The nurse is caring for an older adult in the medical-surgical unit:
84-year-old female was admitted to the medical-surgical unit with a three-day history of abdominal pain, distention, nausea, and persistent vomiting. She reports that she has not had a bowel movement in five days and has no appetite.
Which of the following findings are consistent with a small bowel obstruction: Select all that apply.
Right lower quadrant abdominal pain
Fever
Nausea and vomiting
Unable to pass stool
distended abdomen
Correct Answer : C,D,E
Choice A rationale: Small bowel obstructions typically present with diffuse, crampy abdominal pain rather than localized pain in the right lower quadrant.
Choice B rationale: While fever can be present in some cases, it's not a consistent finding with small bowel obstruction unless there's perforation.
Choice C rationale: Common symptoms of small bowel obstruction due to the buildup of contents proximal to the obstruction.
Choice D rationale: A key feature of small bowel obstruction due to the blockage preventing normal bowel movements.
Choice E rationale: Accumulation of gas and fluid above the obstruction causes abdominal distention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale: Gastrointestinal reflux disease is not typically a contraindication for sumatriptan.
Choice B rationale: Mild emphysema is not typically a contraindication for sumatriptan.
Choice C rationale: Hyperthyroidism is not typically a contraindication for sumatriptan.
Choice D rationale: Sumatriptan, a medication used for migraines, may elevate blood pressure, so it would be questionable for a client with hypertension.
Correct Answer is ["B","C","D","E"]
Explanation
Choice A rationale: A/V fistula assessment is not concerning because a positive bruit and thrill indicate adequate blood flow through the fistula. A dry dressing with scant amount of blood is expected after hemodialysis.
Choice B rationale: The client's low blood pressure could indicate hypotension, which can be critical, especially after hemodialysis. It may contribute to the client's reported dizziness and fatigue.
Choice C rationale: The client’s pulse is irregular which may indicate cardiac arrhythmia. Choice D rationale: Anuria, the absence of urine output, is a significant concern. It could indicate kidney dysfunction or inadequate clearance of waste products, which may have implications following hemodialysis.
Choice E rationale: Oxygen saturation at 92% is relatively low. While the client is alert and oriented, a low oxygen saturation level may indicate potential respiratory compromise or inadequate oxygenation.
Choice F rationale: Temperature is not concerning because it is within normal range.
Choice G rationale: Neurological assessment is not concerning because the client is alert and oriented. The dizziness is likely related to the hypotension and will resolve once the blood pressure is stabilized.
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