Nokea
For which patient is misoprostol contraindicated?
- A. An older adult
- B. A pregnant female
- C. A patient taking daily aspirin
- D. A patient taking a proton pump inhibitor
Correct Answer: B
Rationale: Misoprostol is a prostaglandin analog that acts as a gastric mucosal protectant against NSAID-induced ulcers. A patient who is pregnant cannot take misoprostol, because it will cause miscarriage.
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A patient with a large inguinal hernia has abdominal distention and inguinal pain. The nurse recognizes these as indicators of which type of hernia?
- A. Strangulated
- B. Hiatal
- C. Ventral
- D. Umbilical
Correct Answer: A
Rationale: The hernia is strangulated when the blood supply and intestinal flow are occluded, which results in pain and distention.
A male patient reports that he will never adjust to his colostomy. Which is the best action for the nurse in this situation?
- A. Encourage him to express his concern.
- B. Suggest that he discuss his concerns with his physician.
- C. Counsel him that everything will be all right.
- D. Assure him that his concerns will diminish when he is able to care for his colostomy.
Correct Answer: A
Rationale: When a colostomy is performed, the patient or significant other should be able to verbalize concerns about the ostomy to the nurse.
The nurse caring for a patient with a peptic ulcer who has had a nasogastric tube inserted notes bright blood in the tube, the patient complains of pain and has become hypotensive. Which condition should the nurse recognize these as signs of?
- A. Hiatal hernia
- B. Gastritis
- C. Perforation
- D. Bowel obstruction
Correct Answer: C
Rationale: Perforation of the gastric wall causes pain, hypotension, and hematemesis. Immediate reporting to the charge nurse/physician is essential as peritonitis, potentially lethal, is the result of a perforation.
The nurse points out which is an example of a nonmechanical bowel obstruction?
- A. A paralytic ileus
- B. Narrowed bowel lumen from an inflammatory process
- C. Tumor of the bowel
- D. Fecal impaction
Correct Answer: A
Rationale: A nonmechanical bowel obstruction can be caused by a paralytic ileus.
In caring for a patient with gastric bleeding who has a nasogastric (NG) tube in place, the nurse expects to see which intervention for the nasogastric tube included in the plan of care?
- A. clamp for 10 minutes every hour.
- B. keep the patent with irrigation.
- C. frequently reposition to the opposite nostril.
- D. change every 72 hours.
Correct Answer: B
Rationale: Irrigating the NG tube as needed will keep the tube patent and ensure effective decompression.