Nokea
The nurse is caring for a client who is receiving prescribed dicyclomine. Which of the following client findings would indicate a therapeutic response?
- A. Decreased abdominal cramping
- B. Absence of nausea and vomiting
- C. Decreased urinary retention
- D. Less burning with urination
Correct Answer: A
Rationale: Dicyclomine, an anticholinergic, reduces intestinal spasms, so decreased abdominal cramping indicates a therapeutic response. It is not primarily for nausea, urinary retention, or dysuria.
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The nurse is assessing a client diagnosed with necrotizing pancreatitis. Which of the following assessment findings would be expected?
- A. Ecchymotic discoloration in the periumbilical region
- B. Dysuria
- C. Hyperactive bowel sounds
- D. Hematuria
Correct Answer: A
Rationale: Ecchymotic discoloration in the periumbilical region (A), known as Cullen's sign, is expected in necrotizing pancreatitis due to retroperitoneal hemorrhage.
The nurse in the intensive care unit is caring for a client being treated for necrotizing pancreatitis. Which of the following findings would indicate the client is experiencing a complication?
- A. Periumbilical bruising
- B. Abdominal pain rated 5/10 on the numerical rating scale
- C. White blood cell count 13,500 mm3 [5,000-10,000 mm3]
- D. Decreased lung sounds in the left lower lung fields
Correct Answer: D
Rationale: Decreased lung sounds (D) may indicate a complication like pleural effusion or atelectasis in necrotizing pancreatitis, requiring further evaluation.
The nurse is assessing a client with cholecystitis. To support this finding, the nurse expects the client to localize the pain in the
- A. Right upper quadrant, radiating to the right shoulder.
- B. Right upper quadrant, radiating to the left shoulder.
- C. Right lower quadrant, radiating to the pelvic bones.
- D. Right lower quadrant, radiating to the umbilicus.
Correct Answer: A
Rationale: Cholecystitis typically causes pain in the right upper quadrant radiating to the right shoulder (A) due to gallbladder inflammation and referred pain via the phrenic nerve.
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.
The nurse is developing a teaching plan for a client with post-gastrectomy dumping syndrome. Which of the following statements should the nurse make to the client?
- A. Take small sips of water during meals to soften the food for easier digestion.
- B. Symptoms will resolve in about 4-6 weeks as the stomach adjusts post-surgery.
- C. Plan rest periods of 10 minutes after every meal.
- D. Meals should consist of dry foods with low carbohydrates, moderate fat, and high protein content.
Correct Answer: D
Rationale: Dry, low-carbohydrate, moderate-fat, high-protein meals (D) slow gastric emptying, reducing dumping syndrome symptoms. Sips during meals (A), expecting resolution in 4-6 weeks (B), or short rest periods (C) are incorrect.