The nurse is caring for a client on the third day following abdominal surgery and assesses the absence of bowel sounds, abdominal distention, and the client passing no flatus. These findings indicate the client is experiencing which of the following postoperative complications?
Fecal impaction
Incisional infection
Health care-associated Clostridium difficile
Paralytic ileus
The Correct Answer is D
Choice A reason: Fecal impaction typically presents with the inability to pass stool and may not be associated with the absence of bowel sounds.
Choice B reason: Incisional infection is usually indicated by localized redness, warmth, and possible discharge, not necessarily by the absence of bowel sounds or flatus.
Choice C reason: Health care-associated Clostridium difficile often presents with diarrhea, not the absence of bowel sounds or flatus.
Choice D reason: Paralytic ileus is characterized by impaired intestinal motility and transit, absence of the passage of flatus, diminished bowel sounds, abdominal distension, and intestinal dilatation, fitting the symptoms described.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: While providing information on stress reduction is helpful, it is not the immediate priority.
Choice B reason: Assisting the client to identify triggers is a priority as it directly addresses the cause of the OCD behaviors.
Choice C reason: Speaking to the client in a calm manner is supportive but does not address the underlying OCD behaviors.
Choice D reason: Identifying anxiety levels can be part of the intervention, but it is not as specific as identifying triggers for the OCD behaviors.
Correct Answer is B
Explanation
Choice A reason: While patients with HbA1c levels below 6% are generally considered to have good glycemic control, this does not guarantee they will be free from complications.
Choice B reason: Diabetes complications often involve vascular issues, affecting both large (macrovascular) and small (microvascular) blood vessels, leading to a range of complications such as cardiovascular disease and neuropathy.
Choice C reason: Chronic hypoglycemia can lead to various health issues, but it is not typically classified as a long-term complication of diabetes. Instead, it is a risk associated with diabetes management, particularly with insulin use.
Choice D reason: Both Type 1 and Type 2 diabetics are at risk for complications. Tight glycemic control can reduce the risk, but it does not eliminate it, and Type 1 diabetics are not necessarily at the greatest risk.
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