ADVANCED MED SURG FINAL EXAM; MOST RECENT (+1000 QUESTIONS ALL ANSWERED 100% CORRECT WITH RATIONALE |VERIFIED| GUARANTEE A+ SCORE
A 54-year-old
... [Show More] critically ill patient with sepsis is frequently incontinent of watery stools. What action by the nurse will prevent complications associated with ongoing incontinence?
a. Apply incontinence briefs.
b. Use a fecal management system
c. Insert a rectal tube with a drainage bag.
d. Assist the patient to a commode frequently. {{Correct Ans- B
Which question from the nurse would help determine if a patient's abdominal pain might indicate irritable bowel syndrome?
a. "Have you been passing a lot of gas?"
b. "What foods affect your bowel patterns?"
c. "Do you have any abdominal distention?"
d. "How long have you had abdominal pain?" {{Correct Ans- D
A patient in the emergency department has just been diagnosed with peritonitis caused by a ruptured diverticulum. Which prescribed intervention will the nurse implement first?
a. Insert a urinary catheter to drainage.
b. Infuse metronidazole (Flagyl) 500 mg IV.
c. Send the patient for a computerized tomography scan.
d. Place a nasogastric (NG) tube to intermittent low suction. {{Correct Ans- B
A 25-year-old male patient calls the clinic complaining of diarrhea for 24 hours. Which action should the nurse take first?
a. Inform the patient that laboratory testing of blood and stools will be necessary.
b. Ask the patient to describe the character of the stools and any associated symptoms.
c. Suggest that the patient drink clear liquid fluids with electrolytes, such as Gatorade or Pedialyte.
d. Advise the patient to use over-the-counter loperamide (Imodium) to slow gastrointestinal (GI) motility. {{Correct Ans- B
A 45-year-old patient is admitted to the emergency department with severe abdominal pain and rebound tenderness. Vital signs include temperature 102° F (38.3° C), pulse 120, respirations 32, and blood pressure (BP) 82/54. Which prescribed intervention should the nurse implement first?
a. Administer IV ketorolac (Toradol) 15 mg.
b. Draw blood for a complete blood count (CBC).
c. Obtain a computed tomography (CT) scan of the abdomen.
d. Infuse 1 liter of lactated Ringer's solution over 30 minutes. {{Correct Ans- D Give IV solution to increase the low blood pressure due to excesses fluid loss
Four hours after a bowel resection, a 74-year-old male patient with a nasogastric tube to suction complains of nausea and abdominal distention. The first action by the nurse should be to
a. auscultate for hypotonic bowel sounds.
b. notify the patient's health care provider.
c. reposition the tube and check for placement.
d. remove the tube and replace it with a new one. {{Correct Ans- C the tube may have been misplaced and accumulation of fluid is causing the nausea and distension
A 19-year-old female is brought to the emergency department with a knife handle protruding from the abdomen. During the initial assessment of the patient, the nurse should
a. remove the knife and assess the wound.
b. determine the presence of Rovsing sign.
c. check for circulation and tissue perfusion.
d. insert a urinary catheter and assess for hematuria. {{Correct Ans- C AB C'SSSSS check the circulation before doing anything else
Which activity in the care of a 48-year-old female patient with a new colostomy could the nurse delegate to unlicensed assistive personnel (UAP)?
a. Document the appearance of the stoma.
b. Place a pouching system over the ostomy.
c. Drain and measure the output from the ostomy.
d. Check the skin around the stoma for breakdown. {{Correct Ans- C [Show Less]