratory results shows serum sodium 130 mEq/L (136-145 mEq/L) and potassium 3.1 mEq/L (3.5-5.0 mEq/L). Which action should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is admitting a client who has acute pancreatitis. Which of the following provider prescriptions should the nurse anticipate?

Correct Answer is C

Explanation

The nurse should evaluate results of which laboratory tests while caring for a client who has cirrhosis of the liver? Select all that apply.

Correct Answer is ["A","B","C"]

Explanation

The nurse is caring for a client with chronic pancreatitis who exhibits signs of malabsorption. The nurse recognizes that this is due to which pathophysiology process?

The nurse is preparing a client presentation regarding pancrelipase (Viokase) therapy. Which information would the nurse include in the teaching session?

A female client is visiting the Medical Clinic with suspected hepatitis C. Which assessment question should the nurse ask this client?

A nurse is planning care for a client who has hepatitis B. Which of the following interventions should the nurse include in the plan?

When planning care for a client with acute pancreatitis, which order would the nurse anticipate that will contribute to pain control?

The nurse is collecting a health history of a client admitted for possible acute pancreatitis. Which health history item would increase the client's risk for this diagnosis?

A client with cirrhosis has the following laboratory results: albumin 4.9 g/dl. (3.5-5 g/dL), PT 13 seconds (11-12.5 sec), and serum ammonia 68 mcg/dL (15-45 mcg/dL). Based on this information, what is the nurse's next action?