Question 1

The nurse is providing care to a client who is being admitted to rule out acute pancreatitis. Which item found in the client's history increases the client's risk for this disease process?
A)Systemic lupus
B)Alcoholism
C)Cystic fibrosis
D)Hypertriglyceridemia

Accepted Answer

A)Risk factors for acute pancreatitis include alcoholism and gallstones. Autoimmune disorders, such as systemic lupus, cystic fibrosis, and hypertriglyceridemia, are all risk factors for chronic pancreatitis.
B)Risk factors for acute pancreatitis include alcoholism and gallstones. Autoimmune disorders, such as systemic lupus, cystic fibrosis, and hypertriglyceridemia, are all risk factors for chronic pancreatitis.
C)Risk factors for acute pancreatitis include alcoholism and gallstones. Autoimmune disorders, such as systemic lupus, cystic fibrosis, and hypertriglyceridemia, are all risk factors for chronic pancreatitis.
D)Risk factors for acute pancreatitis include alcoholism and gallstones. Autoimmune disorders, such as systemic lupus, cystic fibrosis, and hypertriglyceridemia, are all risk factors for chronic pancreatitis.

Question 2

A nurse is caring for a client diagnosed with an HBV infection. Which of the following clinical manifestations would indicate that this client had entered the icteric phase?
A)Fatigue
B)Jaundice
C)Loss of appetite
D)Nausea

Accepted Answer

A)The icteric phase begins with the onset of jaundice, approximately 5-10 days after initial symptoms manifest, although some clients will never develop jaundice. The prodromal phase of acute hepatitis occurs between exposure to the virus and the appearance of clinical manifestations such as jaundice resulting from increased levels of bilirubin in the blood. Fatigue, loss of appetite, and nausea are among the symptoms that may be seen during this phase.
B)The icteric phase begins with the onset of jaundice, approximately 5-10 days after initial symptoms manifest, although some clients will never develop jaundice. The prodromal phase of acute hepatitis occurs between exposure to the virus and the appearance of clinical manifestations such as jaundice resulting from increased levels of bilirubin in the blood. Fatigue, loss of appetite, and nausea are among the symptoms that may be seen during this phase.
C)The icteric phase begins with the onset of jaundice, approximately 5-10 days after initial symptoms manifest, although some clients will never develop jaundice. The prodromal phase of acute hepatitis occurs between exposure to the virus and the appearance of clinical manifestations such as jaundice resulting from increased levels of bilirubin in the blood. Fatigue, loss of appetite, and nausea are among the symptoms that may be seen during this phase.
D)The icteric phase begins with the onset of jaundice, approximately 5-10 days after initial symptoms manifest, although some clients will never develop jaundice. The prodromal phase of acute hepatitis occurs between exposure to the virus and the appearance of clinical manifestations such as jaundice resulting from increased levels of bilirubin in the blood. Fatigue, loss of appetite, and nausea are among the symptoms that may be seen during this phase.

Question 3

The nurse is explaining hepatitis to a high school health occupations class. The students all volunteer examples of how hepatitis is transmitted. Which student statement indicates the need for further education?
A)"Body piercing or tattoo with infected equipment."
B)"Contaminated food or fluids."
C)"Alcoholism or high doses of acetaminophen."
D)"Bite of an infected mosquito or tick."

Accepted Answer

A)The student who believes the bite of a mosquito or tick will transmit hepatitis is incorrect and needs further education. The students who said that infected needles, contaminated food or fluids, alcoholism, or high doses of acetaminophen can cause different types of hepatitis were correct and do not require further education.
B)The student who believes the bite of a mosquito or tick will transmit hepatitis is incorrect and needs further education. The students who said that infected needles, contaminated food or fluids, alcoholism, or high doses of acetaminophen can cause different types of hepatitis were correct and do not require further education.
C)The student who believes the bite of a mosquito or tick will transmit hepatitis is incorrect and needs further education. The students who said that infected needles, contaminated food or fluids, alcoholism, or high doses of acetaminophen can cause different types of hepatitis were correct and do not require further education.
D)The student who believes the bite of a mosquito or tick will transmit hepatitis is incorrect and needs further education. The students who said that infected needles, contaminated food or fluids, alcoholism, or high doses of acetaminophen can cause different types of hepatitis were correct and do not require further education.

