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. Bowel sounds are typically present and indicate normal gastrointestinal motility. A change from normoactive (normal) to absent bowel sounds can indicate bowel obstruction, perforation, or peritonitis, which are serious complications of diverticulitis. This change warrants immediate reporting to the physician as it may indicate a worsening condition requiring urgent intervention.
A. A temperature of 101.2°F (38.4°C) is slightly elevated and may indicate the presence of infection, which is concerning in the context of diverticulitis. Fever is a common symptom of diverticulitis, but an elevated temperature may also suggest worsening infection or the development of complications such as abscess formation or perforation.
C. Left lower quadrant discomfort is a common symptom of diverticulitis due to inflammation in the sigmoid colon, where diverticula are most prevalent. While discomfort is expected in diverticulitis, the severity and persistence of pain should be assessed.
D. An elevated white blood cell (WBC) count is indicative of inflammation or infection and is commonly seen in diverticulitis. However, the significance of the elevation depends on the degree of increase and the presence of other clinical findings.

A. Lower abdominal pain B. Joint stiffness C. Chest pain D. Frequent urination

Correct Answer is C

Explanation

C. Chest pain is a common symptom of esophageal ulcers. The chest pain associated with esophageal ulcers can vary in intensity and may be described as burning, gnawing, or sharp. The pain may worsen with swallowing and may be relieved by antacids or other medications that reduce stomach acid.
A. Lower abdominal pain is not a common symptom of esophageal ulcers. Esophageal ulcers typically present with symptoms localized to the chest and upper abdomen, such as chest pain or epigastric discomfort.
B. Joint stiffness is not typically associated with esophageal ulcers. Joint stiffness may occur in conditions such as arthritis but is not a characteristic symptom of esophageal ulcers.
D. Frequent urination is not typically associated with esophageal ulcers. This symptom may be indicative of urinary tract infections, diabetes, or other urinary system disorders but is not directly related to esophageal ulcers.

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

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