A nurse is assessing a client who is 3 days postoperative following abdominal surgery and notes the absence of bowel sounds, abdominal distention, and the client passing no flatus. Which of the following conditions should the nurse suspect?

Wound dehiscence

Cholecystitis

Ulcerative colitis

Paralytic ileus

Answer and Explanation

The Correct Answer is D

Choice A reason: Wound dehiscence refers to the separation of surgical incision edges and is typically associated with visible changes at the wound site, such as drainage or protrusion of internal contents. It does not cause absent bowel sounds or distention.

Choice B reason: Cholecystitis is inflammation of the gallbladder, often presenting with right upper quadrant pain, fever, and nausea. It does not typically cause generalized abdominal distention or absence of bowel sounds.

Choice C reason: Ulcerative colitis is a chronic inflammatory bowel disease affecting the colon. It presents with diarrhea, rectal bleeding, and abdominal cramping, but not with absent bowel sounds or postoperative ileus.

Choice D reason: Paralytic ileus is a temporary cessation of bowel motility, often occurring after abdominal surgery. It presents with absent bowel sounds, abdominal distention, and failure to pass flatus or stool. This is the most likely diagnosis in a postoperative patient with these findings.

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Correct Answer is B

Explanation

Choice A reason: Hydrocodone is an opioid analgesic, not an NSAID. While effective for moderate to severe pain, it carries risks such as respiratory depression, dependence, and constipation. It does not cause gastrointestinal bleeding in the same way NSAIDs do.

Choice B reason: Ketorolac is a potent NSAID used for short-term management of moderate to severe pain, often postoperatively. It is associated with a significant risk of gastrointestinal bleeding, especially when used beyond the recommended duration (typically no more than 5 days). It inhibits prostaglandin synthesis, which compromises gastric mucosal protection, making monitoring essential.

Choice C reason: Morphine is a strong opioid analgesic used for severe pain. It does not belong to the NSAID class and does not pose a direct risk for gastrointestinal bleeding. Its adverse effects are more related to sedation, respiratory depression, and constipation.

Choice D reason: Fentanyl is a synthetic opioid used for severe pain, particularly in chronic or cancer-related cases. It is not an NSAID and does not cause gastrointestinal bleeding. Its risks include profound respiratory depression and overdose potential.

A. Glucosamine B. Flaxseed oil C. Saw palmetto D. Gingko biloba E. Black cohosh

Correct Answer is ["A","B","C","D"]

Explanation

Choice A reason: Glucosamine may potentiate the effects of warfarin and increase the risk of bleeding. Though commonly used for joint health, its interaction with anticoagulants warrants caution and discontinuation prior to initiating warfarin therapy.

Choice B reason: Flaxseed oil has antiplatelet properties and may increase bleeding risk when combined with warfarin. It is often used for cardiovascular health but should be avoided due to its potential to enhance anticoagulant effects.

Choice C reason: Saw palmetto can inhibit platelet aggregation and may increase the risk of bleeding when taken with warfarin. It is typically used for prostate health but poses a safety concern in anticoagulated patients.

Choice D reason: Gingko biloba is well-known for its antiplatelet effects and has been documented to increase bleeding risk when combined with warfarin. It should be discontinued to prevent hemorrhagic complications.

Choice E reason: Black cohosh is primarily used for menopausal symptoms and does not have a strong documented interaction with warfarin. While caution is always advised with herbal supplements, it is not among the primary supplements contraindicated with warfarin.

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A nurse is assessing a client who is 3 days postoperative following abdominal surgery and notes the absence of bowel sounds, abdominal distention, and the client passing no flatus. Which of the following conditions should the nurse suspect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which NSAID is commonly used for mild to moderate pain management and requires monitoring for potential gastrointestinal bleeding?

Correct Answer is B

Explanation

A nurse is caring for a male client who has peripheral vascular disease (PVD), is taking dietary supplements, and has a new prescription for warfarin. The nurse should instruct the client to stop which of the following supplements prior to starting the warfarin? (Select all that apply.)

Correct Answer is ["A","B","C","D"]

Explanation

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In a patient receiving hydrocodone for moderate pain, which of the following should the nurse prioritize to assess for potential adverse effects? (Select all that apply.)

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