The nurse is caring for a 52-year-old male patient with a bowel obstruction. Which of these signs would be the earliest indicator to the nurse that the patient is developing symptoms of shock?

Urine output 18 mL/hr.

Blood pressure 88/50 mmHg.

Lethargy.

Pulse 110 bpm.

Answer and Explanation

The Correct Answer is A

Choice A reason: A urine output of 18 mL/hr is significantly lower than the normal range (typically around 0.5-1 mL/kg/hr), indicating possible renal hypoperfusion, an early sign of shock.

Choice B reason: While blood pressure is an important indicator, it may not drop until later stages of shock.

Choice C reason: Lethargy can be a sign of shock, but it is a more subjective and later symptom compared to the objective measure of urine output.

Choice D reason: An elevated pulse is a compensatory mechanism in shock, but it is not as specific an early indicator as a decrease in urine output.

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Correct Answer is C

Explanation

Choice A reason: Using the incentive spirometer is important, but it is not specifically related to deep breathing and coughing exercises.

Choice B reason: Breathing deeply and coughing every 4 hours is part of postoperative care, but it does not indicate understanding of the technique to protect the incision.

Choice C reason: Splinting the incision with a pillow while coughing is a recommended technique to support the incision and reduce pain during coughing, indicating an understanding of the instructions.

Choice D reason: Lying flat is not recommended for deep breathing and coughing exercises as it can inhibit lung expansion and is not conducive to effective coughing.

A. Patients with HbA1c levels below 6% are less likely to experience complications. B. Most complications involve either the large or tiny vessels of the body. C. Chronic hypoglycemia causes a variety of serious complications. D. Type 1 diabetics are at greatest risk for complications even with tight control.

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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The nurse is caring for a 52-year-old male patient with a bowel obstruction. Which of these signs would be the earliest indicator to the nurse that the patient is developing symptoms of shock?

Nursing Test Bank

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