A 47-year-old patient with cholelithiasis is admitted for acute biliary colic. The provider prescribes: Morphine 2 mg IV every 2 hours PRN for severe pain (≥7/10) Oxycodone 5 mg PO every 4 hours PRN for moderate pain (4–6/10) At 1000, the patient reports pain of 8/10 and receives morphine IV. At 1030, the nurse reassesses: pain is 6/10, respiratory rate is 16/min, oxygen saturation is 98% on room air, and the patient requests additional medication. Which action by the nurse is most appropriate?  

A 58-year-old patient with long-standing alcohol-related cirrhosis is admitted with increasing abdominal distention and confusion. Assessment findings include ascites, jaundice, and asterixis. Vital signs: BP 90/58 mmHg, HR 118 bpm. Laboratory results: serum albumin 2.1 g/dL, ammonia 75 µg/dL (normal 15 to 45 µg/dL), sodium 128 mEq/L, INR 2.8. The provider prescribes: Lactulose 30 mL PO TID Spironolactone 100 mg daily Propranolol 20 mg BID Large-volume paracentesis Which nursing action is highest priority prior to implementing these orders?  

A 52-year-old patient with chronic pancreatitis reports persistent epigastric pain rated 5/10 despite taking prescribed oxycodone every 4 hours as directed. The patient also reports greasy, foul-smelling stools and a 10-pound weight loss over the past month and states, “The pain is worst after I eat.” Which action by the nurse is most appropriate?  

A 44-year-old patient presents to the emergency department with sudden onset severe epigastric pain radiating to the back, nausea, and vomiting after eating a high-fat meal. The patient denies alcohol use. Vital signs: BP 100/60 mmHg, HR 118 bpm, Temp 37.3 C. An abdominal ultrasound shows no gallstones. Laboratory results reveal lipase 740 U/L (normal 23–300 U/L) and triglycerides 1,240 mg/dL. Which conclusion by the nurse is most accurate?  

A nurse is caring for a patient admitted with acute cholecystitis. On assessment the nurse notes a positive Murphy’s sign, RUQ tenderness, temperature of 38.2°C, and nausea after eating. Which nursing interventions does the nurse include in the plan of care? (Select all that apply)  

A patient with cirrhosis and hepatic encephalopathy is receiving dietary teaching. Which lunch tray selection indicates the patient has understood the teaching?  

A patient with severe acute pancreatitis has the following vital sign trends over the past 4 hours:   0800 1000 1200 BP 118/76 104/68 92/60 HR 88 102 118 RR 18 22 26 Temp 37.8 C 38.5 C 39.3 C   Which interpretation by the nurse reflects the highest clinical priority?

A 62-year-old patient with decompensated cirrhosis and severe ascites undergoes a large-volume paracentesis with removal of 6 liters of fluid. Six hours later, the nurse notes: BP: 86/54 mmHg HR: 118 bpm Urine output: 15 mL/hr Serum creatinine: increased from 1.0 to 1.9 mg/dL Sodium: 126 mEq/L Abdomen: softer, less distended No evidence of bleeding Which interpretation by the nurse is most accurate?  

A nurse in the emergency department is assessing a child with suspected acute appendicitis. Based on the progression of the disorder, which findings should the nurse anticipate and prioritize as consistent with appendicitis? (Select all that apply.)

A patient diagnosed with cirrhosis is being treated with lactulose. Current serum ammonia level is elevated. Which clinical manifestation would indicate a complication of this elevation?