NUR 103- UNIT 3 QUESTIONS AND CORRECT ANSWERS

NUR 103- UNIT 3 QUESTIONS AND
CORRECT ANSWERS
____A219.A2TheA2nurseA2isA2reinforcingA2teachingA2providedA2toA2aA2patientA2withA2gallsto
nes.A2WhatA2substanceA2shouldA2theA2nurseA2instructA2thatA2makesA2upA2mostA2gallstone
s?
a.A2Sodium
b.A2Calcium
c.A2Cholesterol
d.A2PhosphorusA2-A2Ans--ANSA2C
A2C.A2CholelithiasisA2isA2theA2presenceA2ofA2stonesA2inA2theA2gallbladder.A2TheseA2stonesA
2areA2mostA2oftenA2composedA2primarilyA2ofA2cholesterol.A2
B.A2PigmentA2stonesA2appearA2toA2beA2composedA2ofA2calcium
bilirubinate,A2whichA2occursA2whenA2freeA2bilirubinA2combinesA2withA2calcium;A2however,A
2thisA2isA2notA2theA2mostA2frequentA2substance.A2
A.A2D.A2SodiumA2andA2phosphorusA2areA2notA2primaryA2componentsA2ofA2gallstones.

____A220.A2AA2patientA2withA2gallstonesA2asksA2whyA2jaundiceA2hasA2developed.A2WhatA2
shouldA2theA2nurseA2explainA2asA2theA2mostA2likelyA2causeA2forA2theA2patientsA2jaundice?
a.A2Hepatitis
b.A2Cirrhosis
c.A2Hemolysis
d.A2BileA2ductA2obstructionA2-A2Ans--ANS:A2D

JaundiceA2occursA2whenA2theA2bileA2ductA2isA2obstructedA2andA2freeA2flowA2ofA2bileA2intoA2
theA2intestineA2isA2interrupted.A2
A.A2B.A2C.A2Hemolysis,A2cirrhosis,A2andA2hepatitisA2canA2allA2causeA2jaundiceA2butA2areA2n
otA2theA2mostA2commonA2causeA2inA2patientsA2withA2gallbladderA2disease.

____A221.A2AA2patientA2withA2cholelithiasisA2isA2havingA2clay-
coloredA2stools.A2WhatA2shouldA2theA2nurseA2realizeA2asA2theA2mostA2commonA2causeA2of
A2clay-coloredA2stools?
a.A2RetrogradeA2bileA2flowA2intoA2theA2liver
b.A2AccumulationA2ofA2bileA2saltsA2inA2theA2skin
c.A2CirrhosisA2fromA2chronicA2liverA2irritation
d.A2AA2gallstoneA2lodgedA2inA2theA2commonA2bileA2ductA2-A2Ans--ANS:A2D

ObstructionA2ofA2bileA2flowA2(e.g.,A2fromA2aA2stoneA2inA2theA2duct)A2mayA2resultA2inA2stools
A2thatA2areA2claycolored,A2becauseA2bileA2isA2notA2presentA2inA2theA2stoolA2toA2giveA2itA2col
or.A2
A.A2B.A2C.A2OtherA2liverA2andA2gallbladderA2disordersA2canA2alsoA2causeA2clay-
coloredA2stools,A2butA2inA2aA2patientA2withA2cholelithiasis,
aA2stoneA2lodgedA2inA2theA2ductA2wouldA2beA2theA2mostA2common.

,____A222.A2TheA2nurseA2isA2contributingA2toA2theA2teachingA2planA2forA2aA2patientA2recover
ingA2fromA2aA2cholecystectomy.A2WhichA2dietaryA2modificationA2shouldA2theA2nurseA2reco
mmendA2forA2theA2firstA2fewA2weeksA2afterA2surgery?

a.A2DecreaseA2intakeA2ofA2freshA2fruitsA2andA2vegetablesA2toA2minimizeA2pressureA2onA2th
eA2smallA2intestine.
b.A2ConsumeA2atA2leastA2fourA2servingsA2ofA2meat,A2cheese,A2andA2peanutA2butterA2dailyA2
toA2boostA2proteinA2intakeA2andA2aidA2healing.
c.A2DistributeA2fatA2intakeA2inA2smallA2portionsA2throughoutA2theA2dayA2toA2preventA2exces
siveA2fatA2inA2theA2intestineA2atA2anyA2oneA2time.
d.A2TakeA2pancreaticA2enzymesA2withA2mealsA2toA2replaceA2enzymesA2thatA2wouldA2norm
allyA2haveA2beenA2secretedA2beforeA2theA2cholecystectomy.A2-A2Ans--ANS:A2C

PatientsA2areA2putA2onA2high-protein,A2low-
fatA2diets.A2FatA2shouldA2beA2slowlyA2reintroducedA2intoA2theA2diet.A2OnceA2theA2duodenu
mA2becomesA2accustomedA2toA2constantA2infusionA2ofA2bile,A2theA2patientsA2individualA2tol
eranceA2forA2fatA2becomesA2theA2onlyA2restrictionA2forA2diet.A2
A.A2FruitsA2andA2vegetablesA2areA2notA2contraindicated.A2
B.A2Meat,A2cheese,A2andA2peanutA2butterA2areA2highA2inA2fat.A2
D.A2PancreaticA2enzymesA2areA2notA2necessaryA2theA2pancreasA2hasA2notA2beenA2remov
ed.

