A client presents with a possible bowel obstruction, and the nurse completes a detailed abdominal assessment. Which of the following clinical manifestations are consistent with a large bowel obstruction? (Select all that apply).

Profuse vomiting with fecal odor

Epigastric abdominal distention

Intermittent abdominal cramping

Ribbon-like stools or diarrhea

Metabolic acidosis

Severe fluid and electrolyte imbalance

Answer and Explanation

Correct Answer : A,B,C,D,E,F

Choice A reason:Profuse vomiting with a fecal odor can occur in large bowel obstructions due to the backward flow of bowel contents.

Choice B reason:Epigastric abdominal distention is a common finding in bowel obstructions due to the accumulation of gas and fluids.

Choice C reason:Intermittent abdominal cramping results from the bowel's attempt to push contents through the obstructed area.

Choice D reason:Ribbon-like stools or diarrhea may occur if there is a partial obstruction allowing some contents to pass.

Choice E reason:Metabolic acidosis can develop due to the accumulation of lactic acid from tissue hypoxia and decreased perfusion.

Choice F reason:Severe fluid and electrolyte imbalance can result from vomiting and the inability to absorb fluids and nutrients properly.

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Correct Answer is A

Explanation

Choice A reason:Providing oral care every 4 hours and as needed is an evidence-based practice to lower the risk of ventilator-associated pneumonia by minimizing the buildup of bacteria in the mouth³.

Choice B reason:Positioning the head of the client's bed in the flat position is not recommended as it can increase the risk of aspiration; elevating the head of the bed to 30° to 45° is the standard practice.

Choice C reason:Turning the client every 4 hours is important for preventing pressure ulcers and improving lung function but is not the primary action for reducing pneumonia risk³.

Choice D reason:Providing humidity helps to maintain mucous membrane integrity but must be carefully managed to prevent bacterial growth and is not the primary action for reducing pneumonia risk³.

A. BUN 8 mg/dL and creatinine 0.7 mg/dL B. BUN 45 mg/dL and creatinine 8 mg/dL C. BUN 10 mg/dL and creatinine 0.3 mg/dL D. BUN 23 mg/dL and creatinine 1.0 mg/dL

Correct Answer is B

Explanation

Choice A reason: A BUN level of 8 mg/dL and creatinine level of 0.7 mg/dL are within normal ranges and would not be expected in a client with CKD².

Choice B reason: Elevated BUN and creatinine levels, such as 45 mg/dL and 8 mg/dL respectively, are indicative of impaired kidney function, which is consistent with CKD².

Choice C reason: A BUN level of 10 mg/dL and creatinine level of 0.3 mg/dL are lower than the expected values for a client with CKD, indicating better kidney function than typically seen in CKD².

Choice D reason: A BUN level of 23 mg/dL and creatinine level of 1.0 mg/dL may be slightly elevated but are not as indicative of CKD as the values in choice B².

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A client presents with a possible bowel obstruction, and the nurse completes a detailed abdominal assessment. Which of the following clinical manifestations are consistent with a large bowel obstruction? (Select all that apply).

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Naxlex Comprehensive Predictor Exams

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