Question 4

A school-age child, recently diagnosed with celiac disease, is underweight, vitamin deficient, and anemic and experiences frequent diarrhea. In addition to removing gluten from his diet, what other recommendations will the nurse provide for this child and family? Select all that apply.
A)Fat restriction
B)A high-carbohydrate diet
C)Vitamin supplements
D)High-calorie diet
E)High-protein diet

Accepted Answer

A)A child with celiac disease who is underweight, vitamin-deficient, anemic, and experiencing diarrhea will require a low-fat, high-calorie, high-protein diet. Vitamin supplements are also likely required given that this child is vitamin deficient. In celiac disease, gastrointestinal dysfunction may cause carbohydrates to be incompletely digested, leading to malabsorption and intolerance.
B)A child with celiac disease who is underweight, vitamin-deficient, anemic, and experiencing diarrhea will require a low-fat, high-calorie, high-protein diet. Vitamin supplements are also likely required given that this child is vitamin deficient. In celiac disease, gastrointestinal dysfunction may cause carbohydrates to be incompletely digested, leading to malabsorption and intolerance.
C)A child with celiac disease who is underweight, vitamin-deficient, anemic, and experiencing diarrhea will require a low-fat, high-calorie, high-protein diet. Vitamin supplements are also likely required given that this child is vitamin deficient. In celiac disease, gastrointestinal dysfunction may cause carbohydrates to be incompletely digested, leading to malabsorption and intolerance.
D)A child with celiac disease who is underweight, vitamin-deficient, anemic, and experiencing diarrhea will require a low-fat, high-calorie, high-protein diet. Vitamin supplements are also likely required given that this child is vitamin deficient. In celiac disease, gastrointestinal dysfunction may cause carbohydrates to be incompletely digested, leading to malabsorption and intolerance.
E)A child with celiac disease who is underweight, vitamin-deficient, anemic, and experiencing diarrhea will require a low-fat, high-calorie, high-protein diet. Vitamin supplements are also likely required given that this child is vitamin deficient. In celiac disease, gastrointestinal dysfunction may cause carbohydrates to be incompletely digested, leading to malabsorption and intolerance.

Question 5

When planning care for a client with chronic hepatitis, which collaborative discipline will be most helpful in treating continued alcohol use?
A)Social worker
B)Primary provider
C)Pharmacist
D)Dietitian

Accepted Answer

A)The social worker is an expert at identifying additional resources for treatment of substance abuse. The primary provider, pharmacist, and dietitian will all contribute to the plan of care.
B)The social worker is an expert at identifying additional resources for treatment of substance abuse. The primary provider, pharmacist, and dietitian will all contribute to the plan of care.
C)The social worker is an expert at identifying additional resources for treatment of substance abuse. The primary provider, pharmacist, and dietitian will all contribute to the plan of care.
D)The social worker is an expert at identifying additional resources for treatment of substance abuse. The primary provider, pharmacist, and dietitian will all contribute to the plan of care.

Question 6

The nurse is planning education for an adolescent client recently diagnosed with hepatitis. The client moved back to the parents' home. Which recommendation to the client's parents will best prevent them from acquiring hepatitis B (HBV)?
A)Refuse to donate blood.
B)Avoid contaminated water.
C)Obtain postexposure prophylaxis.
D)Abstain from alcohol.

Accepted Answer

A)Obtaining postexposure prophylaxis treatment will best help the client's parents from acquiring HBV. The HBV vaccine is started concurrently. HBV is not spread in water. Alcohol abuse is implicated in nonviral hepatitis. Donating blood will not increase the risk of acquiring HBV.
B)Obtaining postexposure prophylaxis treatment will best help the client's parents from acquiring HBV. The HBV vaccine is started concurrently. HBV is not spread in water. Alcohol abuse is implicated in nonviral hepatitis. Donating blood will not increase the risk of acquiring HBV.
C)Obtaining postexposure prophylaxis treatment will best help the client's parents from acquiring HBV. The HBV vaccine is started concurrently. HBV is not spread in water. Alcohol abuse is implicated in nonviral hepatitis. Donating blood will not increase the risk of acquiring HBV.
D)Obtaining postexposure prophylaxis treatment will best help the client's parents from acquiring HBV. The HBV vaccine is started concurrently. HBV is not spread in water. Alcohol abuse is implicated in nonviral hepatitis. Donating blood will not increase the risk of acquiring HBV.

Question 7

The nurse is providing care to an older adult client admitted to the medical unit for acute gastric and left upper abdominal pain radiating to the back. The healthcare provider has diagnosed the client with chronic pancreatitis. Which items are appropriate to include in the discharge teaching for this client? Select all that apply.
A)Encouraging a high-fat diet
B)Eliminating alcoholic beverages
C)Properly administering pancrelipase
D)Reporting symptoms of infection
E)Taking antacids

