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Ati lpn Med Surg exam1
Total Questions : 50
Showing 10 questions, Sign in for more- The client has a history of diverticulitis and is allergic to penicillin. The client states that the pain started yesterday and has been worsening. He also reports nausea and vomiting, and he is unable to eat or drink anything without vomiting.
- Client presents with left lower quadrant (LLQ) pain, rated 9 on a 0 to 10 pain scale.
- Client is nauseous and has vomited twice since arrival.
- Client states he has not had a bowel movement in two days.
- Abdomen is distended and tender to palpation in the LLQ.
- Bowel sounds are hypoactive in all four quadrants.
- Client is oriented to person, place, and time.
- Client is able to move all extremities without difficulty.
• Temperature: 37.4°C (99.3°F)
• Heart rate: 100/min
• Respiratory rate: 20/min
• Blood pressure: 148/76 mm Hg
• Oxygen saturation: 97% on room air
• Sodium: 140 mEq/L (136-145 mEq/L)
• Potassium: 3.5 mEq/L (3.5-5.0 mEq/L)
• BUN: 19 mg/dL (10-20 mg/dL)
• Creatinine: 1.1 mg/dL (0.6-1.3 mg/dL)
• White Blood Cell Count: 28,000/mm³ (5,000-10,000/mm³)
• Red Blood Cell Count: 4.8 million/mm³ (4.7-6.1 million/mm³)
• Hemoglobin: 12 g/dL (14-18 g/dL)
• Hematocrit: 37% (42%-52%)
• Platelet Count: 230,000/mm³ (150,000-400,000/mm³)
• Stool for Occult Blood: positive
A nurse is caring for a 45-year-old male client in the emergency department who reports severe abdominal pain.
Based on the information provided, which of the following provider’s prescriptions are anticipated, nonessential, or contraindicated for the client? Select one response per row.
Explanation
• Increase fiber intake: This is nonessential at this time. While a high-fiber diet can help prevent future episodes of diverticulitis, it won’t help in the acute phase, especially when the client is unable to eat or drink without vomiting.
• CT of the abdomen with contrast: This is an anticipated action. A CT scan can help confirm the diagnosis of diverticulitis and assess the severity of the condition.
• Flexible sigmoidoscopy: This is an anticipated action. A flexible sigmoidoscopy can help visualize the diverticula and assess the extent of the inflammation.
• Change IV fluids to 0.9% sodium chloride with KCl: This is an anticipated action. The client is likely dehydrated due to vomiting and unable to take oral fluids, so IV hydration is necessary. The client’s potassium level is at the lower end of the normal range, so adding KCl to the IV fluids can help prevent hypokalemia.
• Type and crossmatch blood: This is an anticipated action. The client has a positive stool occult blood test and a lower than normal hemoglobin and hematocrit, suggesting that he may be experiencing bleeding. It’s important to have blood ready for a transfusion if necessary.
• Administer IV piperacillin-tazobactam: This is contraindicated. Piperacillin-tazobactam is a penicillin-based antibiotic, and the client has a known allergy to penicillin. Another class of antibiotics should be used. Please note that these are potential actions and the healthcare provider should be informed immediately for further evaluation and management. It’s important to continue following the provider’s prescriptions and closely monitor the client’s condition.
A client with hepatitis has contracted the infection from contaminated food. Which type of hepatitis is this client most likely experiencing?
A nurse is assisting in the plan of care for a client who had surgery for a bowel obstruction. The client has a nasogastric tube in place.Which of the following actions should the nurse include in the client’s plan of care? (Select all that apply)
The nurse is caring for a client who received a new diet prescription from the physician for nothing by mouth (NPO) except ice chips.
Which actions would the nurse take to alleviate the effects of dehydration? Select all that apply
A nurse is collecting data from a client who is 12 hr postoperative following a colectomy with colostomy placement. Which of the following findings should the nurse report to the provider?
A nurse in a provider’s office is reviewing the health histories of four clients.
For which of the following clients should the nurse anticipate scheduling a colonoscopy?
The nurse is preparing to perform an abdominal examination. Which step would be taken first?
A nurse is collecting data from a client who has been taking omeprazole for the past 4 weeks.
The nurse determines that the medication is effective when the client reports relief from which of the following symptoms?
The nurse provides education for a patient about the treatment for acute gastritis. Which patient statement requires correction by the nurse?
A nurse is assisting with the plan of care for a client who had an upper endoscopy 1 hr ago. The nurse should place the priority on monitoring which of the following?
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