What is an appropriate diagnostic study for abdominal pain described as distended, bloated, that is improved after flatulence possibly related to large bowel obstruction?
Endoscopy
Colonoscopy
Ultrasound
KUB
The Correct Answer is D
Rationale:
A. Used to visualize the upper gastrointestinal tract (esophagus, stomach, duodenum). It does not provide information about bowel obstruction in the large intestine.
B. Allows direct visualization of the colon mucosa but is not typically used initially in suspected acute bowel obstruction due to the risk of perforation.
C. Useful for evaluating gallbladder, liver, kidneys, and sometimes bowel, but it is less sensitive for detecting large bowel obstruction.
D. A plain abdominal X-ray (KUB) is often the first-line diagnostic study for suspected large bowel obstruction. It can show dilated bowel loops, air-fluid levels, and fecal loading, which correlate with the patient’s symptoms of bloating, distention, and relief after flatulence.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Hematemesis (vomiting blood) indicates active gastrointestinal bleeding, which can lead to hypovolemic shock and is a life-threatening complication of peptic ulcer disease. It is therefore the priority assessment finding.
B. Dyspepsia (indigestion) is a common symptom of peptic ulcer disease but is not immediately life-threatening.
C. Epigastric discomfort is a typical symptom but is less urgent compared to active bleeding.
D. Constipation is a non-specific gastrointestinal symptom and does not pose an immediate threat in peptic ulcer disease.
Correct Answer is ["A","B","C","E"]
Explanation
Rationale:
A. Tap water enemas are hypotonic, and repeated or large-volume use can lead to hyponatremia or other electrolyte disturbances, particularly in infants, elderly clients, or those with renal or cardiac issues.
B. Administering a tap water enema in a client with suspected appendicitis can increase intra-abdominal pressure, potentially causing perforation or worsening the condition.
C. Tap water enemas can further disrupt fluid and electrolyte balance in clients who are already dehydrated, exacerbating their condition.
D. Regular use of laxatives is not a strict contraindication for a tap water enema but may reduce its effectiveness over time due to bowel adaptation.
E. Clients with recent bowel surgery or structural abnormalities are at higher risk for perforation or injury when receiving an enema.
F. Tap water enemas are not indicated for clients with normal bowel function because they are unnecessary and can cause discomfort or dependence.
G. While maintaining hydration is important, it does not contraindicate the use of a tap water enema; it may actually support bowel function.
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