Exhibits

For each of the findings listed, click to indicate which are consistent with the disease process of aortic aneurysm versus gastric cancer. Each column must have at least one response option selected.

Auscultation of bruit

Pulsatile mass

Fatigue

Indigestion

Feeling of fullness

Back pain

Answer and Explanation

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

Rationale:

Auscultation of bruit: A bruit heard over the abdomen suggests turbulent blood flow, a key feature of aortic aneurysm. It results from abnormal dilation of the aortic vessel, which disrupts normal flow and produces an audible vibration on auscultation.
Pulsatile mass: A pulsatile mass in the periumbilical area is highly suggestive of an abdominal aortic aneurysm. This occurs due to the expansion of the weakened aortic wall, making the pulse visible or palpable through the abdominal wall.
Fatigue: Fatigue can appear in both conditions. In gastric cancer, it may be due to anemia or cancer-related systemic effects. In aortic aneurysm, it may be linked to poor circulation or cardiac workload from concurrent conditions like atrial fibrillation.
Indigestion: Indigestion is more common in gastric cancer due to delayed gastric emptying, mucosal irritation, or tumor growth. It presents as bloating, discomfort, or heartburn and is not typically associated with aortic aneurysm.
Feeling of fullness: Early satiety or a persistent sense of fullness can occur with gastric cancer as tumors restrict gastric expansion or interfere with digestion. This symptom is uncommon in aortic aneurysm unless the aneurysm is compressing nearby digestive organs, which is rare.
Back pain: Back pain is a key warning sign of aortic aneurysm, especially if the aneurysm is enlarging or nearing rupture. It results from pressure on surrounding tissues or vertebrae and requires urgent follow-up to prevent life-threatening complications.

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Correct Answer is A

Explanation

Rationale:

A. Prepare a new water-seal system and reattach the chest tube: After temporarily placing the disconnected tube in sterile water to prevent air entry, the priority is to re-establish a closed drainage system to maintain negative intrathoracic pressure and prevent complications like tension pneumothorax.

B. Clamp the chest tube and maintain its distal end in the water: Clamping a chest tube can increase the risk of tension pneumothorax by trapping air inside the pleural cavity. It should only be done momentarily and under specific circumstances.

C. Apply pressure to the chest tube site using a petroleum gauze: This is appropriate if the chest tube becomes dislodged from the insertion site, not if it's disconnected from the drainage system. The insertion site remains intact in this case.

D. Begin manual ventilation while returning the client to the bed: There is no indication of respiratory distress or collapse requiring manual ventilation. The immediate need is to restore the chest tube drainage system.

A. Report the COVID-19 result to the local health department according to the Center for Disease Control (CDC) guidelines. B. Isolate the client from other clients, family, and healthcare workers not wearing proper personal protective equipment (PPE). C. Notify the charge nurse the client will need assignment to the COVID-19 specified area of the facility. D. Place the nasal swab specimen for COVID-19 directly into a biohazard bag.

Correct Answer is B

Explanation

Rationale:
A. Report the COVID-19 result to the local health department according to the Center for Disease Control (CDC) guidelines: Reporting is important for public health surveillance but is not the nurse’s most immediate priority. Isolation should occur first to prevent the spread of infection, especially before confirmatory test results are available.

B. Isolate the client from other clients, family, and healthcare workers not wearing proper personal protective equipment (PPE): Prompt isolation is the highest priority to prevent transmission of COVID-19. Even with a previous negative test, current symptoms suggest active infection, and precautions must be implemented immediately to protect others.

C. Notify the charge nurse the client will need assignment to the COVID-19 specified area of the facility: While communication with the charge nurse is necessary for client placement, it should follow immediate implementation of infection control measures.

D. Place the nasal swab specimen for COVID-19 directly into a biohazard bag: Proper specimen handling is critical for safety and test integrity but does not take precedence over isolating a potentially infectious client.

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Exhibits For each of the findings listed, click to indicate which are consistent with the disease process of aortic aneurysm versus gastric cancer. Each column must have at least one response option selected.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

While transferring a client with a chest tube from the bed to a stretcher, the chest tube becomes disconnected from the water- seal drainage container. The nurse immediately immerses the end of the tube in a container of sterile water. Which action should the nurse implement next?

Correct Answer is A

Explanation

Four days after exposure to COVID-19 a client has a negative COVID-19 test result. Eight days after the negative test result, the client presents with fever, fatigue, and cough and the nurse performs a second COVID-19 test. Which action is most important for the nurse to take?

Correct Answer is B

Explanation

The nurse has completed the diet teaching of a client who is being discharged following treatment of a leg wound. A high protein diet is encouraged to promote wound healing. Which lunch choice by the client indicates that the teaching was effective?

While the nurse is conducting an admission assessment of a female client with bipolar disorder, the client suddenly begins to take off her clothes and throw them about the room. Which action should the nurse take first?

The nurse is caring for a client with left-sided hemiparesis after a stroke. Which action should the nurse take to safely assist the client with ambulation?

The nurse is caring for a client who is immobile and developed a stage IV pressure injury on the sacrum. The nurse identifies eschar in the wound bed. Which intervention is most important for the nurse to implement?

Exhibits For each of the findings listed, click to indicate which are consistent with the disease process of aortic aneurysm versus gastric cancer. Each column must have at least one response option selected.

The public health nurse receives funding to initiate a primary prevention program in the community. Which program best fits the nurse's proposal?

Which dietary intervention(s) should the nurse include in the plan of care for a client who had bariatric surgery? Select all that apply.

Exhibits

For each of the findings listed, click to indicate which are consistent with the disease process of aortic aneurysm versus gastric cancer. Each column must have at least one response option selected.