Ch. 45 OBESITY (5)
150 min/week (2.5 hr/week) of aerobic activity + strength training
lab value that indicates jaundice
high Billirubin
A patient with acute cholecystitis reports sharp right upper quadrant pain radiating to the right shoulder. The patient is restless and rates the pain 9/10. Which nursing action is a priority?
A. Place a heating pad on the abdomen
B. Administer prescribed IV morphine
C. Encourage deep breathing exercises
D. Prepare the patient for ambulation
B. Administer prescribed IV morphine
Malignant tumors can spread to other tissues and organs
The nurse is caring for an unresponsive terminally ill patient who has 20-second periods of apnea followed by periods of deep and rapid breathing. Which action would the nurse take?
a. Suction the patient‘s mouth.
b. Administer oxygen via face mask.
c. Document the patient‘s respiratory pattern.
d. Place the patient in high Fowler‘s position.
c. Document the patient‘s respiratory pattern.
Nursing interventions to prevent DUMPING SYNDROME
- no fluid with meals
- high protein diet including some carbs and fiber.
- eating 6 small meals a day rather than 3 large meals a day.
What is the drug LACTULOSE used for?
to decrease ammonia levels.
A patient is admitted with severe epigastric pain radiating to the back. Labs show:
A. The patient is experiencing acute pancreatitis
B. The patient is in acute liver failure
C. The patient has biliary obstruction
D. The patient is experiencing peptic ulcer disease
A. The patient is experiencing acute pancreatitis
what are the main 3 adverse effects of Chemotherapy?
1. Alopecia
2. stomatitis
3. myelosuppression
A patient in hospice is manifesting a decrease in all body system functions except for a heart rate of 124 beats/min and a respiratory rate of 28 breaths/min. Which statement would be accurate for the nurse to make to the patient‘s family?
a. “These vital signs will continue to increase until death finally occurs.”
b. “These vital signs demonstrate the body‘s ability to compensate and heal.”
c. “These vital signs are an expected response now but will slow down later.”
d. “These vital signs may indicate an improvement in the patient‘s condition.”
c. “These vital signs are an expected response now but will slow down later.”
How many calories per day are recommended for weight loss?
1200 calories/day
A 40-year-old female presents to the emergency department with severe right upper quadrant pain radiating to the scapula after eating fried food. Which assessment finding supports the nurse’s suspicion of gallbladder disease?
A. Positive Murphy’s sign
B. Rebound tenderness in the left lower quadrant
C. Grey-Turner’s sign
D. Hypoactive bowel sounds
A. Positive Murphy’s sign
The nurse is caring for a patient following a percutaneous liver biopsy. Which statement made by the patient requires further teaching?
A. “I should lie on my right side after the procedure.”
B. “I will avoid lifting anything heavy for at least a week.”
C. “It’s important not to cough right after the biopsy.”
D. “I can go home and mow the lawn later this afternoon.”
D. “I can go home and mow the lawn later this afternoon.”
The nurse working with oncology clients understands that which age-related change increases the older client’s susceptibility to infection during chemotherapy?
A. Decreased immune function.
B. Diminished nutritional stores.
C. Existing cognitive deficits
D. Poor physical reserves
A. Decreased immune function.
A patient who has been diagnosed with inoperable lung cancer and has a poor prognosis plans
a trip across the country “to settle some issues with family members.” The nurse recognizes
that the patient is manifesting which psychosocial response?
a. Protesting the unfairness of death
b. Anxiety about unfinished business
c. Fear of having lived a meaningless life
d. Restlessness about the uncertain prognosis
b. Anxiety about unfinished business
which hormone would the nurse mention when teaching a patient about satiety?
Leptin
A patient is admitted with acute pancreatitis after binge drinking. Which interventions should the nurse include in the plan of care?
A. Keep NPO with IV fluids
B. Maintain NG tube for gastric decompression if ordered
C. Monitor serum lipase and amylase
D. Encourage high-protein, high-fat snacks
E. Administer IV opioid analgesics as prescribed
A, B, C, E
A. Keep NPO with IV fluids
B. Maintain NG tube for gastric decompression if ordered
C. Monitor serum lipase and amylase
E. Administer IV opioid analgesics as prescribed
A patient with cirrhosis and massive ascites is scheduled for a paracentesis. Which nursing action is a priority before the procedure?
a. Have the patient void
b. Place the patient in the Trendelenburg position
c. Encourage a high-salt snack
d. Administer a cleansing enema
a. Have the patient void
The nurse has taught a client with cancer ways to prevent infection. What statement by the client indicates that more teaching is needed?
a. “I should take my temperature daily and when I don’t feel well.”
b. “I will discard perishable liquids after sitting out for over an hour.”
c. “I won’t let anyone share any of my personal toiletries.”
d. “It’s alright for me to keep my pets and change the litter box.”
d. “It’s alright for me to keep my pets and change the litter box.”
As the nurse admits a patient in end-stage renal disease to the hospital, the patient tells the nurse, “If my heart or breathing stop, I do not want to be resuscitated.” Which action should the nurse take first?
a. Place a “Do Not Resuscitate” (DNR) notation in the patient‘s care plan.
b. Invite the patient to add a notarized advance directive in the health record.
c. Advise the patient to designate a person to make future health care decisions.
d. Ask if the decision has been discussed with the patient‘s health care provider.
d. Ask if the decision has been discussed with the patient‘s health care provider.
How does the drug Phentermine inhibit weight loss?
What are the contraindications for phentermine?
causes a decrease in appetite.
contraindicated in pregnant patients. monthly pregnancy tests indicated for female patients.
The nurse is caring for a patient with advanced cirrhosis. Which new finding requires immediate provider notification?
A. 3+ bilateral lower extremity edema
B. Abdominal distention with ascites
C. Disorientation and flapping tremors
D. Muscle wasting and weight loss
C. Disorientation and flapping tremors
A patient with acute pancreatitis is receiving aggressive IV fluid resuscitation. Which finding best indicates that the treatment is effective?
a. Urine output 45 mL/hr
b. Pain reduced from 9/10 to 6/10
c. Blood glucose 210 mg/dL
d. Lipase trending downward
a. Urine output 45 mL/hr
The nurse at the clinic is interviewing a 64-yr-old woman who is 5 feet, 3 inches tall and weighs 125 lb (57 kg). The patient has not seen a health care provider for 20 years. She walks 5 miles most days and has a glass of wine 2 or 3 times a week. Which topics will the nurse plan to include in patient teaching about cancer screening and decreasing cancer risk? (Select all that apply.)
a. Pap testing
b. Tobacco use
c. Sunscreen use
d. Mammography
e. Colorectal screening
A, C, D, E
a. Pap testing
c. Sunscreen use
d. Mammography
e. Colorectal screening
Which patient would the nurse refer for hospice care?
a. A 40-yr-old patient with AIDS-related dementia who needs pain management
b. A 70-yr-old patient with lymphoma who is unable to discuss issues related to dying
c. A 60-yr-old patient with chronic severe pain because of spinal arthritis and vertebral collapse
d. A 50-yr-old patient with advanced liver failure whose family can no longer provide care at home
a. A 40-yr-old patient with AIDS-related dementia who needs pain management