Nokea
The nurse is caring for a client diagnosed with peptic ulcer disease. The nurse anticipates a prescription for which medication?
- A. Ondansetron
- B. Diphenoxylate with atropine
- C. Famotidine
- D. Psyllium
Correct Answer: C
Rationale: Famotidine, an H2 receptor blocker, reduces gastric acid production, aiding in peptic ulcer healing. Ondansetron is for nausea, diphenoxylate-atropine for diarrhea, and psyllium for constipation, none of which treat ulcers directly.
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The nurse is caring for a client with suspected bowel perforation. Which of the following would be contraindicated?
- A. Administering gastrografin for an upper GI x-ray.
- B. An exploratory laparotomy procedure.
- C. Administering milk of magnesia following an upper GI study.
- D. An abdominal CT scan.
Correct Answer: C
Rationale: Milk of magnesia (C) is contraindicated in suspected bowel perforation as it may worsen the condition by increasing intestinal motility or causing further leakage. Gastrografin (A), laparotomy (B), and CT scans (D) are appropriate diagnostic or therapeutic measures.
The following scenario applies to the next 1 items
The nurse is caring for a client who presents with acute appendicitis
Item 1 of 1
History of Present Illness
19-year-old female admitted with abdominal pain localized to the right lower quadrant. The onset of pain was twelve hours ago, and the client now reports pain is worsening when the client coughs. Endorses nausea and has persistent vomiting.
Vital Signs
• Oral temperature 101° F (38.3°C)
• Pulse 90/minute
• Respirations 18/minute
• Blood Pressure 110/66 mm Hg
• Oxygen saturation 96% on room air
Laboratory Results
• White blood cell count, 11,500 mm3 (5,000-10,000 mm3)
• Creatinine, 0.9 mg/dL (0.6-1.2 mg/dL)
• BUN 26 mg/dL (10-20 mg/dL)
• Potassium 3.3 mEq/L (3.5-5 mEq/L)
Select two (2) findings from the clinical data that require immediate follow-up
- A. Oral temperature 101°F (38.3°C)
- B. White blood cell count, 11,500 mm³
- C. Creatinine, 0.9 mg/dL
- D. Nausea and vomiting
- E. Potassium 3.3 mEq/L
- F. BUN 26 mg/dL
- G. Reports of pain increasing while coughing
Correct Answer: A,D
Rationale: Fever (A) and nausea/vomiting (D) in appendicitis suggest ongoing inflammation or complications, requiring immediate follow-up to prevent rupture or peritonitis.
The nurse cares for a client who reports dumping syndrome following gastric bypass surgery. To alleviate the symptoms of dumping syndrome, the nurse should recommend that the client. Select all that apply.
- A. Take a dose of their prescribed proton pump inhibitor immediately before meals.
- B. Stay upright for 30 minutes following eating.
- C. Eat high-fiber foods to decrease late dumping syndrome.
- D. Increase their intake of simple carbohydrates to prevent spikes in blood sugar.
- E. Eat five to six small meals a day to avoid overloading the stomach.
Correct Answer: B,C,E
Rationale: Staying upright (B), eating high-fiber foods (C), and consuming small, frequent meals (E) slow gastric emptying, reducing dumping syndrome symptoms. PPIs (A) are unrelated, and simple carbohydrates (D) worsen symptoms.
The following scenario applies to the next 1 items
The nurse is caring for an older adult in the medical-surgical unit
Item 1 of 1
Health History
84-year-old female was admitted to the medical-surgical unit with a three-day history of abdominal pain, distention, nausea, and persistent vomiting. She reports that she has not had a bowel movement in five days and has no appetite.
Vital Signs
Oral temperature 101.1° F (38.3° C)
Pulse 108/minute
Respirations 22/minute
Blood pressure 100/64 mm Hg
Oxygen saturation 96% on room air.
The nurse reviews the client's health history and vital signs. Click to specify if the findings are consistent with a small bowel obstruction or appendicitis. Each row must have at least one but may have more than one response option selected.
- A. Unable to pass stool
- B. Fever
- C. Distended abdomen
- D. Right lower quadrant abdominal pain
- E. Nausea and vomiting
Correct Answer: A,B,C,E;A,B,C,D,E
Rationale: Small bowel obstruction: A (Unable to pass stool), B (Fever), C (Distended abdomen), E (Nausea and vomiting). Appendicitis: A, B, C, D (Right lower quadrant abdominal pain), E. Both conditions can present with these symptoms, though right lower quadrant pain is more specific to appendicitis.
The nurse is supervising a student nurse performing an abdominal assessment on a client with gastroenteritis. It would indicate effective technique if the student performs the assessment in which order?
- A. Auscultation, inspection, palpation, percussion
- B. Inspection, palpation, percussion, auscultation
- C. Palpation, percussion, inspection, auscultation
- D. Inspection, auscultation, percussion, palpation
Correct Answer: D
Rationale: The correct order for abdominal assessment is inspection, auscultation, percussion, palpation (D). Auscultation before palpation prevents altering bowel sounds.