A nurse is caring for a 45-year-old male client in the emergency department who reports severe abdominal pain.

Exhibits

Based on the information provided, which of the following provider’s prescriptions are anticipated, nonessential, or contraindicated for the client? Select one response per row.

Increase fiber intake

CT of the abdomen with contrast

Flexible sigmoidoscopy

Change IV fluids to 0.9% sodium chloride with KCl

Type and crossmatch blood

Administer IV piperacillin-tazobactam

Answer and Explanation

The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"C"}}

•   Increase fiber intake: This is nonessential at this time. While a high-fiber diet can help prevent future episodes of diverticulitis, it won’t help in the acute phase, especially when the client is unable to eat or drink without vomiting.
•   CT of the abdomen with contrast: This is an anticipated action. A CT scan can help confirm the diagnosis of diverticulitis and assess the severity of the condition.
•   Flexible sigmoidoscopy: This is an anticipated action. A flexible sigmoidoscopy can help visualize the diverticula and assess the extent of the inflammation.

•   Change IV fluids to 0.9% sodium chloride with KCl: This is an anticipated action. The client is likely dehydrated due to vomiting and unable to take oral fluids, so IV hydration is necessary. The client’s potassium level is at the lower end of the normal range, so adding KCl to the IV fluids can help prevent hypokalemia.
•   Type and crossmatch blood: This is an anticipated action. The client has a positive stool occult blood test and a lower than normal hemoglobin and hematocrit, suggesting that he may be experiencing bleeding. It’s important to have blood ready for a transfusion if necessary.
•   Administer IV piperacillin-tazobactam: This is contraindicated. Piperacillin-tazobactam is a penicillin-based antibiotic, and the client has a known allergy to penicillin. Another class of antibiotics should be used. Please note that these are potential actions and the healthcare provider should be informed immediately for further evaluation and management. It’s important to continue following the provider’s prescriptions and closely monitor the client’s condition.

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Correct Answer is B

Explanation

Choice A rationale
Pain located in the right lower quadrant is typically associated with conditions such as appendicitis, not diverticulitis.
Choice B rationale
Diverticulitis is often associated with cramping, constant pain in the left lower quadrant. This is because the most common site of diverticula, small bulging pouches that can form in the lining of the digestive system, is in the sigmoid and descending colon, which are located in the left lower quadrant of the abdomen.
Choice C rationale
Sudden onset of pain 2 hours ago is not typically indicative of diverticulitis. While diverticulitis pain can be sudden, it usually worsens over several days.
Choice D rationale
Diarrhea for the past 3 days is not specifically indicative of diverticulitis. While changes in bowel habits can occur with diverticulitis, it is not a defining symptom.

A. Weigh the patient weekly. B. Position the patient flat in bed. C. Measure the patient’s abdominal girth every 8 hours. D. Administer acetaminophen for discomfort.

Correct Answer is C

Explanation

Choice A rationale
Weighing the patient weekly may not be sufficient in the case of cirrhosis with ascites. Fluid accumulation can occur rapidly, and more frequent weight checks may be necessary.
Choice B rationale
Positioning the patient flat in bed is not typically recommended for patients with ascites, as this can increase pressure on the diaphragm and make breathing more difficult.
Choice C rationale
Measuring the patient’s abdominal girth every 8 hours is a common nursing intervention for patients with ascites. It allows for monitoring of fluid accumulation in the abdomen.
Choice D rationale
While managing discomfort is important, acetaminophen should be used cautiously in patients with liver disease, as the liver is involved in drug metabolism.

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A nurse is caring for a 45-year-old male client in the emergency department who reports severe abdominal pain. Exhibits Based on the information provided, which of the following provider’s prescriptions are anticipated, nonessential, or contraindicated for the client? Select one response per row.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is gathering information from a patient with abdominal pain. Which description of pain is consistent with diverticulitis?

Correct Answer is B

Explanation

A nurse is assisting in the care of a patient who has cirrhosis of the liver with ascites. What action should the nurse take?

Correct Answer is C

Explanation

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The nurse is collecting data for a client with abdominal pain. Which pain description is consistent with diverticulitis?

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