The experienced nurse is teaching the new nurse about surger...

The experienced nurse is teaching the new nurse about surgery to repair a hiatal hernia. The experienced nurse is most likely to state that the surgery is becoming more common to prevent which emergency complication?

A. Severe dysphagia
B. Esophageal edema
C. Hernia strangulation
D. Aspiration

Correct Answer: C

Rationale: A. Although dysphagia is a complication of hiatal hernia, it is not an emergency condition. B. Esophageal edema is not a complication of hiatal hernia. C. A hiatal hernia can become strangulated (Circulation of blood to the hernia is cut off by constriction). Strangulation can occur with any type of hernia. D. Although aspiration is a complication of hiatal hernia, it is not an emergency condition.

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Which assessment data indicate to the nurse the client's gastric ulcer has perforated?

A. Complaints of sudden, sharp, substernal pain.
B. Rigid, boardlike abdomen with rebound tenderness.
C. Frequent, clay-colored, liquid stool.
D. Complaints of vague abdominal pain in the right upper quadrant.

Correct Answer: B

Rationale: A rigid, boardlike abdomen with rebound tenderness indicates peritonitis, a common complication of ulcer perforation due to leakage of gastric contents into the peritoneal cavity. Substernal pain, clay-colored stools, and vague pain are less specific.

The nurse is caring for a client diagnosed with hemorrhaging duodenal ulcer. Which collaborative interventions should the nurse implement?

A. Perform a complete pain assessment.
B. Assess the client's vital signs frequently.
C. Administer a proton pump inhibitor intravenously.
D. Obtain permission and administer blood products.
E. Monitor the intake of a soft, bland diet.

Correct Answer: B,C,D

Rationale: Frequent vital sign assessment monitors for hypovolemia, IV proton pump inhibitors reduce acid and bleeding, and blood products treat anemia from hemorrhage. Pain assessment is important but less urgent, and a bland diet is inappropriate during active bleeding.

The nurse is planning the care of a client who has had an abdominal-perineal resection for cancer of the colon. Which interventions should the nurse implement?

A. Provide meticulous skin care to stoma.
B. Assess the flank incision.
C. Maintain the indwelling catheter.
D. Irrigate the (JP) drains every shift.
E. Position the client semirecumbent.

Correct Answer: A,C,E

Rationale: Stoma skin care prevents irritation, an indwelling catheter is maintained post-surgery to monitor output, and a semirecumbent position aids breathing and comfort. Flank incisions are not typical, and JP drains are not irrigated.

The nurse at the scene of a knife fight is caring for a young man who has a knife in his abdomen. Which action should the nurse implement?

A. Stabilize the knife.
B. Remove the knife gently.
C. Turn the client on the side.
D. Apply pressure to the insertion site.

Correct Answer: A

Rationale: Stabilizing the knife prevents further internal damage until surgical intervention. Removing it, turning the client, or applying pressure risks worsening bleeding.

The nurse is preparing to hang a new bag of total parenteral nutrition for a client with an abdominal perineal resection. The bag has 1,500 mL of 50% dextrose, 10 mL of trace elements, 20 mL of multivitamins, 20 mL of potassium chloride, and 500 mL of lipids. The bag is to infuse over the next 24 hours. At what rate should the nurse set the pump?

Correct Answer: 83 mL/hr

Rationale: Total volume = 1,500 + 10 + 20 + 20 + 500 = 2,050 mL. Infusion over 24 hours: 2,050 ÷ 24 = 85.42 mL/hr, rounded to 83 mL/hr for pump settings.