The nurse is assisting with the care of a client.

Exhibits

For each finding, click to specify if the finding is consistent with small bowel obstruction or acute pancreatitis. Each finding may support more than 1 disease process.

Pain level

Social history

Skin findings

Lipase level

WBC count

Abdominal findings

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A,B"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"A"}}

Pain level:

Small bowel obstruction: The client reports mid-abdominal pain, which is characteristic of small bowel obstruction as the pain is often crampy and located around the abdomen.
Acute pancreatitis: Abdominal pain is also a common symptom of acute pancreatitis, typically described as severe and persistent.

Social history:

Small bowel obstruction: Alcohol consumption is not a typical cause of obstruction.
Acute pancreatitis: Chronic alcohol use is a major risk factor for acute pancreatitis.

Skin findings:

Small bowel obstruction: Skin findings are usually unaffected.
Acute pancreatitis: In severe cases, pancreatic enzymes can leak into the skin, leading to ecchymosis (e.g., Grey Turner's or Cullen's sign). While jaundice can occur in acute pancreatitis due to bile duct obstruction, its absence does not rule out the condition.

Lipase level:

Small bowel obstruction: Lipase is generally normal.
Acute pancreatitis: Elevated lipase levels are highly indicative of acute pancreatitis.

WBC count:

Small bowel obstruction: A mild increase in WBC may occur due to bowel distension. The client’s WBC count is 9,000/mm³, which is within the normal range.
Acute pancreatitis: WBC levels are often elevated due to inflammation.

Abdominal findings:

Small bowel obstruction: Tenderness and high-pitched bowel sounds are typical signs.
Acute pancreatitis: Abdominal tenderness can also be present in acute pancreatitis, but high-pitched bowel sounds are more specific to small bowel obstruction.

Nursing Test Bank

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Correct Answer is C

Explanation

A. Keeping both arms below the level of the client's heart is not recommended for preventing lymphedema. The affected arm should be elevated when possible to reduce the risk of fluid accumulation.
B. Obtaining blood pressure readings on the affected arm is contraindicated because it can increase the risk of lymphedema.
C. Use the client's left arm to obtain blood samples: To prevent lymphedema, it's important to avoid using the affected arm (the right arm in this case) for invasive procedures like blood draws or blood pressure measurements, as this can increase the risk of lymphedema by promoting fluid retention.
D. Limiting range-of-motion exercises could impair recovery and muscle function. Early and gentle exercises should be encouraged to maintain mobility and avoid complications.

A. Replace wet clothing with warmed blankets. B. Use an axillary thermometer to monitor the client's temperature. C. Assist the client to perform range-of-motion exercises. D. Administer an antihypertensive medication.

Correct Answer is A

Explanation

A. "Replace wet clothing with warmed blankets.": Hypothermia is a significant concern after near-drowning in cold conditions. Replacing wet clothing with warmed blankets helps stabilize body temperature.
B. "Use an axillary thermometer to monitor the client's temperature.": Axillary thermometers are not accurate for hypothermic clients. Core temperature monitoring is more reliable.
C. "Assist the client to perform range-of-motion exercises.": This is not a priority in acute care following hypothermia or near-drowning.
D. "Administer an antihypertensive medication.": Hypertension is not the focus unless specific cardiovascular conditions are present.

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The nurse is assisting with the care of a client. Exhibits For each finding, click to specify if the finding is consistent with small bowel obstruction or acute pancreatitis. Each finding may support more than 1 disease process.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is postoperative following a right radical mastectomy. Which of the following actions should the nurse take to prevent the development of lymphedema?

Correct Answer is C

Explanation

A nurse at an urgent care clinic is contributing to the plan of care for a client following a near drowning while attempting to walk across a frozen pond. Which of the following interventions should the nurse recommend?

Correct Answer is A

Explanation

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The nurse is assisting with the care of a client.

Exhibits

For each finding, click to specify if the finding is consistent with small bowel obstruction or acute pancreatitis. Each finding may support more than 1 disease process.