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.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. Restlessness can occur with electrolyte imbalances or hypoxia, but it is not a hallmark of low albumin or protein malnutrition.
B. Low serum albumin and total protein decrease plasma oncotic pressure, allowing fluid to shift from the vascular space into interstitial tissues, leading to peripheral and sometimes generalized edema (anasarca).
C. Pallor is more indicative of anemia, which may coexist but is not a direct effect of hypoalbuminemia.
D. Confusion can result from electrolyte disturbances, hypoxia, or hepatic encephalopathy, but it is not a direct manifestation of low albumin.
Correct Answer is C
Explanation
Rationale:
A. Magnesium levels may actually drop, not rise, during refeeding syndrome due to intracellular shifts.
B. Calcium levels are typically not elevated as a direct result of refeeding syndrome.
C. Refeeding syndrome occurs when malnourished patients receive rapid carbohydrate reintroduction, triggering insulin release. This drives phosphate, potassium, and magnesium into cells, with phosphate depletion being the hallmark and most clinically significant electrolyte disturbance. Hypophosphatemia can cause muscle weakness, respiratory failure, and cardiac dysfunction.
D. Sodium levels may fluctuate, but hyponatremia is not the primary concern in refeeding syndrome.
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