A nurse is assessing a client who has a complete small bowel obstruction. Which of the following manifestations should the nurse expect? (Select all that apply.)

Urticaria

Vomiting

Distended abdomen

Fluid overload

Obstipation

Answer and Explanation

Correct Answer : B,C,E

A) Urticaria:
Urticaria, or hives, is a skin reaction characterized by itchy, raised welts. It is not typically associated with a small bowel obstruction, which primarily affects the gastrointestinal system rather than the skin.

B) Vomiting:
Vomiting is a common symptom of a complete small bowel obstruction. It occurs due to the blockage in the intestines, which prevents the passage of contents, leading to nausea and vomiting as the body tries to expel the obstruction.

C) Distended abdomen:
A distended abdomen is expected in cases of small bowel obstruction. The blockage causes a buildup of gas and fluids, leading to abdominal swelling and distention as the normal passage of intestinal contents is impeded.

D) Fluid overload:
Fluid overload is not a typical manifestation of a small bowel obstruction. Instead, dehydration and electrolyte imbalances are more likely due to vomiting and the inability to absorb fluids and nutrients properly.

E) Obstipation:
Obstipation, or severe constipation with an inability to pass stool or gas, is a key sign of a complete small bowel obstruction. The obstruction prevents the normal movement of intestinal contents, leading to a cessation of bowel movements.

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Correct Answer is D

Explanation

A) Diarrhea: Metabolic alkalosis is more likely to be associated with constipation rather than diarrhea. Diarrhea is typically a cause of metabolic acidosis due to the loss of bicarbonate in stool, rather than a result of metabolic alkalosis.

B) Bradycardia: Bradycardia is not a typical manifestation of metabolic alkalosis. Alkalosis can lead to arrhythmias, but it generally does not cause a slow heart rate. Instead, tachycardia might occur as the body compensates for the altered acid-base balance.

C) Tinnitus: Tinnitus is not a common symptom of metabolic alkalosis. It is more often associated with aspirin toxicity or other conditions affecting the auditory system, rather than changes in acid-base balance.

D) Tetany: Tetany is a common manifestation of metabolic alkalosis. The alkalosis causes a decrease in ionized calcium levels, which increases neuromuscular excitability and can lead to muscle cramps, spasms, and tetany. This is a key sign for nurses to monitor as it indicates significant electrolyte disturbances associated with the alkalotic state.

A. "I will rotate the earmold forward when I insert my hearing aid." B. "If my hearing aid gets dirty, I can clean it with alcohol swabs." C. "I should turn the hearing aid on before I insert it." D. "If my hearing aid whistles, I should change the battery."

Correct Answer is A

Explanation

A) Rotating the earmold forward when inserting the hearing aid is a correct technique. This ensures a proper fit and helps to position the hearing aid comfortably in the ear canal, which can enhance the effectiveness and comfort of the device.

B) Cleaning the hearing aid with alcohol swabs can damage the delicate components of the device. Instead, hearing aids should be cleaned with a dry cloth or a soft brush specifically designed for this purpose to avoid damaging the hearing aid.

C) Turning the hearing aid on before inserting it may result in feedback or a whistling sound. It's usually recommended to insert the hearing aid first and then turn it on to avoid any discomfort or unwanted noise.

D) If the hearing aid whistles, it is not typically related to the battery. Whistling is often caused by improper fit, earwax buildup, or feedback issues. Changing the battery is unlikely to resolve the whistling problem and is not the recommended solution.

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A nurse is assessing a client who has a complete small bowel obstruction. Which of the following manifestations should the nurse expect? (Select all that apply.)

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