Accepted Answer

A)Appropriate teaching for a client diagnosed with chronic pancreatitis includes eliminating alcoholic beverages, proper administration of pancrelipase, and the importance of taking antacids to prevent the destruction of the enzymes by hydrochloric acid. The client should be taught to follow a low-fat diet. The client should report any symptoms of infection (high fever, pain, rapid pulse, malaise).
B)Appropriate teaching for a client diagnosed with chronic pancreatitis includes eliminating alcoholic beverages, proper administration of pancrelipase, and the importance of taking antacids to prevent the destruction of the enzymes by hydrochloric acid. The client should be taught to follow a low-fat diet. The client should report any symptoms of infection (high fever, pain, rapid pulse, malaise).
C)Appropriate teaching for a client diagnosed with chronic pancreatitis includes eliminating alcoholic beverages, proper administration of pancrelipase, and the importance of taking antacids to prevent the destruction of the enzymes by hydrochloric acid. The client should be taught to follow a low-fat diet. The client should report any symptoms of infection (high fever, pain, rapid pulse, malaise).
D)Appropriate teaching for a client diagnosed with chronic pancreatitis includes eliminating alcoholic beverages, proper administration of pancrelipase, and the importance of taking antacids to prevent the destruction of the enzymes by hydrochloric acid. The client should be taught to follow a low-fat diet. The client should report any symptoms of infection (high fever, pain, rapid pulse, malaise).
E)Appropriate teaching for a client diagnosed with chronic pancreatitis includes eliminating alcoholic beverages, proper administration of pancrelipase, and the importance of taking antacids to prevent the destruction of the enzymes by hydrochloric acid. The client should be taught to follow a low-fat diet. The client should report any symptoms of infection (high fever, pain, rapid pulse, malaise).

Question 8

Which of the following statements best describes the role of gluten in celiac disease?
A)It acts as a toxin damaging the villi of the small intestine.
B)It acts as an immunological body to destroy pathogens.
C)It acts as a virus to cause disease.
D)It acts as a foreign substance that provokes an immune response.

Accepted Answer

A)In celiac disease, gluten is a foreign substance that provokes an immune response. The immune response prompts an inflammatory response in the small bowel, which in turn leads to a loss of villi and microvilli; the immune response causes this to happen, not gluten. Gluten doesn't act as an antibody as part of the immunological response of the body; it provokes that response. It doesn't act as a viral pathogen to cause disease but as an antigen.
B)In celiac disease, gluten is a foreign substance that provokes an immune response. The immune response prompts an inflammatory response in the small bowel, which in turn leads to a loss of villi and microvilli; the immune response causes this to happen, not gluten. Gluten doesn't act as an antibody as part of the immunological response of the body; it provokes that response. It doesn't act as a viral pathogen to cause disease but as an antigen.
C)In celiac disease, gluten is a foreign substance that provokes an immune response. The immune response prompts an inflammatory response in the small bowel, which in turn leads to a loss of villi and microvilli; the immune response causes this to happen, not gluten. Gluten doesn't act as an antibody as part of the immunological response of the body; it provokes that response. It doesn't act as a viral pathogen to cause disease but as an antigen.
D)In celiac disease, gluten is a foreign substance that provokes an immune response. The immune response prompts an inflammatory response in the small bowel, which in turn leads to a loss of villi and microvilli; the immune response causes this to happen, not gluten. Gluten doesn't act as an antibody as part of the immunological response of the body; it provokes that response. It doesn't act as a viral pathogen to cause disease but as an antigen.

Question 9

During an interview with a 67-year-old client diagnosed with acute hepatitis B, the nurse obtains the following data: 10 kg weight loss is noted from the client's last visit 4 months ago; review of systems reveals (1)limiting fatigue, (2)not well enough for sexual intercourse, (3)drinks 3-5 mixed drinks weekly socially, (4)right upper quadrant (RUQ)pain rated at 6/10, and 5)"constant" pruritus. Which findings indicate that the client's hepatitis may have progressed to a chronic stage? Select all that apply.
A)Fatigue
B)Drinks 3-5 mixed drinks weekly socially
C)RUQ pain rated at 6/10
D)Pruritus

Accepted Answer

A)Acute hepatitis B tends to be asymptomatic in older adults, so although fatigue, RUQ pain, and pruritus are common clinical manifestations of acute hepatitis B, this client exhibiting these symptoms is a sign that the client's condition has progressed to chronic hepatitis B, a progression that tends to happen more quickly with older adults. The client being a social drinker does not indicate anything about the progress of the client's hepatitis.
B)Acute hepatitis B tends to be asymptomatic in older adults, so although fatigue, RUQ pain, and pruritus are common clinical manifestations of acute hepatitis B, this client exhibiting these symptoms is a sign that the client's condition has progressed to chronic hepatitis B, a progression that tends to happen more quickly with older adults. The client being a social drinker does not indicate anything about the progress of the client's hepatitis.
C)Acute hepatitis B tends to be asymptomatic in older adults, so although fatigue, RUQ pain, and pruritus are common clinical manifestations of acute hepatitis B, this client exhibiting these symptoms is a sign that the client's condition has progressed to chronic hepatitis B, a progression that tends to happen more quickly with older adults. The client being a social drinker does not indicate anything about the progress of the client's hepatitis.
D)Acute hepatitis B tends to be asymptomatic in older adults, so although fatigue, RUQ pain, and pruritus are common clinical manifestations of acute hepatitis B, this client exhibiting these symptoms is a sign that the client's condition has progressed to chronic hepatitis B, a progression that tends to happen more quickly with older adults. The client being a social drinker does not indicate anything about the progress of the client's hepatitis.

