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 C
Explanation
Choice A reason: Neuroticism is a personality trait characterized by anxiety, fear, moodiness, worry, envy, frustration, jealousy, and loneliness. It does not involve pretending to be ill.
Choice B reason: Psychosis refers to a mental disorder in which thought and emotions are so impaired that contact is lost with external reality. It is not associated with deliberately pretending to be ill.
Choice C reason: Malingering is the act of exaggerating or feigning illness for a secondary gain, such as financial compensation or avoidance of work.
Choice D reason: Hypochondriasis is a condition in which a person is excessively and unduly worried about having a serious illness. It does not involve deliberately pretending to be ill.
Correct Answer is A
Explanation
Choice A reason: A positive pregnancy test is a significant concern for a patient preparing for surgery as it can affect the type of anesthesia used and the surgical approach, due to the potential impact on the fetus.
Choice B reason: While a family history of hypertension is important, it is not as immediately concerning as a positive pregnancy test in a patient preparing for surgery.
Choice C reason: A signed advance directive is a document that outlines a patient's wishes regarding medical treatment and is not a concern but rather a part of preoperative preparation.
Choice D reason: A medical history of diabetes is important to consider in surgical patients due to potential complications with wound healing and blood glucose control, but it is not as urgent as confirming pregnancy status before surgery.
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