A burse is assessing a client who is 3 days postoperative and has a nonmechanical obstruction of the small bowel. Which of the following findings should the nurse expect?

Metabolic acidosis

Hyperactive bowel sounds

Distended abdomen

Passing flatus

Answer and Explanation

The Correct Answer is C

A. Metabolic acidosis: Small bowel obstructions are more commonly associated with metabolic alkalosis due to loss of gastric contents from vomiting. Acidosis is less typical in the early stages of obstruction.
B. Hyperactive bowel sounds: In nonmechanical (paralytic ileus) obstruction, bowel sounds are usually absent or hypoactive, not hyperactive, due to lack of peristalsis. Hyperactive sounds are more typical in early mechanical obstruction.
C. Distended abdomen: Abdominal distention is a classic sign of bowel obstruction, resulting from gas and fluid accumulation above the site of obstruction. It is expected in both mechanical and nonmechanical types.
D. Passing flatus: The absence of flatus is common in bowel obstruction, as bowel movement is halted. Continued passage of flatus would suggest partial or resolving obstruction, not a typical finding in active nonmechanical obstruction.

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Correct Answer is C

Explanation

A. Document assessment findings and interventions after providing care for a group of clients: Delaying documentation increases the risk of forgetting important details and can compromise accuracy and continuity of care. Timely documentation is critical.
B. Delay cleaning personal work area until the end of the shift: Postponing cleaning may lead to disorganization and inefficiency throughout the shift, potentially impacting infection control and readiness for patient care.
C. Complete activities for one client before moving to the next client: Focusing on completing care for one client at a time promotes continuity, reduces task repetition, and improves prioritization and time management.
D. Gather supplies for a client's dressing change after removing the old dressing: This approach wastes time and may expose the wound to contaminants. Preparing all supplies in advance supports efficiency and infection control.

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"D"}

Explanation

Rationale for correct choices:

Opioid intoxication: The client was found unresponsive with a needle in the antecubital space, had pinpoint pupils, and responded to naloxone—all classic signs of opioid overdose. Vital signs showing bradycardia and hypoventilation support CNS depression consistent with opioid toxicity.
Pupil characteristic: Pinpoint pupils (miosis) are a hallmark of opioid intoxication and help distinguish it from other conditions like withdrawal or alcohol-related disorders. This ocular finding, combined with sedation and history of IV drug use, makes it a key diagnostic indicator.

Rationale for incorrect choices:

Alcohol withdrawal: Withdrawal from alcohol typically presents with symptoms like tremors, agitation, anxiety, tachycardia, and possibly seizures or hallucinations—not pinpoint pupils or decreased responsiveness. The client does not show these signs.
Opioid withdrawal: The previous hospitalization showed opioid withdrawal symptoms at 1000 (mydriasis, hyperreflexia, diaphoresis, piloerection) after receiving buprenorphine/naloxone. The current symptoms are not consistent with withdrawal.Today’s sedation and miosis indicate overdose, not withdrawal.
Alcohol intoxication|: While alcohol intoxication can cause sedation and decreased coordination, it does not cause miosis. The ingestion of one beer, as reported, would not account for unconsciousness and respiratory depression, and naloxone would not reverse alcohol effects.
Current temperature: The client’s temperature is within normal range and not specific to any of the listed conditions. It offers no diagnostic value in distinguishing between opioid use, withdrawal, or alcohol-related issues.
Amount of alcohol consumed: The report of one beer is not enough to support alcohol intoxication, especially with the severity of the symptoms. The more pressing concern is the needle mark and opioid-related signs.
Breath sounds: Breath sounds are clear and equal, which does not support or oppose any of the listed conditions. While important in ruling out aspiration or pulmonary issues, they do not guide the diagnosis here.

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A burse is assessing a client who is 3 days postoperative and has a nonmechanical obstruction of the small bowel. Which of the following findings should the nurse expect?

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Naxlex Comprehensive Predictor Exams

A nurse on a medical-surgical unit is planning care for assigned clients. Which of the following actions should the nurse plan to take to demonstrate effective time management?

Correct Answer is C

Explanation

A nurse is caring for a client in the emergency department. Exhibits Complete the following sentence by using the lists of options. The client is likely experiencing dropdownas evidenced bydropdown.

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"D"}

Explanation

Exhibits Select the 3 findings that require immediate follow-up by the nurse.

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