The nurse is caring for a client with intestinal obstruction who presents with severe, colicky abdominal pain, nausea, vomiting, and abdominal distention. Which pathophysiologic mechanism supports the client's clinical presentation?
Nerve degeneration due to chronic gastric reflux.
Volvulus that occurred during an appendectomy.
Esophagitis due to reflux of gastric contents.
A history of having Helicobacter pylori infection.
The Correct Answer is B
A) Nerve degeneration due to chronic gastric reflux:
Nerve degeneration due to chronic gastric reflux may lead to conditions such as gastroesophageal reflux disease (GERD) or esophagitis, but it is not directly related to the clinical presentation of intestinal obstruction. Symptoms of GERD or esophagitis typically include heartburn, regurgitation, and dysphagia rather than severe, colicky abdominal pain, nausea, vomiting, and abdominal distention.
B) Volvulus that occurred during an appendectomy:
Correct. Volvulus refers to the twisting of a segment of the intestine around its mesentery, leading to obstruction of the bowel lumen and compromising blood flow to the affected area. In this scenario, the client's clinical presentation of severe, colicky abdominal pain, nausea, vomiting, and abdominal distention is consistent with symptoms of intestinal obstruction, which can occur secondary to volvulus. Volvulus may result from various factors, including prior abdominal surgeries, such as an appendectomy, leading to abnormal positioning or adhesions within the abdomen.
C) Esophagitis due to reflux of gastric contents:
Esophagitis due to reflux of gastric contents can cause symptoms such as heartburn, chest pain, and difficulty swallowing, but it is not typically associated with severe, colicky abdominal pain, nausea, vomiting, and abdominal distention characteristic of intestinal obstruction.
D) A history of having Helicobacter pylori infection:
Helicobacter pylori infection is associated with conditions such as peptic ulcer disease and gastritis, but it is not directly related to the clinical presentation of intestinal obstruction. Symptoms of H. pylori infection may include abdominal pain, nausea, and vomiting, but they are not typically colicky and severe as those seen in intestinal obstruction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Benign prostatic hyperplasia (BPH) is a condition characterized by non-cancerous growth of the prostate gland, leading to its enlargement. This enlargement can contribute to urinary retention by obstructing the flow of urine through the urethra. Here's the breakdown of the explanation:
A) Abnormal growth results in loss of bladder muscle tone:
While BPH can lead to urinary symptoms such as urinary frequency, urgency, and nocturia, it does not directly cause loss of bladder muscle tone. Instead, the enlarged prostate gland obstructs the bladder outlet, making it difficult for urine to pass through the urethra.
B) Inflammation causes spasms of the gland:
Inflammation of the prostate gland, known as prostatitis, can cause symptoms such as pelvic pain, dysuria, and urinary frequency, but it is not typically associated with BPH. BPH is characterized by benign growth of the prostate tissue rather than inflammation and spasms.
C) The enlarged gland compresses the urethra:
Correct. The primary mechanism by which BPH causes urinary retention is by compressing the urethra, which obstructs the flow of urine from the bladder. As the prostate gland enlarges, it can constrict the urethra, leading to symptoms such as hesitancy, weak urinary stream, incomplete emptying, and urinary retention.
D) Nerve compression decreases the sensation that the bladder is full:
While compression of nerves in the pelvic region can contribute to urinary symptoms, such as decreased sensation of bladder fullness, it is not the primary mechanism by which BPH causes urinary retention. The compression of the urethra by the enlarged prostate gland is the main factor leading to urinary obstruction and retention.
Correct Answer is C
Explanation
Smoking is a well-established risk factor for lung cancer, and the pathophysiological process underlying this association involves the exposure of the lungs to carcinogenic agents present in tobacco smoke. Here's why option C is the correct choice:
A) Vasoconstrictive properties of nicotine reduce oxygenation and stimulate metabolism:
While nicotine is a primary addictive component of tobacco smoke and can lead to vasoconstriction, reduced oxygenation, and increased metabolism, these effects primarily contribute to cardiovascular diseases associated with smoking, such as coronary artery disease and stroke, rather than the development of lung cancer.
B) Drug addiction changes the neurochemical messages in the brain causing cravings:
This statement addresses the addictive nature of nicotine and its impact on neurochemistry, leading to cravings and dependence. While addiction is a significant aspect of tobacco use, it does not directly explain the pathophysiological process by which smoking causes lung cancer.
C) Carcinogenic agents in tobacco alter cellular cytology, morphology, and function of the lung:
Correct. Tobacco smoke contains numerous carcinogenic compounds, such as polycyclic aromatic hydrocarbons (PAHs), nitrosamines, and benzene, which can directly damage the DNA of lung cells. This DNA damage can lead to mutations and alterations in cellular cytology, morphology, and function, ultimately contributing to the development of lung cancer.
D) Risk for comorbidities increase incidence of chronic diseases and decrease longevity:
While smoking is associated with an increased risk of various comorbidities and chronic diseases, such as cardiovascular diseases, respiratory diseases, and certain cancers, this option does not specifically address the pathophysiological process of lung cancer development.
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