A nurse is caring for a 45-year-old male client in the emergency department who reports severe abdominal pain.

Exhibits

Based on the information provided, which of the following provider’s prescriptions are anticipated, nonessential, or contraindicated for the client? Select one response per row.

Increase fiber intake

CT of the abdomen with contrast

Flexible sigmoidoscopy

Change IV fluids to 0.9% sodium chloride with KCl

Type and crossmatch blood

Administer IV piperacillin-tazobactam

Answer and Explanation

The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"C"}}

•   Increase fiber intake: This is nonessential at this time. While a high-fiber diet can help prevent future episodes of diverticulitis, it won’t help in the acute phase, especially when the client is unable to eat or drink without vomiting.
•   CT of the abdomen with contrast: This is an anticipated action. A CT scan can help confirm the diagnosis of diverticulitis and assess the severity of the condition.
•   Flexible sigmoidoscopy: This is an anticipated action. A flexible sigmoidoscopy can help visualize the diverticula and assess the extent of the inflammation.

•   Change IV fluids to 0.9% sodium chloride with KCl: This is an anticipated action. The client is likely dehydrated due to vomiting and unable to take oral fluids, so IV hydration is necessary. The client’s potassium level is at the lower end of the normal range, so adding KCl to the IV fluids can help prevent hypokalemia.
•   Type and crossmatch blood: This is an anticipated action. The client has a positive stool occult blood test and a lower than normal hemoglobin and hematocrit, suggesting that he may be experiencing bleeding. It’s important to have blood ready for a transfusion if necessary.
•   Administer IV piperacillin-tazobactam: This is contraindicated. Piperacillin-tazobactam is a penicillin-based antibiotic, and the client has a known allergy to penicillin. Another class of antibiotics should be used. Please note that these are potential actions and the healthcare provider should be informed immediately for further evaluation and management. It’s important to continue following the provider’s prescriptions and closely monitor the client’s condition.

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Correct Answer is A

Explanation

Choice A rationale
Dumping syndrome is a condition that occurs when food moves too fast from the stomach to the duodenum, usually after a surgery to the stomach. Early signs of dumping syndrome include abdominal cramps, diarrhea, nausea, vomiting, flushing, dizziness, and rapid heart rate. One of the late symptoms of dumping syndrome is sweating. Therefore, sweating and pallor can indicate the occurrence of dumping syndrome.
Choice B rationale
Bradycardia and indigestion are not typically associated with dumping syndrome. While digestive issues can occur, they usually manifest as nausea, vomiting, and diarrhea rather than indigestion.
Choice C rationale
Dry skin and stomach pain are not typically associated with dumping syndrome. The primary symptoms of dumping syndrome are related to the digestive system and the body’s response to rapid changes in blood sugar levels.
Choice D rationale
Double vision and chest pain are not typically associated with dumping syndrome. These symptoms may be indicative of other medical conditions and should be evaluated separately

A. Intestinal obstruction. B. Fluid and electrolyte imbalance. C. Malabsorption of fat. D. Folate deficiency.

Correct Answer is B

Explanation

Choice A rationale
While intestinal obstruction can occur after any abdominal surgery, it is not the most common complication following ileostomy creation.
Choice B rationale
Fluid and electrolyte imbalance is a common complication following ileostomy surgery. This is due to the fact that the ileum, which is now rerouted to an external opening in the abdominal wall, is responsible for absorbing a significant amount of fluid and electrolytes. When it is diverted, these substances can be lost, leading to imbalances.
Choice C rationale
Malabsorption of fat is not typically a primary concern following ileostomy surgery. While malabsorption can occur in diseases affecting the ileum, it is not a direct result of the surgery itself.
Choice D rationale
Folate deficiency is not a common complication following ileostomy surgery. The terminal ileum, which is typically used to create the ileostomy, is primarily responsible for the absorption of vitamin B12, not folate.

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A nurse is caring for a 45-year-old male client in the emergency department who reports severe abdominal pain. Exhibits Based on the information provided, which of the following provider’s prescriptions are anticipated, nonessential, or contraindicated for the client? Select one response per row.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is observing a patient for the early signs and symptoms of dumping syndrome. Which symptom indicates this occurrence?

Correct Answer is A

Explanation

A patient with Crohn’s disease has recently undergone surgery to create an ileostomy. For which common complication of this type of surgery should the nurse monitor the patient in the postoperative period?

Correct Answer is B

Explanation

A nurse is collecting data from a client who is 12 hr postoperative following a colectomy with colostomy placement. Which of the following findings should the nurse report to the provider?

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The nurse is providing discharge instructions to a client who has undergone a gastrectomy. Which strategy should the nurse include in the teaching to help prevent dumping syndrome?