A client is diagnosed with a large bowel obstruction. Which assessment findings by the nurse would be expected?

Abdominal distention

Hypoactive bowel sounds

Diarrhea

Fever

Answer and Explanation

The Correct Answer is A

Choice A Reason:
Abdominal distention is a common finding in large bowel obstruction due to the accumulation of intestinal contents, gas, and fluid proximal to the obstruction site. This can lead to a visibly swollen abdomen and is often accompanied by discomfort or pain.

Choice B Reason:
Hypoactive bowel sounds are expected in large bowel obstruction as the peristaltic activity decreases below the point of obstruction. Initially, bowel sounds may be high-pitched or tinkling due to the intestine's attempt to move contents past the obstruction, but as the condition progresses, the sounds become less frequent or even absent.

Choice C Reason:
Diarrhea is not typically associated with large bowel obstruction. In fact, constipation or cessation of stool is a more common symptom. If diarrhea occurs, it may be due to a partial obstruction or the presence of liquid stool that can pass around the blockage.

Choice D Reason:
Fever may indicate a complication of large bowel obstruction, such as ischemia or perforation, leading to infection and inflammation. However, fever is not a primary symptom of uncomplicated large bowel obstruction and should prompt immediate further investigation.

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Correct Answer is C

Explanation

Choice A Reason
While coronary artery spasm can cause chest pain, it is not the typical cause of unstable angina. Unstable angina is generally due to atherosclerotic heart disease, where plaque buildup in the coronary arteries restricts blood flow. This statement does not fully reflect an understanding of the condition.

Choice B Reason
Beta blockers are often prescribed to manage angina as they reduce the heart's workload and oxygen demand. However, they do not always prevent angina pain, especially in the case of unstable angina, which can occur unpredictably and not just during exertion. This statement shows partial understanding but lacks the urgency associated with unstable angina.

Choice C Reason
Seeking immediate medical attention when experiencing angina pain is crucial, especially in the case of unstable angina, which can signal an impending heart attack. This statement indicates that the client understands the seriousness of their condition and the need for prompt action.

Choice D Reason
While rest can help alleviate stable angina pain, unstable angina is less predictable and may not be relieved by rest. This type of angina requires medical evaluation to prevent more serious complications, such as myocardial infarction. This statement does not convey an adequate understanding of the condition.

A. Move into a side-lying position with the head elevated. B. Lay in the Trendelenburg position. C. Lean over the bedside table. D. Sit in Fowler's position with heels off the bed.

Correct Answer is C

Explanation

Choice A Reason:
A side-lying position with the head elevated may provide some comfort but is not the most effective position for reducing the work of breathing in emphysema patients. This position does not maximize lung expansion or aid in the optimal use of respiratory muscles.

Choice B Reason:
The Trendelenburg position, where the body is laid flat on the back with the feet higher than the head, is not recommended for emphysema patients as it can increase the pressure on the diaphragm, making breathing more difficult.

Choice C Reason:
Leaning over the bedside table, often referred to as the tripod position, is beneficial for emphysema patients. This position allows for the optimal use of respiratory muscles and helps to reduce the work of breathing by supporting the arms and allowing the shoulder girdle muscles to assist in the breathing process.

Choice D Reason:
Fowler's position, where the patient is seated with the legs either bent or straight out in front, may not be as effective as the tripod position for emphysema patients. While it does allow for better lung expansion than lying flat, it does not provide the same level of support for the respiratory muscles as leaning forward does.

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A client is diagnosed with a large bowel obstruction. Which assessment findings by the nurse would be expected?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which statement, made by the client diagnosed with unstable angina, reflects an understanding of the nurse's discharge teaching?

Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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