A client presents to the emergency department vomiting dark brown emesis and in severe abdominal pain. The client reports to the nurse of recently being diagnosed with adenocarcinoma of the small intestine. After auscultating bowel sounds and obtaining vital signs, which prescription should the nurse implement next?

Insert a nasogastric tube (NGT) and attach to low intermittent suction.

Place an indwelling urinary catheter and attach a bedside drainage unit.

Send the client to x-ray for a flat plate of the abdomen.

Give a prescribed analgesic for temperature above 101°F (38.3°C).

Answer and Explanation

The Correct Answer is A

A. Inserting a nasogastric tube (NGT) and attaching it to low intermittent suction would be appropriate in this situation. Dark brown emesis could indicate gastrointestinal bleeding, which may require gastric decompression to prevent further vomiting and assess the volume and characteristics of the gastric contents.

B. Placing an indwelling urinary catheter and attaching a bedside drainage unit is not the priority intervention in this scenario.

C. Sending the client to x-ray for a flat plate of the abdomen may provide diagnostic information, but it is not the most immediate intervention needed in this situation.

D. Giving a prescribed analgesic for a temperature above 101°F (38.3°C) is not the priority intervention in this scenario.

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Correct Answer is A

Explanation

A. Isoniazid is an antitubercular medication commonly used in the treatment of active tuberculosis (TB). One of the primary goals of TB treatment is to reduce the symptoms associated with the infection, such as cough and sputum production.

B. While weight loss and decreased appetite can be symptoms of active tuberculosis, the goal of treatment with isoniazid is to improve symptoms and promote recovery.

C. A positive sputum smear and culture would indicate ongoing TB infection or treatment failure, rather than the effectiveness of isoniazid therapy.

D. Vertigo (dizziness) and tinnitus (ringing in the ears) are not typical side effects or outcomes associated with isoniazid therapy.

A. Review with the client the need to avoid foods that are rich in milk and cream. B. Reinforce the teaching by asking the client to make a list of snack foods high in dairy content. C. Remind the client that it is also important to switch to decaffeinated coffee and tea. D. Suggest that the client also plan to eat frequent small meals to reduce discomfort.

Correct Answer is A

Explanation

A. Consuming dairy products, especially those rich in milk and cream, can stimulate gastric acid secretion and exacerbate symptoms of a duodenal ulcer. Therefore, it is essential for the nurse to review with the client the importance of avoiding foods that can aggravate the ulcer and worsen symptoms.

B. While reinforcing teaching about dietary modifications is important, encouraging the client to make a list of snack foods high in dairy content would not address the issue of avoiding dairy products to protect the duodenal ulcer.

C. While switching to decaffeinated coffee and tea can be beneficial for individuals with duodenal ulcers, it does not directly address the client's misconception about using dairy products to coat and protect the ulcer.

D. Eating frequent small meals can help reduce discomfort associated with duodenal ulcers by minimizing gastric acid secretion and preventing large fluctuations in stomach volume.

However, this option does not address the client's misconception.

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Naxlex Comprehensive Predictor Exams

The antitubercular drug isoniazid is prescribed for a client with active tuberculosis. To evaluate the effectiveness of this medication, which outcome can the nurse expect this client to exhibit?

Correct Answer is A

Explanation

Following discharge teaching, a client with a duodenal ulcer tells the nurse of plans to eat plenty of dairy products to help coat and protect the duodenal ulcer. Which is the best follow- up action by the nurse?

Correct Answer is A

Explanation

A client has been administered lactulose for several days. Which therapeutic response should the nurse expect for a client with hepatic encephalopathy?

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