While performing a physical examination on a client with cirrhosis, which of the following interventions should the nurse report immediately to the physician?

Pode the client with non-prescription laxatives.

Measure abdominal girth according to a set routine.

Ask the client about food intake.

Check for signs of hepatic encephalopathy.

Answer and Explanation

The Correct Answer is A

Giving non-prescription laxatives to a client with cirrhosis can cause severe dehydration and electrolyte imbalances, which can be life-threatening. The nurse should report this intervention immediately to the physician.

Choice B is incorrect because measuring abdominal girth is a standard nursing intervention for clients with cirrhosis to assess for ascites.

Choice C is incorrect because asking the client about food intake is a standard nursing intervention for assessing nutritional status.

Choice D is incorrect because checking for signs of hepatic encephalopathy is a standard nursing intervention for clients with cirrhosis.

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Correct Answer is B

Explanation

Gigantism. Oversecretion of growth hormone before puberty leads to gigantism, which is characterized by excessive growth in height and length of bones. The growth hormone stimulates the growth of cartilage and bone, resulting in an increased height. When oversecretion occurs after puberty, it results in acromegaly, which is characterized by the enlargement of bones in the face, hands, and feet.

Choice A, Acromegaly, is incorrect because acromegaly results from oversecretion of growth hormone after puberty, and not before puberty.

Choice C, Dwarfism, is incorrect because dwarfism is caused by insufficient growth hormone secretion or poor response to the hormone, and not oversecretion.

Choice D, Simmonds disease, is incorrect because Simmonds disease is a rare disorder characterized by the atrophy of the pituitary gland, which results in decreased secretion of several hormones, including growth hormone.

A. Report the condition to the physician immediately. B. Provide the client with nonprescription laxatives. C. Measure abdominal girth according to a set routine. D. Ask the client about food intake.

Correct Answer is C

Explanation

Measure abdominal girth according to a set routine. Abdominal enlargement is a common finding in clients with cirrhosis, which is a condition characterized by liver scarring and impaired liver function. Measuring abdominal girth regularly is an important nursing intervention to monitor the progression of abdominal distention and to identify potential complications such as ascites, which is an accumulation of fluid in the abdomen.

Choice A, reporting the condition to the physician immediately, may be necessary if the abdominal enlargement is sudden or accompanied by other symptoms such as severe pain or shortness of breath.

Choice B, providing the client with nonprescription laxatives, is not indicated for abdominal enlargement in clients with cirrhosis.

Choice D, asking the client about food intake, is not relevant to the assessment of abdominal enlargement in clients with cirrhosis.

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While performing a physical examination on a client with cirrhosis, which of the following interventions should the nurse report immediately to the physician?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is reviewing a client's history which reveals that the client has had an oversecretion of growth hormone (GH) that occurred before puberty. The nurse interprets this as which of the following?

Correct Answer is B

Explanation

When performing a physical examination on a client with cirrhosis, a nurse notices that the abdomen is enlarged. Which of the following interventions should the nurse consider?

Correct Answer is C

Explanation

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