The nurse is assessing a client who has a large bowel obstruction. Which late clinical finding would the nurse expect?

Loops of large bowel become visibly outlined through the abdominal wall

Intense thirst, parched tongue and dry mucous membranes

Vomiting of bile-stained gastric contents

High-pitched, frequent bowel sounds

Answer and Explanation

The Correct Answer is A

A. Loops of large bowel become visibly outlined through the abdominal wall is a typical late clinical finding of a large bowel obstruction. In fact, visible loops of bowel through the abdominal wall may be observed in cases of a severe bowel obstruction, but it is not typically considered a late finding.

B. Intense thirst, parched tongue, and dry mucous membranes suggest dehydration, which can occur as a result of vomiting, decreased fluid intake, or fluid loss due to the obstruction. However, dehydration may occur earlier in the course of a bowel obstruction and may not be considered a late finding.
C. Vomiting in large bowel obstruction is commonly of fecal contents.
D. High-pitched, frequent bowel sounds is not a typical late clinical finding of a large bowel obstruction. Instead, bowel sounds are usually diminished or absent in cases of bowel obstruction due to decreased peristalsis beyond the site of obstruction.

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Correct Answer is B

Explanation

B. It is essential to complete the full course of antibiotics as prescribed by the healthcare provider, even if symptoms improve before the course is finished. This ensures that all bacteria causing the infection are eradicated, reducing the risk of recurrence and development of antibiotic resistance.
A. Antibiotics should be taken exactly as prescribed and for the full duration of the treatment course. Incomplete or inconsistent use of antibiotics can lead to incomplete eradication of the infection, development of antibiotic resistance, and recurrence of the infection.
C. While cranberry juice is often recommended for urinary tract health due to its ability to prevent bacterial adherence to the bladder wall, it is not a substitute for antibiotics in treating urinary tract infections.
D. Typically, urine cultures are reserved for cases where the diagnosis is uncertain, or the infection is recurrent or complicated. In uncomplicated UTIs, empirical antibiotic treatment based on symptoms and clinical presentation is usually sufficient.

A. Chronic pain B. Impaired urinary elimination C. Risk for bleeding D. Risk for urinary tract injury

Correct Answer is B

Explanation

B. Impaired urinary elimination: This is the priority problem for a client diagnosed with BPH. BPH commonly obstructs the flow of urine out of the bladder, leading to symptoms such as urinary hesitancy, weak urinary stream, incomplete emptying, and urinary retention. Addressing impaired urinary elimination is crucial to prevent complications such as urinary retention, urinary tract infections, and kidney damage.

A. While BPH can cause symptoms such as urinary hesitancy, frequency, urgency, and incomplete emptying, chronic pain is not typically a primary symptom of BPH itself. However, complications of BPH, such as urinary retention or urinary tract infections, may cause discomfort or pain. Addressing pain related to complications of BPH is important but may not be the priority in all cases.
C. While BPH itself does not typically increase the risk of bleeding, procedures used to diagnose or treat BPH, such as transurethral resection of the prostate (TURP), may carry a risk of bleeding. However, this risk is usually managed intraoperatively and postoperatively by healthcare providers. In the absence of specific interventions or procedures with bleeding risks, addressing bleeding may not be the priority for a client with BPH.
D. Urinary tract injury, particularly during surgical procedures to treat BPH, is a potential complication. However, it may not be the priority problem in the absence of planned interventions or procedures.

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