Nokea
A client's ulcerative colitis symptoms have been present for longer than 1 week. The nurse recognizes that the client should be assessed carefully for signs of which of the following complications?
- A. Heart failure
- B. DVT
- C. Hypokalemia
- D. Hypocalcemia
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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Arthur has a family history of colon cancer and is scheduled to have a sigmoidoscopy. He is crying as he tells you, "I know that I have colon cancer, too." Which response is most therapeutic?
- A. I know just how you feel.
- B. You seem upset.
- C. Oh, don't worry about it, everything will be just fine.
- D. Why do you think you have cancer?
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The nurse evaluates the client's stoma during the initial post-op period. Which of the following observations should be reported immediately to the physician?
- A. The stoma is slightly edematous
- B. The stoma is dark red to purple
- C. The stoma oozes a small amount of blood
- D. The stoma does not expel stool
Correct Answer: B
Rationale: A dark red to purple stoma may indicate compromised blood flow or ischemia, which requires immediate medical attention. This color change could be a sign of inadequate blood supply to the stoma tissue, leading to tissue damage or necrosis. Reporting this observation promptly is crucial to prevent further complications. Choices A, C, and D are not indicative of immediate medical concern. A slightly edematous stoma, oozing a small amount of blood, or not expelling stool may not be uncommon findings during the initial post-op period and can be managed without urgent intervention.
Michael, a 42 y.o. man is admitted to the med-surg floor with a diagnosis of acute pancreatitis. His BP is 136/76, pulse 96, Resps 22 and temp 101. His past history includes hyperlipidemia and alcohol abuse. The doctor prescribes an NG tube. Before inserting the tube, you explain the purpose to patient. Which of the following is a most accurate explanation?
- A. It empties the stomach of fluids and gas.
- B. It prevents spasms at the sphincter of Oddi.
- C. It prevents air from forming in the small intestine and large intestine.
- D. It removes bile from the gallbladder.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
You're caring for Beth who underwent a Billroth II procedure (surgical removal of the pylorus and duodenum) for treatment of a peptic ulcer. Which findings suggest that the patient is developing dumping syndrome, a complication associated with this procedure?
- A. Flushed, dry skin.
- B. Headache and bradycardia.
- C. Dizziness and sweating.
- D. Dyspnea and chest pain.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
You promote hemodynamic stability in a patient with upper GI bleeding by:
- A. Encouraging oral fluid intake.
- B. Monitoring central venous pressure.
- C. Monitoring laboratory test results and vital signs.
- D. Giving blood, electrolyte and fluid replacement.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.