Question 10

An older adult African American client with a history of celiac disease presents with abdominal cramps, pain, and diarrhea. The client denies the use of alcohol, but states, "My favorite foods are steak, cheese, and ice cream." Based on this data, which condition does the nurse suspect?
A)Acute pancreatitis
B)Appendicitis
C)Lactase deficiency
D)Food poisoning

Accepted Answer

A)The most common risk factor for pancreatitis is alcohol abuse. Appendicitis usually involves loss of appetite and nausea and/or vomiting soon after abdominal pain begins. Lactose intolerance is more common in Native Americans, Asians, Hispanics, and African Americans and in those with a history of celiac disease. Food poisoning generally causes some nausea and vomiting.
B)The most common risk factor for pancreatitis is alcohol abuse. Appendicitis usually involves loss of appetite and nausea and/or vomiting soon after abdominal pain begins. Lactose intolerance is more common in Native Americans, Asians, Hispanics, and African Americans and in those with a history of celiac disease. Food poisoning generally causes some nausea and vomiting.
C)The most common risk factor for pancreatitis is alcohol abuse. Appendicitis usually involves loss of appetite and nausea and/or vomiting soon after abdominal pain begins. Lactose intolerance is more common in Native Americans, Asians, Hispanics, and African Americans and in those with a history of celiac disease. Food poisoning generally causes some nausea and vomiting.
D)The most common risk factor for pancreatitis is alcohol abuse. Appendicitis usually involves loss of appetite and nausea and/or vomiting soon after abdominal pain begins. Lactose intolerance is more common in Native Americans, Asians, Hispanics, and African Americans and in those with a history of celiac disease. Food poisoning generally causes some nausea and vomiting.

Question 11

Parents of a child diagnosed with celiac disease have requested guidance on how to implement an appropriate diet. In addition to a list of foods to include and exclude, which interventions by the nurse are appropriate? Select all that apply.
A)Obtaining a dietary prescription
B)Implementing a recommended exercise program
C)Training on how to read food labels
D)Providing a referral to support groups
E)Encouraging the use of a gluten-free cookbook

Accepted Answer

A)Education that should be provided to the child and their family include obtaining a dietary prescription that will enable them to deduct the cost of special ingredients and commercially prepared products as a medical expense; education on how to read a food label; providing referrals to a support group; and encouraging the use of a gluten-free cookbook. Exercise is not considered an intervention that is specifically aimed at treating celiac disease.
B)Education that should be provided to the child and their family include obtaining a dietary prescription that will enable them to deduct the cost of special ingredients and commercially prepared products as a medical expense; education on how to read a food label; providing referrals to a support group; and encouraging the use of a gluten-free cookbook. Exercise is not considered an intervention that is specifically aimed at treating celiac disease.
C)Education that should be provided to the child and their family include obtaining a dietary prescription that will enable them to deduct the cost of special ingredients and commercially prepared products as a medical expense; education on how to read a food label; providing referrals to a support group; and encouraging the use of a gluten-free cookbook. Exercise is not considered an intervention that is specifically aimed at treating celiac disease.
D)Education that should be provided to the child and their family include obtaining a dietary prescription that will enable them to deduct the cost of special ingredients and commercially prepared products as a medical expense; education on how to read a food label; providing referrals to a support group; and encouraging the use of a gluten-free cookbook. Exercise is not considered an intervention that is specifically aimed at treating celiac disease.
E)Education that should be provided to the child and their family include obtaining a dietary prescription that will enable them to deduct the cost of special ingredients and commercially prepared products as a medical expense; education on how to read a food label; providing referrals to a support group; and encouraging the use of a gluten-free cookbook. Exercise is not considered an intervention that is specifically aimed at treating celiac disease.

