Nokea
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.
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The patient has come to the PACU following an ileostomy for the treatment of ulcerative colitis. The patient is conscious and has a nasogastric tube in place and a pouch over the stoma. What should be the nurse's initial action?
- A. Turn patient to right side.
- B. Give patient ice chips to moisten mouth.
- C. Attach NG tube to suction.
- D. Irrigate NG tube.
Correct Answer: C
Rationale: Initially, the NG tube should be attached to suction to decompress the stomach and prevent nausea. Assessing the tube for the need of future irrigation will be part of the postoperative care.
The nurse clarifies that the end product of food is absorbed and put into the bloodstream by which anatomical feature?
- A. gastric lining of the stomach.
- B. villi of the small intestine.
- C. bile of the liver in the large intestine.
- D. excretion from the cecum.
Correct Answer: B
Rationale: The inner surface of the small intestine contains millions of tiny, fingerlike projections called villi, which contain small blood vessels. They are responsible for absorbing the products of digestion.
The nurse anticipates that the patient who has had a subtotal gastrectomy will need which type of supplement?
- A. protein due to the loss of some of the digestive processes.
- B. vitamin B12 due to the loss of the intrinsic factor.
- C. bulk to prevent constipation.
- D. vitamin A due to the loss of the gastric lining.
Correct Answer: B
Rationale: It is recommended that all patients with a gastrectomy have a blood serum vitamin B12 level measured every 1 to 2 years. Decreased absorption of vitamin B12 may cause pernicious anemia.
What is the most lethal complication of a peptic ulcer?
- A. Bleeding
- B. Perforation
- C. Severe pain
- D. Gastric outlet obstruction
Correct Answer: B
Rationale: Perforation is considered the most lethal complication of peptic ulcer. Bleeding may occur when the ulcer erodes into a blood vessel; however, perforation occurs when the ulcer crater penetrates the entire thickness of the wall of the stomach or duodenum. Gastric outlet obstruction can occur at any time and can be relieved by NG aspiration of stomach contents.
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.