Nokea
Donald is a 61 y.o. man with diverticulitis. Diverticulitis is characterized by:
- A. Periodic rectal hemorrhage.
- B. Hypertension and tachycardia.
- C. Vomiting and elevated temperature.
- D. Crampy and lower left quadrant pain and low-grade fever.
Correct Answer: D
Rationale: The correct answer is D because diverticulitis typically presents with crampy pain in the lower left quadrant of the abdomen and a low-grade fever. This is due to inflammation or infection of the diverticula.
A: Periodic rectal hemorrhage is more characteristic of diverticular bleeding, not diverticulitis.
B: Hypertension and tachycardia are not typically associated with diverticulitis but may occur in severe cases or with complications.
C: Vomiting and elevated temperature can occur but are not as specific to diverticulitis as the combination of symptoms described in option D.
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A physician just told a patient that she has a volvulus. When the patient asks the nurse what this is, what is the best description for the nurse to give her?
- A. Bowel folding on itself
- B. Twisting of bowel on itself
- C. Emboli of arterial supply to the bowel
- D. Protrusion of bowel in weak or abnormal opening
Correct Answer: B
Rationale: A volvulus is the twisting of the bowel, which can cause obstruction and is a medical emergency.
You must rearrange the room assignment for several clients. Which two clients would be best suited to put in the same room?
- A. A 35-year-old female with copious, intractable diarrhea and vomiting.
- B. A 43-year-old female second day post-operative cholecystectomy.
- C. A 53-year-old female with pain related to alcohol-associated pancreatitis.
- D. A 62-year-old female with colon cancer receiving chemotherapy and radiation.
Correct Answer: C
Rationale: Post-op and immunocompromised patients should not share a room with someone with an infectious condition. The best match is non-infectious conditions.
A nurse is caring for a client who has peptic ulcer disease. The nurse should monitor the client for which of the following findings as an indication of gastrointestinal perforation?
- A. Hyperactive bowel sounds
- B. Sudden abdominal pain
- C. Increased blood pressure
- D. Bradycardia
Correct Answer: B
Rationale: The correct answer is B: Sudden abdominal pain. Gastrointestinal perforation is a serious complication of peptic ulcer disease. Sudden abdominal pain is a key indicator as perforation can lead to leakage of stomach contents into the abdominal cavity causing severe pain. Hyperactive bowel sounds (A) are more indicative of bowel obstruction. Increased blood pressure (C) can occur due to pain or stress but is not specific to gastrointestinal perforation. Bradycardia (D) is not typically associated with gastrointestinal perforation.
When teaching a patient about weight reduction diets
- A. the nurse teaches the patient that an appropriate single serving of a food is
- B. a 6-inch bagel.
- C. 1 cup of chopped vegetables.
- D. a piece of cheese the size of three dice.
Correct Answer: D
Rationale: A serving of protein is typically the size of a deck of cards (approximately 3-4 oz), which helps patients understand appropriate portion sizes.
The nurse identifies a need for additional teaching when a patient with acute infectious diarrhea makes which statement?
- A. I can use A&D ointment or Vaseline jelly around the anal area to protect my skin.'
- B. Gatorade is a good liquid to drink because it replaces the fluid and salts I have lost.'
- C. I may use over-the-counter Imodium or Parepectolin when I need to control the diarrhea.'
- D. I must wash my hands after every bowel movement to prevent spreading the diarrhea to my family.'
Correct Answer: C
Rationale: The use of Imodium or Parepectolin for diarrhea should be avoided in acute infectious diarrhea as it may delay the elimination of the causative agent and worsen the condition.