Nursing Elites

1. A nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis. The client is scheduled for surgery in 2 hours. The client begins to complain of increased abdominal pain and begins to vomit. On assessment the nurse notes that the abdomen is distended and the bowel sounds are diminished. Which of the following is the most appropriate nursing intervention?

• A. Administer dilaudid
• B. Notify the physician
• C. Call and ask the operating room team to perform the surgery as soon as possible
• D. Reposition the client and apply a heating pad on a warm setting to the client’s abdomen.

Correct answer: B

Rationale: The symptoms suggest possible perforation or peritonitis, which are serious complications requiring immediate medical attention. The nurse should promptly notify the physician.

2. The client being seen in a physician’s office has just been scheduled for a barium swallow the next day. The nurse writes down which of the following instructions for the client to follow before the test?

• A. Fast for 8 hours before the test.
• B. Eat a regular supper and breakfast.
• C. Continue to take all oral medications as scheduled.
• D. Monitor own bowel movement pattern for constipation

Correct answer: A

Rationale: A barium swallow is an x-ray study that uses a substance called barium for contrast to highlight abnormalities in the gastrointestinal tract. The client should fast for 8 to 12 hours before the test, depending on physician instructions. Most oral medications also are withheld before the test. After the procedure the nurse must monitor for constipation, which can occur as a result of the presence of barium in the gastrointestinal tract.

3. Colon cancer is most closely associated with which of the following conditions?

• A. Appendicitis
• B. Hemorrhoids
• C. Hiatal hernia
• D. Ulcerative colitis

Correct answer: D

Rationale: Ulcerative colitis is a condition closely associated with an increased risk of developing colon cancer due to chronic inflammation of the colon.

4. Which of the following complications is thought to be the most common cause of appendicitis?

• A. A fecalith
• B. Bowel kinking
• C. Internal bowel occlusion
• D. Abdominal bowel swelling

Correct answer: A

Rationale: A fecalith is a hardened stool that can block the appendix, leading to inflammation and infection, which is the most common cause of appendicitis.

5. You’re performing an abdominal assessment on Brent who is 52 y.o. In which order do you proceed?

• A. Observation, percussion, palpation, auscultation
• B. Observation, auscultation, percussion, palpation
• C. Percussion, palpation, auscultation, observation
• D. Palpation, percussion, observation, auscultation

Correct answer: B

Rationale: The correct order for performing an abdominal assessment is observation, auscultation, percussion, and palpation.

Similar Questions