Nokea
A nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis. The client is scheduled for surgery in 2 hours. The client begins to complain of increased abdominal pain and begins to vomit. On assessment the nurse notes that the abdomen is distended and the bowel sounds are diminished. Which of the following is the most appropriate nursing intervention?
- A. Administer dilaudid
- B. Notify the physician
- C. Call and ask the operating room team to perform the surgery as soon as possible
- D. Reposition the client and apply a heating pad on a warm setting to the client's abdomen.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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Which of the following mechanisms can facilitate the development of diverticulosis into diverticulitis?
- A. Treating constipation with chronic laxative use, leading to dependence on laxatives
- B. Chronic constipation causing an obstruction, reducing forward flow of intestinal contents
- C. Herniation of the intestinal mucosa, rupturing the wall of the intestine
- D. Undigested food blocking the diverticulum, predisposing the area to bacterial invasion
Correct Answer: D
Rationale: The correct answer is D. Undigested food blocking the diverticulum can lead to bacterial invasion, causing inflammation and turning diverticulosis into diverticulitis. Choices A, B, and C do not directly facilitate the development of diverticulitis. Choice A involves a different mechanism related to laxative use, choice B describes a complication of chronic constipation but does not necessarily lead to diverticulitis, and choice C refers to a different condition involving herniation of the intestinal mucosa.
After a right hemicolectomy for treatment of colon cancer, a 57-year old client is reluctant to turn while on bed rest. Which action by the nurse would be appropriate?
- A. Asking a co-worker to help turn the client
- B. Explaining to the client why turning is important.
- C. Allowing the client to turn when he's ready to do so
- D. Telling the client that the physician's order states he must turn every 2 hours
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The nurse is caring for a hospitalized client with a diagnosis of ulcerative colitis. Which finding, if noted on assessment of the client, would the nurse report to the physician?
- A. Bloody diarrhea
- B. Hypotension
- C. A hemoglobin of 12 mg/dL
- D. Rebound tenderness
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Which of the following aspects is the priority focus of nursing management for a client with peritonitis?
- A. Fluid and electrolyte balance
- B. Gastric irrigation
- C. Pain management
- D. Psychosocial issues
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The nurse is monitoring a client for the early signs of dumping syndrome. Which symptom indicates this occurrence?
- A. Abdominal cramping and pain
- B. Bradycardia and indigestion
- C. Sweating and pallor
- D. Double vision and chest pain
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.