Question 12

A school nurse is providing care to a number of school-age children diagnosed with celiac disease. Which interventions are appropriate for the nurse to implement with this group of students? Select all that apply.
A)Teaching about gluten-free food choices
B)Emphasizing low-calorie food selections
C)Implementing a school-based prevention program to eliminate the disease process
D)Labeling gluten-free choices in the school lunch program
E)Demonstrating coping strategies for living with celiac disease

Accepted Answer

A)Appropriate interventions for the school nurse to implement include teaching the children with celiac disease about gluten-free food choices. The nurse would also implement the labeling of gluten-free food choices in the school lunch program to aid the children in choosing foods to eat while at school. School-age clients may also benefit from learning about coping strategies. Food selections should be high in calories and protein. Celiac disease cannot be prevented.
B)Appropriate interventions for the school nurse to implement include teaching the children with celiac disease about gluten-free food choices. The nurse would also implement the labeling of gluten-free food choices in the school lunch program to aid the children in choosing foods to eat while at school. Food selections should be high in calories and protein. Celiac disease cannot be prevented.
C)Appropriate interventions for the school nurse to implement include teaching the children with celiac disease about gluten-free food choices. The nurse would also implement the labeling of gluten-free food choices in the school lunch program to aid the children in choosing foods to eat while at school. School-age clients may also benefit from learning about coping strategies. Food selections should be high in calories and protein. Celiac disease cannot be prevented.
D)Appropriate interventions for the school nurse to implement include teaching the children with celiac disease about gluten-free food choices. The nurse would also implement the labeling of gluten-free food choices in the school lunch program to aid the children in choosing foods to eat while at school. School-age clients may also benefit from learning about coping strategies. Food selections should be high in calories and protein. Celiac disease cannot be prevented.
E)Appropriate interventions for the school nurse to implement include teaching the children with celiac disease about gluten-free food choices. The nurse would also implement the labeling of gluten-free food choices in the school lunch program to aid the children in choosing foods to eat while at school. School-age clients may also benefit from learning about coping strategies. Food selections should be high in calories and protein. Celiac disease cannot be prevented.

Question 13

The nurse is providing care to a client diagnosed with celiac disease who experiences frequent diarrhea. Based on this data, the nurse anticipates the client may also experience which associated problems? Select all that apply.
A)Skin breakdown
B)Fluid and electrolyte imbalance
C)Hair loss
D)Lifestyle issues
E)Sexual dysfunction

Accepted Answer

A)Clients with diarrhea may have perianal skin irritation and skin breakdown. Diarrhea disturbs the fluid and electrolyte balance and can disrupt normal life activities. There is no known direct connection between diarrhea and hair loss or sexual dysfunction.
B)Clients with diarrhea may have perianal skin irritation and skin breakdown. Diarrhea disturbs the fluid and electrolyte balance and can disrupt normal life activities. There is no known direct connection between diarrhea and hair loss or sexual dysfunction.
C)Clients with diarrhea may have perianal skin irritation and skin breakdown. Diarrhea disturbs the fluid and electrolyte balance and can disrupt normal life activities. There is no known direct connection between diarrhea and hair loss or sexual dysfunction.
D)Clients with diarrhea may have perianal skin irritation and skin breakdown. Diarrhea disturbs the fluid and electrolyte balance and can disrupt normal life activities. There is no known direct connection between diarrhea and hair loss or sexual dysfunction.
E)Clients with diarrhea may have perianal skin irritation and skin breakdown. Diarrhea disturbs the fluid and electrolyte balance and can disrupt normal life activities. There is no known direct connection between diarrhea and hair loss or sexual dysfunction.

Question 14

A nurse recommends a gluten-free diet to a client recently diagnosed with celiac disease. The client says that she wants to become pregnant and asks how a gluten-free diet might aid in that. What is not a benefit for this client of a gluten-free diet?
A)A gluten-free diet may lower the risk of infertility.
B)A gluten-free diet may lower the risk of miscarriage.
C)A gluten-free diet may increase the probability that the child's birth weight will be healthy.
D)A gluten-free diet may improve fetal bone development.

