Question 1 of 5.

Extract:The emergency department (ED) nurse is caring for a 45-year-old male client. Item 6 of 6 Laboratory & Imaging Results 0630 Exam: CT Abdomen and Pelvis with IV Contrast Indication: Acute onset of epigastric abdominal pain, nausea, vomiting. Findings: Pancreas: Diffuse enlargement of the pancreas with heterogeneous enhancement. Peripancreatic fat stranding and inflammatory changes are present, most pronounced around the pancreatic head and body. No evidence of necrosis at this time. No discrete mass or cystic lesion noted. Biliary system: Gallbladder is distended with no wall thickening or pericholecystic fluid. No gallstones visualized. Common bile duct is normal in caliber (~5 mm). Liver, spleen, kidneys, and adrenal glands: Normal in appearance. No focal lesions. Bowel: No obstruction or bowel wall thickening noted. Impression: Imaging findings are consistent with acute interstitial edematous pancreatitis. No evidence of pancreatic necrosis or pseudocyst formation at this time. Nurses' Notes 0600: The client reports sudden, severe epigastric pain. He has a history of chronic alcohol use disorder (30+ years), GERD, and hypertension. His home medications include pantoprazole and lisinopril. Upon assessment, the client is noted to be alert and oriented x4. He is mildly diaphoretic, with pulses 2+ and regular. Abdomen is distended, guarding on palpation, diminished bowel sounds, and no stool in the last 24 hours. He reports nausea and vomiting, and his pain is worse after eating fatty foods, rated 7/10 and radiating to his back. Breath sounds slightly diminished bilaterally, no adventitious sounds, denies cough or dyspnea. He reports heavy alcohol intake two days ago. Fingerstick glucose is 145 mg/dL (8.06 mmol/L) [70-110 mg/dL; 4-6 mmol/L]. Temperature is 101.3°F (38.5°C), heart rate of 112 bpm, respiratory rate of 24 breaths/min, blood pressure of 98/64 mmHg, and oxygen saturation of 95% on room air. 0630: Physician confirmed the diagnosis of acute pancreatitis based on clinical presentation, laboratory findings, and imaging studies. 1030: Client receiving LR at 150 mL/hr, calcium replacement completed. Urine output over the last 4 hours is 80 mL of dark amber urine. The client reports increased thirst. The abdomen continues to be distended with diminished bowel sounds. He reports that nausea has improved after receiving PRN medication. Increased edema noted in the lower extremities. Orders 0630 • Ondansetron 4mg IV q6h PRN • Calcium gluconate 2g IV over 5-10 minutes • Lactated Ringer's solution continuous infusion IV rate of 150mL/hr

The nurse knows that the client's condition is improving when they report a reduction in [condition].

Question 2 of 5.

The nurse is caring for a client receiving total parenteral nutrition (TPN), which was initiated twelve hours ago. The priority assessment for this client is which of the following?

Question 3 of 5.

The nurse is conducting a telephone call following up with a client with a colostomy placed two weeks ago. Select the findings reported by the client that require follow-up by the nurse.

Question 4 of 5.

The nurse is assessing a client who has appendicitis. Which of the following would be an expected finding? Select all that apply.

Question 5 of 5.

Extract:The following scenario applies to the next 1 items The nurse is caring for a client in the outpatient clinic Item 1 of 1 Nurses' Note 35-year-female arrives at the clinic for reported loss of appetite and nausea. The client reports that she is not eating as much because she experiences palpitations, sweating, and dizziness about thirty minutes after she eats. She reports that she has not been adherent to the prescribed diet and her symptoms worsen when she eats something sweet and drinks cola. Medical History • Morbid obesity (BMI 42) • Roux-en-Y procedure eight weeks ago

Complete the following sentence by choosing from the list of options. To prevent.........., the nurse should instruct the client ............. and ...........