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.

Exhibits

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

Answer and Explanation

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

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Naxlex Comprehensive Predictor Exams

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Free Nursing Study Resources

Correct Answer is C

Explanation

Choice A rationale: Performing active range of motion exercises may not be safe or appropriate immediately following a hemorrhagic stroke.

Choice B rationale: Maintaining the head of bed flat or at a 30-degree position might be used for ischemic strokes but not necessarily for hemorrhagic strokes.

Choice C rationale: Teaching measures to avoid the Valsalva maneuver (straining during activities like defecation) helps prevent sudden increases in intracranial pressure, which can be detrimental after a hemorrhagic stroke.

Choice D rationale: Monitoring for Battle's sign (bruising behind the ears associated with basilar skull fracture) is not relevant in the care of a hemorrhagic stroke.

A. A 60-year-old patient with diabetes who has cellulitis of the left ankle. B. A 50-year-old patient with diabetes just returned from the post-anesthesia care unit after a below-knee amputation. C. A 72-year-old patient with diabetes with diabetic ketoacidosis who is receiving IV insulin. D. A 70-year-old patient with diabetes who is showing signs of hyperglycemia.

Correct Answer is A

Explanation

Choice A rationale: Cellulitis management typically involves wound care, antibiotics, and monitoring. It's a suitable assignment for a new graduate nurse to begin learning about wound management and diabetic care.

Choice B rationale: Post-operative care for an amputation requires experience in assessing and managing post-surgical complications, which might not be suitable for a new graduate nurse.

Choice C rationale: Diabetic ketoacidosis management involves complex insulin therapy and critical care, which might be overwhelming for a new graduate nurse.

Choice D rationale: While hyperglycemia requires monitoring and intervention, the cause and severity need to be determined before assigning this patient to a new

graduate nurse.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who is admitted with a hemorrhagic stroke. Which nursing action should be included in the plan of care?

Correct Answer is C

Explanation

The RN is serving as preceptor to a new graduate nurse who has recently passed the RN licensure (NCLEX®) examination. The new nurse has only been on the unit for 2 days. Which patient should be assigned to the new graduate nurse?

Correct Answer is A

Explanation

While reviewing the clinical history of a client with brain injury, the nurse finds that there is a periorbital ecchymosis, which is referred to as raccoon eyes. The client also has leakage of cerebrospinal fluid (CSF) from the nose. Which fracture should the nurse suspect in the client?

While performing the genital assessment of a male client, a nurse observes that the client has curvature of the penis. Which condition does the nurse suspect in the client?

A client is receiving 10 mL/hr of a prescribed regular insulin infusion. The label on the bag reads 50 units of regular insulin in 100 mL of 0.9% saline. How many units of insulin is the client receiving every hour? Fill in the blank. Round your answer to the nearest whole number.

A 45-year-old man on the neurology floor can understand instructions but is unable to express himself through talking. Which lobe of the brain controls the expression of speech?

A client arrives at the clinic with his daughter, reporting memory impairments: Exhibits Which of the following clinical feature are consistent with delirium? Select all that apply?

The nurse is most likely to report which finding to the primary care provider for a client who has an established colostomy?