The nurse is caring for a client admitted with an obstruction in the duodenum. Which initial clinical manifestation is associated with this condition?

Severe abdominal distention and cramping

Vomiting of fecal material and absent bowel sounds

Ribbon-like stools and mild discomfort

Crampy abdominal pain, wavelike and colicky

Answer and Explanation

The Correct Answer is D

D. The initial clinical manifestation associated with an obstruction in the duodenum is crampy abdominal pain, wavelike, and colicky. This discomfort occurs due to the blockage of the small intestine, leading to spasms and pain as the body tries to move contents past the obstruction.
A. Severe abdominal distention and cramping can occur with various gastrointestinal conditions, including an obstruction in the duodenum. However, this manifestation is not specific to duodenal obstruction and can occur with obstructions at other locations in the gastrointestinal tract.
B. Vomiting of fecal material, known as feculent vomiting, is a hallmark sign of a complete obstruction in the lower gastrointestinal tract.
C. Ribbon-like stools are more commonly associated with conditions affecting the lower gastrointestinal tract, such as colorectal cancer or irritable bowel syndrome (IBS).

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Correct Answer is A

Explanation

A. Cleans and dries the perianal area after each diarrheal stool: This is the correct option. Effective perianal care for a client with diarrhea, such as ulcerative colitis, involves gentle cleansing and thorough drying of the perianal area after each stool. Proper hygiene helps prevent skin breakdown and irritation caused by prolonged contact with stool.
B. Alcohol can be irritating to the skin and may exacerbate perianal irritation and discomfort. Therefore, using alcohol compresses is not considered an appropriate perianal care practice.
C. While antidiarrheal medications may be prescribed for clients with ulcerative colitis to help manage symptoms, asking for medication after each stool is not a typical or recommended approach. The frequency and timing of antidiarrheal medication administration should be based on healthcare provider recommendations and individual symptom management plans.
D. While Sitz baths can provide relief from perianal discomfort and promote healing, taking an hour-long Sitz bath after each stool may be impractical and excessive. Sitz baths are typically recommended for shorter durations (e.g., 10-20 minutes) and may be used periodically rather than after every stool.

A. Pencil-thin stools B. Fecal-smelling breath C. Passage of mucus and blood in stools D. Absent bowel sounds and absent passage of flatus

Correct Answer is D

Explanation

D. In paralytic ileus, there is a lack of bowel motility, resulting in absent or diminished bowel sounds on auscultation and absent passage of flatus. The bowel sounds may be hypoactive or completely absent due to the lack of peristalsis. Additionally, the client may experience abdominal distention and discomfort due to the accumulation of gas and fluid in the intestines.
A. Pencil-thin stools are more commonly associated with conditions such as colorectal cancer or rectal strictures. In paralytic ileus, where there is a lack of bowel motility, the stools are typically absent rather than thin.
B. Fecal-smelling breath is not a typical finding in paralytic ileus. While it may occur in conditions associated with severe constipation or bowel obstruction, it is not specific to paralytic ileus.
C. Passage of mucus and blood in stools is not a characteristic finding of paralytic ileus. It is more commonly associated with conditions such as inflammatory bowel disease or colorectal cancer.

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The nurse is caring for a client admitted with an obstruction in the duodenum. Which initial clinical manifestation is associated with this condition?

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Naxlex Comprehensive Predictor Exams

The nurse identifies a client problem of impaired skin integrity related to diarrhea for a client who has ulcerative colitis. The nurse recognizes that teaching about perianal care has been effective when the client:

Correct Answer is A

Explanation

A nurse is caring for a client diagnosed with a paralytic ileus. What would be an expected assessment finding?

Correct Answer is D

Explanation

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