A male client is admitted to the emergency department (ED) while vomiting dark brown, foul-smelling emesis. He reports having a surgical repair of a recurrent inguinal hernia a week ago and is troubled by intense abdominal pain. After finding that his bowel sounds are hyperactive, which prescription should the nurse implement first?

Place an indwelling urinary catheter and attach a bedside drainage unit.

Give a prescribed analgesic for temperature above 101°F (38.3°C), orally.

Send the client to x-ray for a flat plate of the abdomen.

Insert a nasogastric tube (NGT) and attach to low intermittent suction (LIS).

Answer and Explanation

The Correct Answer is D

Choice A reason: Placing an indwelling urinary catheter is not immediately relevant to the client's symptoms.

Choice B reason: Giving an analgesic for a fever does not address the underlying issue of bowel obstruction.

Choice C reason: Sending the client to x-ray can help diagnose the issue but is not the first action to relieve symptoms.

Choice D reason:

The correct answer is d) because inserting a nasogastric tube and attaching it to low intermittent suction helps decompress the stomach and relieve symptoms of bowel obstruction.

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Correct Answer is C

Explanation

Choice A reason: Bile-stained emesis indicates an obstruction, but it is not as immediately critical as a distended, hard, and rigid abdomen.

Choice B reason: Clay-colored stool is a sign of bile duct obstruction but is not as urgent as the abdomen findings.

Choice C reason:

The correct answer is c) because a distended, hard, and rigid abdomen suggests peritonitis or a perforated organ, which requires immediate medical intervention.

Choice D reason: Radiating, sharp pain in the right shoulder is common in gallbladder issues but is not as immediately life-threatening as a distended, hard, and rigid abdomen.

A. Extra pillows can be used if needed to elevate the client's head. B. The procedure is performed with the client in an upright position. C. A thoracentesis is a brief procedure that has minimal discomfort. D. Orthopnea is frequently caused by a client's uncontrolled anxiety.

Correct Answer is B

Explanation

Choice A reason: Using extra pillows may help with comfort but is not the basis of the nurse's response to the concern about thoracentesis.

Choice B reason:

The correct answer is b) because during thoracentesis, the client is positioned upright, which helps ease breathing and access the pleural space.

Choice C reason: While the procedure may be brief, this response does not directly address the concern about breathing.

Choice D reason: Orthopnea can be caused by conditions other than anxiety and should be addressed appropriately.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with cholelithiasis is admitted with jaundice due to obstruction of the common bile duct. Which finding is most important for the nurse to report to the healthcare provider?

Correct Answer is C

Explanation

A client with orthopnea expresses concern about the ability to "get enough air" during a scheduled thoracentesis. On which information should the nurse's response be based?

Correct Answer is B

Explanation

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