A nurse caring for a client with acute peritonitis reviews the physician's orders. The orders include an NPO diet, insertion of a nasogastric tube set to low intermittent suction, and IV fluids at 50 mL per hour. When asked why he will need the NG tube, what is the nurse's best reply?
To administer medications and electrolytes
To dilate the stomach as a presurgical preparation
You will not be able to eat for several days
To remove secretions and decompress your stomach
The Correct Answer is D
Choice A Reason: This is incorrect because administering medications and electrolytes is not the primary purpose of inserting a nasogastric tube for a client with acute peritonitis. Medications and electrolytes can be given through other routes, such as IV or oral.
Choice B Reason: This is incorrect because dilating the stomach as a presurgical preparation is not a relevant Reason for inserting a nasogastric tube for a client with acute peritonitis. Dilating the stomach may be done before some types of gastric surgery, but it does not apply to peritonitis.
Choice C Reason: This is incorrect because stating that you will not be able to eat for several days is not an adequate explanation for inserting a nasogastric tube for a client with acute peritonitis. This statement does not address the rationale or the benefits of the procedure. It may also cause anxiety and resentment in the client.
Choice D Reason: This is the correct choice because removing secretions and decompressing the stomach is the main Reason for inserting a nasogastric tube for a client with acute peritonitis. Peritonitis is an inflammation of the peritoneum, the membrane that lines the abdominal cavity. It can cause abdominal distension, pain, nausea, and vomiting. A nasogastric tube can suction out the gastric contents and reduce the pressure and irritation in the abdomen.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason: The client needs total nursing care is the expected outcome for a client who has a score of 6 on the Glasgow Coma Scale, which is a tool that measures the level of consciousness based on eye opening, verbal response, and motor response. A score of 6 indicates severe brain injury and coma, meaning that the client is unresponsive and dependent on others for all activities of daily living.
Choice B Reason: Indicates stable neurologic status is not the expected outcome for a client who has a score of 6 on the Glasgow Coma Scale, which indicates severe brain injury and coma. A stable neurologic status means that there are no changes in the level of consciousness, vital signs, or neurological signs.
Choice C Reason: The client has a decline in level of consciousness but is able to protect his airway is not the expected outcome for a client who has a score of 6 on the Glasgow Coma Scale, which indicates severe brain injury and coma. A decline in level of consciousness means that the client is less alert and responsive than normal, but still able to respond to stimuli and maintain airway patency.
Choice D Reason: The client is alert and oriented is not the expected outcome for a client who has a score of 6 on the Glasgow Coma Scale, which indicates severe brain injury and coma. Alert and oriented means that the client is fully awake and aware of person, place, time, and situation.
Correct Answer is B
Explanation
Choice A reason: This is correct because eating frequent small meals can help the client with IBS to avoid overloading the digestive system and triggering diarrhea. The nurse should advise the client to eat slowly chew well, and avoid foods that are spicy, fatty, or gas-producing.
Choice B reason: This is incorrect because increasing the intake of leafy greens and other sources of dietary fiber can worsen diarrhea by increasing stool bulk and motility. The nurse should advise the client to limit or avoid high-fiber foods, such as whole grains, fruits, vegetables, nuts, and seeds, during acute flare-ups of IBS. The client can gradually reintroduce fiber when the symptoms subside.
Choice C reason: This is correct because increasing fluids can help the client with IBS to prevent dehydration and electrolyte imbalance caused by diarrhea. The nurse should advise the client to drink at least 8 glasses of water per day and avoid caffeinated, alcoholic, or carbonated beverages that can irritate the bowel or cause gas.
Choice D reason: This is correct because taking prescribed medications on schedule can help the client with IBS to regulate bowel patterns and reduce diarrhea. The nurse should instruct the client on how to use medications, such as antidiarrheals, antispasmodics, or probiotics, as ordered by the provider. The nurse should also monitor the client for any adverse effects or interactions of the medications.
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