Accepted Answer

A)Calcium is critical for fetal bone development, and pregnant women should consume around 1000 mg of calcium per day, but this is a separate issue from maintaining a gluten-free diet. Studies suggest that negative outcomes in mothers and their children are often the result of undiagnosed celiac disease. Adherence to a strict gluten-free diet after diagnosis may improve outcomes for clients with celiac-related infertility, miscarriage, and stillbirth. Birth weights of children born to mothers with celiac disease who follow a gluten-free diet may also be higher than those of mothers who do not.
B)Calcium is critical for fetal bone development, and pregnant women should consume around 1000 mg of calcium per day, but this is a separate issue from maintaining a gluten-free diet. Studies suggest that negative outcomes in mothers and their children are often the result of undiagnosed celiac disease. Adherence to a strict gluten-free diet after diagnosis may improve outcomes for clients with celiac-related infertility, miscarriage, and stillbirth. Birth weights of children born to mothers with celiac disease who follow a gluten-free diet may also be higher than those of mothers who do not.
C)Calcium is critical for fetal bone development, and pregnant women should consume around 1000 mg of calcium per day, but this is a separate issue from maintaining a gluten-free diet. Studies suggest that negative outcomes in mothers and their children are often the result of undiagnosed celiac disease. Adherence to a strict gluten-free diet after diagnosis may improve outcomes for clients with celiac-related infertility, miscarriage, and stillbirth. Birth weights of children born to mothers with celiac disease who follow a gluten-free diet may also be higher than those of mothers who do not.
D)Calcium is critical for fetal bone development, and pregnant women should consume around 1000 mg of calcium per day, but this is a separate issue from maintaining a gluten-free diet. Studies suggest that negative outcomes in mothers and their children are often the result of undiagnosed celiac disease. Adherence to a strict gluten-free diet after diagnosis may improve outcomes for clients with celiac-related infertility, miscarriage, and stillbirth. Birth weights of children born to mothers with celiac disease who follow a gluten-free diet may also be higher than those of mothers who do not.

Question 15

A home healthcare nurse is providing care to an older adult client who lives alone and has limited financial resources. The client has a history of celiac disease. When planning care for this client, which nursing diagnoses are appropriate? Select all that apply.
A)Risk for Constipation
B)Imbalanced Nutrition: Less than Body Requirements
C)Risk for Imbalanced Fluid Volume
D)Diarrhea
E)Chronic Pain

Accepted Answer

A)Client with celiac disease often have nutritional imbalance, including anemia and vitamin deficiencies; impaired absorption of fluids and electrolyte, which leads to diarrhea and fluid imbalance; and pain related to abdominal bloating and cramping. Constipation is not a normal manifestation of celiac disease.
B)Client with celiac disease often have nutritional imbalance, including anemia and vitamin deficiencies; impaired absorption of fluids and electrolyte, which leads to diarrhea and fluid imbalance; and pain related to abdominal bloating and cramping. Constipation is not a normal manifestation of celiac disease.
C)Client with celiac disease often have nutritional imbalance, including anemia and vitamin deficiencies; impaired absorption of fluids and electrolyte, which leads to diarrhea and fluid imbalance; and pain related to abdominal bloating and cramping. Constipation is not a normal manifestation of celiac disease.
D)Client with celiac disease often have nutritional imbalance, including anemia and vitamin deficiencies; impaired absorption of fluids and electrolyte, which leads to diarrhea and fluid imbalance; and pain related to abdominal bloating and cramping. Constipation is not a normal manifestation of celiac disease.
E)Client with celiac disease often have nutritional imbalance, including anemia and vitamin deficiencies; impaired absorption of fluids and electrolyte, which leads to diarrhea and fluid imbalance; and pain related to abdominal bloating and cramping. Constipation is not a normal manifestation of celiac disease.

Question 16

A young adult waiter has been treated for viral hepatitis at a healthcare clinic. Which client outcome indicates the need for additional intervention? Select all that apply.
A)Body mass index (BMI)changes from 24 to 21.
B)Return demonstration of hand washing is correctly performed.
C)Social Services notified the Health Department of the occurrence.
D)Red scratch marks are noted on the arms and trunk.
E)Client denies abdominal or epigastric pain.

Accepted Answer

A)The client will need additional intervention if weight loss occurs and if the client has continued itching as evidenced by the red scratch marks. No additional intervention is needed if hand washing is performed correctly or pain is controlled. The health department must be notified if a food service worker is diagnosed due to possible exposure of patrons.
B)The client will need additional intervention if weight loss occurs and if the client has continued itching as evidenced by the red scratch marks. No additional intervention is needed if hand washing is performed correctly or pain is controlled. The health department must be notified if a food service worker is diagnosed due to possible exposure of patrons.
C)The client will need additional intervention if weight loss occurs and if the client has continued itching as evidenced by the red scratch marks. No additional intervention is needed if hand washing is performed correctly or pain is controlled. The health department must be notified if a food service worker is diagnosed due to possible exposure of patrons.
D)The client will need additional intervention if weight loss occurs and if the client has continued itching as evidenced by the red scratch marks. No additional intervention is needed if hand washing is performed correctly or pain is controlled. The health department must be notified if a food service worker is diagnosed due to possible exposure of patrons.
E)The client will need additional intervention if weight loss occurs and if the client has continued itching as evidenced by the red scratch marks. No additional intervention is needed if hand washing is performed correctly or pain is controlled. The health department must be notified if a food service worker is diagnosed due to possible exposure of patrons.

