What is a likely finding in the nurse's assessment of a patient who has a large bowel obstruction?
Projectile vomiting
Abdominal distention
Metabolic alkalosis
Referred back pain
The Correct Answer is B
Rationale:
A. Vomiting is more common in small bowel obstruction and is usually less severe in large bowel obstruction.
B. A large bowel obstruction causes accumulation of gas and fecal material proximal to the blockage, leading to significant abdominal distention.
C. Large bowel obstruction may eventually cause metabolic acidosis due to impaired perfusion and tissue hypoxia, not alkalosis.
D. Back pain is not a typical sign of large bowel obstruction; the primary symptom is abdominal discomfort, distention, and constipation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Hypertonic solutions, like TPN with 25% dextrose, can irritate peripheral veins and cause phlebitis. Administering them through a central line allows rapid dilution in a large volume of blood, reducing vein irritation and promoting safe infusion.
B. Blood glucose monitoring is not dependent on the line type; it is done via peripheral blood samples.
C. The infusion rate is determined by the prescribed therapy, not by whether a central line is used.
D. Central lines do not decrease the risk of infection; in fact, they carry a higher risk of central line–associated bloodstream infections compared with peripheral lines.
Correct Answer is B
Explanation
Rationale:
A. This occurs when there is hypoventilation, leading to elevated PaCO2 and decreased pH. In this case, the PaCO2 is low (32 mm Hg) and the pH is high (7.48), so this is not consistent with respiratory acidosis.
B. The high pH (7.48) indicates alkalosis, and the low PaCO2 (32 mm Hg) shows that the alkalosis is caused by excessive exhalation of CO2, characteristic of respiratory alkalosis. The HCO3 is normal, indicating the kidneys have not yet compensated.
C. Metabolic acidosis is characterized by a low pH and low HCO3. Here, the pH is elevated and HCO3 is normal, so this is not consistent with metabolic acidosis.
D. Metabolic alkalosis would present with high pH and elevated HCO3, often due to vomiting or diuretic use. In this scenario, HCO3 is normal, indicating the alkalosis is not metabolic in origin.
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