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","C","D"]

Explanation

Choice A rationale
While some MRI scans may require fasting, it is not universally required for all MRI scans. The need for fasting depends on the specific type of scan and the contrast material used.
Choice B rationale
Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure that combines upper gastrointestinal (GI) endoscopy and x-rays to treat problems of the bile and pancreatic ducts. It often requires fasting before the procedure.

Choice C rationale
Esophagogastroduodenoscopy (EGD) is a procedure that examines the lining of the esophagus, stomach, and upper duodenum with a small camera (endoscope) which is inserted down the throat. It requires fasting before the procedure.
Choice D rationale
A barium swallow is a type of test used to look at the esophagus, the tube that connects the mouth to the stomach. It requires fasting before the procedure.

A. Maintain bed rest for 48 hr following surgery. B. Irrigate the nasogastric tube every 4 to 8 hr. C. Encourage hourly use of an incentive spirometer while awake. D. Perform leg exercises every 2 hr.

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

Explanation

Choice A rationale
Maintaining bed rest for 48 hours following surgery is a common practice to allow the body to heal and recover.
Choice B rationale

Irrigating the nasogastric tube every 4 to 8 hours is necessary to maintain patency and prevent blockage.
Choice C rationale
Encouraging hourly use of an incentive spirometer while awake can help prevent postoperative complications such as pneumonia and atelectasis.
Choice D rationale
Performing leg exercises every 2 hours is not typically included in the plan of care for a client who had surgery for a bowel obstruction and has a nasogastric tube in place.

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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

When teaching patients about diagnostic procedures, the nurse should instruct them to fast and restrict fluids prior to which of these tests? (Select all that apply)

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

Explanation

A nurse is assisting in the plan of care for a client who had surgery for a bowel obstruction. The client has a nasogastric tube in place.Which of the following actions should the nurse include in the client’s plan of care? (Select all that apply)

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

Explanation

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