____A223.A2AA2patientA2withA2cholecystitisA2isA2prescribedA2promethazineA2(Phenergan)A2f
orA2nausea.A2WhichA2adverseA2effectA2ofA2theA2medicationA2shouldA2theA2nurseA2instructA2
theA2patientA2toA2report?

a.A2Diarrhea
b.A2Insomnia
c.A2DryA2mouth
d.A2UrineA2retentionA2-A2Ans--ANS:A2D
UrineA2retentionA2canA2beA2lifeA2threateningA2andA2shouldA2beA2reportedA2immediately.A2
B.A2C.A2DryA2mouthA2andA2insomniaA2areA2notA2emergencies.A2
A.A2Constipation,A2notA2diarrhea,A2isA2moreA2likelyA2toA2occur.

____A224.A2TheA2nurseA2isA2caringA2forA2aA2patientA2withA2chronicA2liverA2failure.A2WhichA2
medicationA2orderA2shouldA2theA2nurseA2question?

a.A2Lactulose
b.A2Neomycin
c.A2Multivitamins
d.A2AcetaminophenA2-A2Ans--ANS:A2D
AcetaminophenA2(Tylenol)A2overdoseA2isA2theA2mostA2commonA2causeA2ofA2ALF.A2Aceta
minophenA2shouldA2notA2exceedA23000A2mgA2inA2aA224A2hourA2period.A2
A.A2B.A2C.A2Multivitamins,A2Lactulose,A2andA2NeomycinA2areA2allA2usedA2toA2treatA2sympto
msA2ofA2liverA2disease.

, ____A225.A2AA2patientA2recoveringA2fromA2aA2cholecystectomyA2earlierA2inA2theA2dayA2isA2r
eluctantA2toA2deepA2breatheA2andA2cough.A2WhatA2interventionA2shouldA2theA2nurseA2useA
2toA2assistA2theA2patientA2toA2coughA2andA2breathe?


a.A2RemindA2theA2patientA2toA2deepA2breatheA2andA2coughA2everyA2hour.
b.A2TeachA2theA2patientA2toA2useA2relaxationA2andA2distractionA2techniques.
c.A2MedicateA2theA2patientA2forA2pain,A2andA2assistA2toA2splintA2theA2abdomen.
d.A2ReinforceA2theA2importanceA2ofA2theA2deepA2breathingA2andA2coughingA2activities.A2-
A2Ans--ANS:A2C
PatientsA2areA2usuallyA2reluctantA2toA2coughA2andA2deepA2breatheA2afterA2cholecystectom
yA2becauseA2theA2highA2incisionA2makesA2coughingA2painful.A2MedicatingA2forA2painA2andA
2splintingA2theA2incisionA2allowA2theA2patientA2toA2coughA2withoutA2excessiveA2pain.A2
A.A2D.A2SimplyA2remindingA2andA2teachingA2doA2notA2solveA2theA2problem.A2
B.A2RelaxationA2isA2helpfulA2butA2shouldA2beA2inA2additionA2to,A2notA2insteadA2of,A2analgesi
a.

____A226.A2TheA2nurseA2isA2identifyingA2careA2toA2delegateA2toA2unlicensedA2assistiveA2pe
rsonnel.A2WhichA2actionsA2couldA2beA2safelyA2delegatedA2inA2theA2careA2ofA2aA2patientA2wi
thA2fulminantA2liverA2failure?

a.A2EvaluatingA2theA2patientsA2mentalA2status
b.A2AssistingA2withA2bathingA2andA2positioning
c.A2AssessingA2theA2stoolA2andA2urineA2forA2blood
d.A2MonitoringA2laboratoryA2studiesA2forA2abnormalA2valuesA2-A2Ans--ANS:A2B
UnlicensedA2assistiveA2personnelA2canA2safelyA2batheA2andA2positionA2aA2patientA2inA2live
rA2failure.A2
A.A2C.A2D.A2Assessment,A2monitoring,A2andA2evaluatingA2areA2nursingA2functionsA2andA2ar
eA2beyondA2theA2scope
ofA2practiceA2forA2unlicensedA2assistiveA2personnel.

____A227.A2AA2patientA2withA2biliaryA2colicA2isA2prescribedA2anA2anticholinergicA2medicatio
nA2toA2helpA2treatA2biliaryA2colic.A2ForA2whichA2medicalA2diagnosisA2shouldA2theA2nurseA2q
uestionA2theA2administrationA2ofA2thisA2medication?

a.A2Asthma
b.A2Psoriasis
c.A2DiabetesA2mellitus
d.A2ProstaticA2hypertrophyA2-A2Ans--ANS:A2D
AnticholinergicA2medicationsA2areA2contraindicatedA2inA2patientsA2withA2prostaticA2hypertr
ophy.A2
A.A2B.A2C.A2AnticholinergicA2medicationsA2areA2notA2contraindicatedA2inA2diabetes,A2asth
ma,A2orA2psoriasis.

____A228.A2TheA2nurseA2isA2providingA2aA2patientA2withA2cholelithiasisA2theA2medicationA2u
rsodiolA2(Actigall).A2WhatA2shouldA2theA2nurseA2instructA2theA2patientA2aboutA2thisA2medic
ation?