A nurse is assessing a client who is 24 hr postoperative following abdominal surgery. Which of the following findings should the nurse report to the provider?

150 mL of greenish yellow NG drainage

Client requests medication for nausea

Urinary output of 250 mL over past 12 hr

Hypoactive bowel sounds

Answer and Explanation

The Correct Answer is C

A. 150 mL of greenish yellow NG drainage: This amount and color of drainage are expected after abdominal surgery, as bile-stained gastric contents can be present. It does not indicate a complication that requires provider notification.

B. Client requests medication for nausea: Nausea is a common postoperative symptom, often managed with antiemetics. While it should be addressed, it is not an urgent finding that requires immediate provider notification.

C. Urinary output of 250 mL over past 12 hr: Oliguria, defined as urine output less than 30 mL/hr (or less than 400 mL in 24 hr), suggests inadequate renal perfusion, possibly due to hypovolemia or acute kidney injury. This finding requires prompt provider notification.

D. Hypoactive bowel sounds: Reduced bowel activity is common after abdominal surgery due to anesthesia and opioid use. While monitoring is necessary, hypoactive sounds alone are not an urgent concern unless accompanied by other signs of ileus or obstruction.

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Correct Answer is ["C","D","E"]

Explanation

A. Born with a high birth weight: Hearing loss is more commonly associated with low birth weight rather than high birth weight. Premature infants or those with complications like neonatal hypoxia are at a greater risk of auditory damage due to underdeveloped structures and increased vulnerability to infections.

B. Frequent exposure to low-volume noise: Prolonged exposure to loud noise, not low-volume noise, is a significant risk factor for hearing loss. High-decibel sounds can cause permanent damage to the cochlear hair cells, leading to sensorineural hearing loss, especially in occupational or recreational settings.

C. Use of a loop diuretic: Loop diuretics like furosemide can be ototoxic, especially when administered in high doses or given too rapidly through IV. They can cause reversible or permanent hearing loss by damaging the stria vascularis of the cochlea, which affects inner ear fluid balance.

D. Chronic infections of the middle ear: Recurrent otitis media can lead to chronic inflammation, scarring, or ossicle damage, resulting in conductive hearing loss. Long-term infections may also cause cholesteatoma formation, which can further impair hearing by destroying middle ear structures.

E. Perforation of the eardrum: Tympanic membrane rupture due to infections, trauma, or barotrauma can lead to conductive hearing loss by impairing sound transmission. While small perforations may heal spontaneously, larger tears might require surgical repair to restore normal hearing function.

A. Asystole B. Ventricular fibrillation C. Pulseless ventricular tachycardia D. Atrial fibrillation

Correct Answer is D

Explanation

A. Asystole: Synchronized cardioversion is ineffective for asystole because there is no electrical activity to reset. The appropriate intervention for asystole is immediate CPR and administration of epinephrine.

B. Ventricular fibrillation: Defibrillation, not synchronized cardioversion, is the appropriate treatment for ventricular fibrillation because it is a pulseless, chaotic rhythm that requires immediate high-energy shocks.

C. Pulseless ventricular tachycardia: Pulseless ventricular tachycardia is treated with defibrillation rather than synchronized cardioversion, as there is no coordinated cardiac activity to synchronize with. CPR and advanced cardiac life support (ACLS) protocols should be initiated.

D. Atrial fibrillation: Synchronized cardioversion is indicated for atrial fibrillation, particularly when it is associated with hemodynamic instability. Cardioversion helps restore a normal sinus rhythm by delivering a shock synchronized to the R wave of the QRS complex.

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A nurse is assessing a client who is 24 hr postoperative following abdominal surgery. Which of the following findings should the nurse report to the provider?

Nursing Test Bank

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