A nurse is contributing to the plan of care of a client who has a small bowel obstruction. Which of the following interventions should the nurse include?

Provide bulk-forming agent.

Elevate the head of the bed.

Measure abdominal girth daily.

Monitor intake and output every 8 hr.

Answer and Explanation

The Correct Answer is B

Choice A: Provide bulk-forming agent. This is incorrect because bulk-forming agents are used to treat constipation, not bowel obstruction. They can worsen the obstruction by increasing the stool volume and pressure in the bowel.

Choice B: Elevate the head of the bed. Elevating the head of the bed is an important intervention for clients with a small bowel obstruction. It can help reduce abdominal pressure, promote comfort, and facilitate better respiratory function, especially if the client is experiencing any associated nausea or vomiting. This position can also aid in the proper positioning of the intestines, potentially helping with any non-complicated obstructions.

Choice D: Monitor intake and output every 8 hr. This is incorrect because monitoring intake and output is not enough to assess the ﬂuid and electrolyte balance of a client with a bowel obstruction. The nurse should monitor intake and output more frequently, such as every 4 hr or every shift, and report any signs of dehydration or imbalance.

Choice C: Measure abdominal girth daily. While this is an important assessment for monitoring the status of the obstruction, the immediate intervention of elevating the head of the bed can provide immediate comfort and support during the acute phase of the obstruction.

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Correct Answer is B

Explanation

Choice A reason: Shock is not a cause of acute pancreatitis, but a possible complication of severe cases that can lead to organ failure and death.

Choice B reason: Gallstones are one of the major causes of acute pancreatitis, as they can block the pancreatic duct and prevent the ﬂow of digestive enzymes, leading to inﬂammation and damage of the pancreas.

Choice C reason: Diabetes mellitus is not a cause of acute pancreatitis, but a possible complication of chronic pancreatitis, as the damage to the pancreas can impair its ability to produce insulin and regulate blood sugar levels.

Choice D reason: GERD (gastroesophageal reﬂux disease) is not a cause of acute pancreatitis, but a condition that aﬀects the lower esophageal sphincter and allows stomach acid to reﬂux into the esophagus, causing heartburn and other symptoms.

A. “I should avoid injecting insulin into my thigh if I am going to go running.” B. “I will carry a complex carbohydrate snack with me when I exercise.” C. “I should exercise first thing in the morning before eating breakfast.” D. “I will increase the intensity of my exercise routine if my urine is positive for ketones.”

Correct Answer is A

Explanation

Choice A reason: Injecting insulin into a muscle that is going to be exercised can increase the absorption of insulin and lower the blood glucose level, leading to hypoglycemia. Therefore, it is advisable to avoid injecting insulin into the same body part that will be involved in the exercise.

Choice B reason: Carrying a complex carbohydrate snack with you when you exercise is not a good idea. Complex carbohydrates take longer to digest and raise the blood glucose level slowly. They are not suitable for treating or preventing hypoglycemia during or after exercise. A simple carbohydrate snack, such as glucose tablets, juice or candy, is more appropriate for this purpose.

Choice C reason: Exercising first thing in the morning before eating breakfast is not recommended for people with type 1 diabetes. This can cause a drop in blood glucose level and increase the risk of hypoglycemia. It is beter to have a balanced breakfast that includes some carbohydrates and adjust the insulin dose accordingly before exercising.

Choice D reason: Increasing the intensity of your exercise routine if your urine is positive for ketones is a dangerous practice. Ketones are produced when the body breaks down fat for energy due to lack of insulin or glucose. High levels of ketones can lead to diabetic ketoacidosis, a life-threatening condition that requires urgent medical atention. Intense exercise can raise the blood glucose level further and worsen the situation. If your urine is positive for ketones, you should avoid vigorous activity and check your blood glucose and ketone levels frequently.

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A nurse is contributing to the plan of care of a client who has a small bowel obstruction. Which of the following interventions should the nurse include?

Nursing Test Bank

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Correct Answer is A

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