A nurse is caring for a client diagnosed with peptic ulcer disease. The nurse should monitor the client for which of the following findings as an indication of gastrointestinal perforation?
Bradycardia
Hyperactive bowel sounds
Increased blood pressure
Sudden abdominal pain
The Correct Answer is D
A. Bradycardia is not typically associated with gastrointestinal perforation. Instead, tachycardia may be observed due to the body's response to a potential emergency or shock.
B. Hyperactive bowel sounds are not typically associated with gastrointestinal perforation. In fact, bowel sounds may decrease or become absent in severe cases of peritonitis or abdominal emergencies.
C. Increased blood pressure is not typically associated with gastrointestinal perforation. Hypotension may be observed due to hypovolemia resulting from fluid leakage into the peritoneal cavity.
D. Sudden abdominal pain is a key clinical manifestation of gastrointestinal perforation. The perforation of the stomach or intestines allows the contents to leak into the abdominal cavity, leading to peritonitis. Sudden and severe abdominal pain is a hallmark symptom, often described as sharp, stabbing, and constant.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Autocratic:
Autocratic leadership involves making decisions without seeking input from others. In this scenario, the charge nurse is eliciting opinions from all group members and organizing a vote, which suggests a more collaborative approach rather than a purely autocratic one.
B. Scientific:
Scientific leadership, often associated with Frederick Taylor's principles of scientific management, involves using data and analysis to make decisions. The scenario does not provide information suggesting a strong emphasis on scientific principles in the decision-making process.
C. Democratic:
Democratic leadership involves including team members in decision-making, seeking their opinions, and often using a voting or consensus-building approach. The charge nurse's approach of eliciting opinions and organizing a vote aligns with democratic leadership.
D. Laizzez-faire:
Laissez-faire leadership involves a hands-off approach, where the leader allows group members considerable freedom to make decisions. In the scenario, the charge nurse is actively seeking input and organizing a vote, which is more indicative of a democratic style rather than laissez-faire.
Correct Answer is D
Explanation
A. Bradycardia is not typically associated with gastrointestinal perforation. Instead, tachycardia may be observed due to the body's response to a potential emergency or shock.
B. Hyperactive bowel sounds are not typically associated with gastrointestinal perforation. In fact, bowel sounds may decrease or become absent in severe cases of peritonitis or abdominal emergencies.
C. Increased blood pressure is not typically associated with gastrointestinal perforation. Hypotension may be observed due to hypovolemia resulting from fluid leakage into the peritoneal cavity.
D. Sudden abdominal pain is a key clinical manifestation of gastrointestinal perforation. The perforation of the stomach or intestines allows the contents to leak into the abdominal cavity, leading to peritonitis. Sudden and severe abdominal pain is a hallmark symptom, often described as sharp, stabbing, and constant.
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