A patient with decompensated cirrhosis missed several doses of lactulose and is now more forgetful. Which assessment findings are most consistent with hepatic encephalopathy? Select all that apply.

A client with cirrhosis had endoscopic band ligation for bleeding esophageal varices 3 hours ago and is now returning to the unit, NPO with vital signs stable. On entering the room, which action should the nurse take first?

A 70-year-old with rapid atrial flutter is discharged on diltiazem ER and apixaban. The patient asks what each medication is for. Which explanation is most accurate?

At the first post-discharge clinic visit after liver transplant, you review self-management. Which instructions are appropriate to include now? Select all that apply.

A client newly diagnosed with rheumatoid arthritis asks, “Which medicine actually slows or prevents joint damage over time?” Which medication class should the nurse emphasize during teaching?  

An adult with prolonged QT history suddenly becomes unresponsive. The monitor shows a rapid polymorphic wide-complex tachycardia with “twisting” QRS axes. No pulse is palpable. Which action should the nurse take first?  

On postoperative day 1 after right-sided ICD insertion, a nurse is preparing the patient for ambulation. Which action by the nurse requires immediate intervention by the charge nurse?

An awake patient with atrial flutter at 160/min and blood pressure 118/72 mm Hg is scheduled for synchronized cardioversion after unsuccessful vagal maneuvers and adenosine. Which device setting is essential before delivering the shock?

gnr ca.jpg The above image shows Gram negative Rods with clear flagella around the bacteria.