Exhibits

Review H and P, nurse's note, laboratory results, and flow sheet.

Complete thee diagram by dragging from the choices area to specify which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.

Answer and Explanation

The Correct Answer is []

Small intestinal obstruction is indicated by the client’s abdominal distension, absence of bowel sounds, refusal to eat, and episodes of vomiting. The laboratory results show metabolic acidosis (HCO3 of 16 mEq), which can be associated with a bowel obstruction.
Placing a nasogastric tube helps decompress the stomach and relieve pressure caused by the obstruction, while giving IV fluids helps to prevent dehydration and electrolyte imbalances that can occur with vomiting and obstruction.
Monitoring signs and symptoms of dehydration is crucial as the client has been vomiting and may not be able to maintain adequate fluid intake. Monitoring temperature is also essential to detect any signs of infection or complications related to the obstruction.

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Correct Answer is B

Explanation

A. Increasing intestinal peristalsis is not a primary goal related to managing a hiatal hernia. While peristalsis is important for digestion, the focus should be on the esophagus and stomach.
B. Preventing esophageal reflux is the main goal for clients with a hiatal hernia, especially sliding type, as the hernia can cause the stomach to push into the esophagus, leading to reflux symptoms. Strategies to prevent reflux may include dietary modifications and positioning.
C. Promoting effective swallowing may be important in some contexts, but it is not a primary goal associated with managing a hiatal hernia.
D. Maintaining intact oral mucosa is generally a broader nursing goal and not specific to the management of a hiatal hernia. The focus should be on preventing reflux rather than oral mucosa integrity in this case.

A. Use salt tablets after strenuous exercise. B. Drink plenty of water whenever thirsty. C. Monitor daily urine output volume. D. Review food labels for sodium content.

Correct Answer is D

Explanation

A. Use salt tablets after strenuous exercise is incorrect. Clients with hypernatremia should avoid excessive sodium intake, including salt tablets, as this can worsen the condition.

B. Drink plenty of water whenever thirsty is incorrect. Thirst is a late sign of dehydration, and clients with hypernatremia should be encouraged to drink water regularly, even before feeling thirsty, to maintain proper hydration and correct sodium imbalances.

C. Monitor daily urine output volume is incorrect. While monitoring fluid balance is important, urine output alone does not directly address sodium intake or management, making reviewing food labels for sodium content a more critical intervention.

D. Review food labels for sodium content is correct. Clients with hypernatremia should limit sodium intake by carefully reading food labels and avoiding processed, canned, and fast foods that are high in sodium.

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Naxlex Comprehensive Predictor Exams

The nurse is planning care for a client with a direct (sliding) hiatal hernia. Nursing actions should be planned to meet which goal?

Correct Answer is B

Explanation

Which instruction should the nurse include in the discharge teaching plan for an adult client with hypernatremia?

Correct Answer is D

Explanation

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