Question 17

The multidisciplinary care team is meeting to discuss care for a client who exhibits symptoms of the prodromal phase of hepatitis. Lab results include a positive anti-HAV IgM. The nurse creates an action plan to present to the team. Which interventions are appropriate? Select all that apply.
A)High-fat, low-calorie, and no-alcohol diet teaching
B)Patient education on acceptable pain medication
C)Early treatment with lamivudine
D)Referral to the liver transplant team
E)Family teaching for transmission prevention

Accepted Answer

A)Patient education on acceptable pain medication is necessary due to the toxic effect of common over-the-counter pain medicine. Family teaching is appropriate to avoid transmission. Most clients recover from acute viral hepatitis without pharmacologic treatment and certainly without liver transplant. A low-fat, high-calorie diet is recommended.
B)Patient education on acceptable pain medication is necessary due to the toxic effect of common over-the-counter pain medicine. Family teaching is appropriate to avoid transmission. Most clients recover from acute viral hepatitis without pharmacologic treatment and certainly without liver transplant. A low-fat, high-calorie diet is recommended.
C)Patient education on acceptable pain medication is necessary due to the toxic effect of common over-the-counter pain medicine. Family teaching is appropriate to avoid transmission. Most clients recover from acute viral hepatitis without pharmacologic treatment and certainly without liver transplant. A low-fat, high-calorie diet is recommended.
D)Patient education on acceptable pain medication is necessary due to the toxic effect of common over-the-counter pain medicine. Family teaching is appropriate to avoid transmission. Most clients recover from acute viral hepatitis without pharmacologic treatment and certainly without liver transplant. A low-fat, high-calorie diet is recommended.
E)Patient education on acceptable pain medication is necessary due to the toxic effect of common over-the-counter pain medicine. Family teaching is appropriate to avoid transmission. Most clients recover from acute viral hepatitis without pharmacologic treatment and certainly without liver transplant. A low-fat, high-calorie diet is recommended.

Question 18

The nurse is providing care to a pediatric client diagnosed with celiac disease. Which outcomes can be anticipated when the appropriate steps for managing celiac disease have been implemented? Select all that apply.
A)The client is free of abdominal discomfort including bloating, gas, indigestion, nausea, and vomiting.
B)The client is able to maintain normal or routine bowel habits.
C)The client has diarrhea fewer than 3 days weekly.
D)The client is able to maintain adequate nutritional status.
E)The client is able to make appropriate menu choices prior to discharge.

Accepted Answer

A)When the client with celiac disease is placed on a gluten-free diet, treatment generally is successful, as long as the client avoids gluten totally. Symptoms such as diarrhea and abdominal discomfort should be eliminated and nutritional status should improve.
B)When the client with celiac disease is placed on a gluten-free diet, treatment generally is successful, as long as the client avoids gluten totally. Symptoms such as diarrhea and abdominal discomfort should be eliminated and nutritional status should improve.
C)When the client with celiac disease is placed on a gluten-free diet, treatment generally is successful, as long as the client avoids gluten totally. Symptoms such as diarrhea and abdominal discomfort should be eliminated and nutritional status should improve.
D)When the client with celiac disease is placed on a gluten-free diet, treatment generally is successful, as long as the client avoids gluten totally. Symptoms such as diarrhea and abdominal discomfort should be eliminated and nutritional status should improve.
E)When the client with celiac disease is placed on a gluten-free diet, treatment generally is successful, as long as the client avoids gluten totally. Symptoms such as diarrhea and abdominal discomfort should be eliminated and nutritional status should improve.

Question 19

The nurse is providing care to a client admitted with acute pancreatitis. Which data support the client's diagnosis? Select all that apply.
A)Severe epigastric pain
B)Nausea and vomiting
C)Elevated temperature
D)Hypotension
E)Steatorrhea

Accepted Answer

A)Acute pancreatitis presents with severe epigastric pain, nausea, vomiting, elevated temperature, and hypotension. Steatorrhea is a clinical manifestation that is associated with chronic pancreatitis.
B)Acute pancreatitis presents with severe epigastric pain, nausea, vomiting, elevated temperature, and hypotension. Steatorrhea is a clinical manifestation that is associated with chronic pancreatitis.
C)Acute pancreatitis presents with severe epigastric pain, nausea, vomiting, elevated temperature, and hypotension. Steatorrhea is a clinical manifestation that is associated with chronic pancreatitis.
D)Acute pancreatitis presents with severe epigastric pain, nausea, vomiting, elevated temperature, and hypotension. Steatorrhea is a clinical manifestation that is associated with chronic pancreatitis.
E)Acute pancreatitis presents with severe epigastric pain, nausea, vomiting, elevated temperature, and hypotension. Steatorrhea is a clinical manifestation that is associated with chronic pancreatitis.

