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 C

Explanation

Choice A rationale
This statement indicates fatigue and lack of energy, which are common symptoms in patients with end-stage liver cancer. However, it does not necessarily indicate denial.
Choice B rationale

This statement suggests acceptance rather than denial. The patient acknowledges the doctor’s efforts and seems to accept their own mortality.
Choice C rationale
This statement indicates denial. The patient is dismissing the doctor’s prognosis and expressing disbelief about the severity of their condition.
Choice D rationale
This statement suggests anger or frustration towards the doctor, but it does not necessarily indicate denial.

A. “Before the procedure, you’ll need to remove any dentures.”. B. “After the procedure, you may have a sore throat for which you can use warm gargles or ice.”. C. “This test will allow the doctor to see directly into your esophagus, stomach, and part of your small intestine.”. D. “After the procedure, you can have something to drink after your gag reflex returns.”.

Correct Answer is D

Explanation

Choice A rationale
While it’s true that dentures and other oral appliances should be removed before an EGD to prevent damage or loss during the procedure, this information is not the most crucial for the patient to understand.
Choice B rationale
Although a sore throat can occur after an EGD due to the passage of the endoscope, it’s not the most important information. The patient should be aware that the sore throat is temporary and can be relieved with warm gargles or ice.
Choice C rationale

This choice is accurate. An EGD allows the doctor to directly visualize the esophagus, stomach, and part of the small intestine. However, this information, while important, is not the most critical aspect for the patient to understand about the post-procedure period.
Choice D rationale
This is the correct answer. After an EGD, it’s crucial for the patient to understand that they should not eat or drink until their gag reflex has returned. This is to prevent aspiration, which can occur if the patient tries to swallow food or liquid before the gag reflex is functioning properly.

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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

A nurse is caring for a patient who has been diagnosed with end-stage liver cancer. Which statement by the patient indicates that the patient is in the denial phase of the grief process?

Correct Answer is C

Explanation

After a diagnostic work-up, a 56-year-old male client was diagnosed with a duodenal ulcer caused by Helicobacter pylori infection. After treatment, the client is to have an esophagogastroduodenoscopy (EGD). Which teaching should the nurse reinforce?

Correct Answer is D

Explanation

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A nurse is caring for a patient who has a Clostridium difficile infection. Which cleansing agent should the nurse use for hand hygiene?

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