Nokea
The client has orders for a nasogastric (NG) tube insertion. During the procedure, instructions that will assist in the insertion would be:
- A. Instruct the client to tilt his head back for insertion in the nostril, then flex his neck for the final insertion
- B. After insertion into the nostril, instruct the client to extend his neck
- C. Introduce the tube with the client's head tilted back, then instruct him to keep his head upright for final insertion
- D. Instruct the client to hold his chin down, then back for insertion of the tube
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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The nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis. The client is scheduled for surgery for 2 hours. The client begins to complain of increases abdominal pain and begins to vomit. On assessment the nurse notes that the abdomen distended and bowel sounds are diminished. Which of the following is the most appropriate nursing intervention?
- A. Administer the prescribed pain medication.
- 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 warm setting to the client's abdomen.
Correct Answer: B
Rationale: Based on the signs and symptoms presented in the question, the nurse should suspect peritonitis and should notify the physician. Administering pain medication is not an appropriate intervention. Heat should never be applied to the abdomen of a client with suspected appendicitis. Scheduling surgical time is not within the scope of nursing practice, although the physician probably would perform the surgery earlier than the prescheduled time.
Which of the following tests can be performed to diagnose a hiatal hernia?
- A. Colonoscopy
- B. Lower GI series
- C. Barium swallow
- D. Abdominal x-rays
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Which of the following symptoms is common with a hiatal hernia?
- A. Left arm pain
- B. Lower back pain
- C. Esophageal reflux
- D. Abdominal cramping
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Which of the following conditions can cause a hiatal hernia?
- A. Increased intrathoracic pressure
- B. Weakness of the esophageal muscle
- C. Increased esophageal muscle pressure
- D. Weakness of the diaphragmic muscle
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The nurse is evaluating the plan of care for a client with peptic ulcer disease with a nursing diagnosis of Acute Pain. The nurse would determine that the client has not met the expected outcomes if the client states
- A. That pain is relieved with histamine H2 receptor antagonists.
- B. That irritating foods have been eliminated from the diet.
- C. The client is being awakened at 2 AM with heartburn.
- D. The client has absence of pain before meals.
Correct Answer: C
Rationale: Expected outcomes for the client with peptic ulcer disease experiencing pain include elimination of irritating foods from the diet, ability to take prescribed medications that will reduce pain, reporting that the pain is relieved or prevented with medication, and an ability to sleep through the night without pain. The client who continues to be awakened by pain requires further modification of medication therapy, which may include adjustment of timing of histamine H2 receptor antagonist or an additional dose of antacid before the time when pain awakens the client.