Question 20

A nurse is planning a teaching session for expectant mothers regarding pediatric clients and hepatitis. Regarding hepatitis A, which of the following statements is correct?
A)Infection of the mother is the most common reason hepatitis A spreads to children.
B)A daycare is typically a high-risk environment for the spread of hepatitis A.
C)Children with hepatitis A are commonly asymptomatic.
D)Hepatitis A in children is typically a very serious illness with long-term health effects.

Accepted Answer

A)Hepatitis A is the most common type of hepatitis in children and is often spread at daycare centers where children are in diapers or are being potty trained. Children with hepatitis B may be asymptomatic, but in the majority of cases, hepatitis A is mild, causes flulike symptoms, and rarely has long-term consequences. Hepatitis A is not perinatal.
B)Hepatitis A is the most common type of hepatitis in children and is often spread at daycare centers where children are in diapers or are being potty trained. Children with hepatitis B may be asymptomatic, but in the majority of cases, hepatitis A is mild, causes flulike symptoms, and rarely has long-term consequences. Hepatitis A is not perinatal.
C)Hepatitis A is the most common type of hepatitis in children and is often spread at daycare centers where children are in diapers or are being potty trained. Children with hepatitis B may be asymptomatic, but in the majority of cases, hepatitis A is mild, causes flulike symptoms, and rarely has long-term consequences. Hepatitis A is not perinatal.
D)Hepatitis A is the most common type of hepatitis in children and is often spread at daycare centers where children are in diapers or are being potty trained. Children with hepatitis B may be asymptomatic, but in the majority of cases, hepatitis A is mild, causes flulike symptoms, and rarely has long-term consequences. Hepatitis A is not perinatal.

Quiz 4: Digestion

The nurse is providing care to a client who is being admitted to rule out acute pancreatitis. Which item found in the client's history increases the client's risk for this disease process?

A nurse is caring for a client diagnosed with an HBV infection. Which of the following clinical manifestations would indicate that this client had entered the icteric phase?

The nurse is explaining hepatitis to a high school health occupations class. The students all volunteer examples of how hepatitis is transmitted. Which student statement indicates the need for further education?

A school-age child, recently diagnosed with celiac disease, is underweight, vitamin deficient, and anemic and experiences frequent diarrhea. In addition to removing gluten from his diet, what other recommendations will the nurse provide for this child and family? Select all that apply.

When planning care for a client with chronic hepatitis, which collaborative discipline will be most helpful in treating continued alcohol use?

The nurse is planning education for an adolescent client recently diagnosed with hepatitis. The client moved back to the parents' home. Which recommendation to the client's parents will best prevent them from acquiring hepatitis B (HBV) ?

Which of the following statements best describes the role of gluten in celiac disease?

An older adult African American client with a history of celiac disease presents with abdominal cramps, pain, and diarrhea. The client denies the use of alcohol, but states, "My favorite foods are steak, cheese, and ice cream." Based on this data, which condition does the nurse suspect?

Parents of a child diagnosed with celiac disease have requested guidance on how to implement an appropriate diet. In addition to a list of foods to include and exclude, which interventions by the nurse are appropriate? Select all that apply.

A school nurse is providing care to a number of school-age children diagnosed with celiac disease. Which interventions are appropriate for the nurse to implement with this group of students? Select all that apply.

The nurse is providing care to a client diagnosed with celiac disease who experiences frequent diarrhea. Based on this data, the nurse anticipates the client may also experience which associated problems? Select all that apply.

A nurse recommends a gluten-free diet to a client recently diagnosed with celiac disease. The client says that she wants to become pregnant and asks how a gluten-free diet might aid in that. What is not a benefit for this client of a gluten-free diet?

A home healthcare nurse is providing care to an older adult client who lives alone and has limited financial resources. The client has a history of celiac disease. When planning care for this client, which nursing diagnoses are appropriate? Select all that apply.

A young adult waiter has been treated for viral hepatitis at a healthcare clinic. Which client outcome indicates the need for additional intervention? Select all that apply.

The multidisciplinary care team is meeting to discuss care for a client who exhibits symptoms of the prodromal phase of hepatitis. Lab results include a positive anti-HAV IgM. The nurse creates an action plan to present to the team. Which interventions are appropriate? Select all that apply.

The nurse is providing care to a pediatric client diagnosed with celiac disease. Which outcomes can be anticipated when the appropriate steps for managing celiac disease have been implemented? Select all that apply.

The nurse is providing care to a client admitted with acute pancreatitis. Which data support the client's diagnosis? Select all that apply.

A nurse is planning a teaching session for expectant mothers regarding pediatric clients and hepatitis. Regarding hepatitis A, which of the following statements is correct?