Exhibits

The nurse reviews the history and physical, the nurses' notes, and the flow sheet to help determine what is causing the client's symptoms.

For each listed finding, click to indicate whether the finding is associated with arthritis or carpal tunnel syndrome. Each column must have at least one response option selected.

Can be caused by aging

Inflammatory disease process

Finger numbness

Experience difficulty with fine motors movements

May have a genetic component

Answer and Explanation

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

Rationale:

Can be caused by aging: Both arthritis and carpal tunnel syndrome are linked to aging. In arthritis, wear and tear on joints over time causes conditions like osteoarthritis. Carpal tunnel syndrome increases with age due to changes in wrist anatomy and nerve compression.
Inflammatory disease process: Arthritis, especially rheumatoid arthritis, is inflammatory, causing joint pain and damage. Carpal tunnel syndrome, however, is caused by mechanical compression of the median nerve, not by inflammation.
Finger numbness: Numbness in the fingers is common with carpal tunnel syndrome due to median nerve compression. While arthritis can cause pain and stiffness in joints, it does not typically cause finger numbness unless there's significant nerve involvement.
Experience difficulty with fine motor movements: Both conditions can impair fine motor skills. Arthritis causes pain and stiffness in joints, while carpal tunnel syndrome affects nerve function, leading to weakness and difficulty performing precise tasks like writing or holding small objects.
May have a genetic component: Arthritis has a genetic predisposition. Carpal tunnel syndrome does not have a strong genetic link but can be influenced by individual anatomical factors, such as a narrower carpal tunnel.

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Free Nursing Study Resources

Correct Answer is []

Explanation

Rationale for Correct Choices:

Bowel obstruction: The client's symptoms are classic signs of a bowel obstruction. Additionally, the lab results showing elevated sodium (165 mEq/L), low potassium (3.2 mEq/L), and low bicarbonate (20 mEq/L) suggest an electrolyte imbalance often seen in bowel obstructions due to fluid loss and impaired bowel function.
Insert nasogastric tube: A nasogastric tube is commonly used in bowel obstruction to decompress the stomach, relieve vomiting, and prevent aspiration. It helps reduce abdominal distention and allows for drainage of the stomach contents.
Maintain NPO status: Maintaining NPO status is essential in bowel obstruction to prevent further complications such as aspiration, vomiting, or perforation. It also helps to prepare the client for possible surgery if needed and allows the bowel to rest.
Signs and symptoms of sepsis: Given the possibility of bowel perforation or ischemia in a bowel obstruction, monitoring for signs and symptoms of sepsis is crucial. Fever, tachycardia, and hypotension could indicate the onset of systemic infection due to bowel perforation or necrosis.
Strict intake and output: Monitoring strict intake and output is vital to assess for dehydration or fluid imbalance, which can occur due to vomiting, diarrhea, or poor oral intake in bowel obstructions. Accurate monitoring helps guide treatment and fluid resuscitation.

Rationale for Incorrect Choices:

Pancreatitis: Pancreatitis presents with severe upper abdominal pain that may radiate to the back, nausea, vomiting, and sometimes jaundice. There are no signs like elevated lipase or amylase levels to suggest pancreatitis.
Food poisoning: Food poisoning can cause nausea, vomiting, and diarrhea, but it usually has an acute onset and resolves within a short period (usually a day or two). This child's symptoms have persisted for two days, and there is no mention of fever or diarrhea.
Ruptured gallbladder: A ruptured gallbladder would present with severe right upper quadrant pain, fever, and jaundice due to bile leakage or infection. There is no indication of right upper quadrant pain or jaundice in this child.

Culture emesis: While culturing emesis may be useful in diagnosing foodborne illnesses or infection, it is not necessary in a case of bowel obstruction. The primary intervention in bowel obstruction is relieving the obstruction and monitoring for complications.
Prep for immediate gallbladder removal: Cholecystectomy is not indicated in this case. The client’s symptoms are not characteristic of gallbladder issues like cholecystitis or gallstone complications. The focus should be on diagnosing and managing the bowel obstruction.
Administer oxygen via face mask: Oxygen administration is typically indicated in cases of respiratory distress or shock. While this client is experiencing discomfort, she is not showing signs of hypoxia or severe circulatory issues. Spo2 is 97% indicating adequate saturation.

Bilirubin levels: Bilirubin levels are typically monitored when jaundice or liver dysfunction is suspected. This client does not show signs of jaundice or liver disease, and her symptoms are more consistent with a bowel obstruction.
Rebound tenderness: Rebound tenderness is useful in cases of peritonitis or bowel perforation. However, the absence of guarding and the fact that the child is not exhibiting acute peritonitis symptoms makes rebound tenderness less relevant.
Arterial blood gas (ABG): ABG measurements are typically used to assess respiratory and metabolic function. While the electrolyte imbalances seen in this patient (e.g., low bicarbonate) could suggest mild acidosis, ABG testing is not immediately necessary unless the client shows signs of severe metabolic disturbance or shock.

A. Plan meals with low fiber. B. Separate fluids from meals. C. Eliminate acidic food choices. D. Offer comfort foods. E. Provide small, frequent meals.

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

Explanation

A. Plan meals with low fiber: After bariatric surgery, the digestive system can be more sensitive, and high-fiber foods may cause discomfort. Planning low-fiber meals helps reduce irritation and minimize symptoms like diarrhea and cramping.

B. Separate fluids from meals: This is an important intervention because drinking fluids during meals can increase the risk of dumping syndrome, leading to nausea, vomiting, and diarrhea. Fluids should be consumed between meals to help avoid these symptoms.

C. Eliminate acidic food choices: Acidic foods (like citrus, tomatoes, some sauces) can irritate the sensitive gastric pouch and small intestine after bariatric surgery, potentially exacerbating symptoms of nausea, abdominal cramps, and discomfort.

D. Offer comfort foods: Comfort foods are not appropriate for this client, as they may be high in fat, sugar, or calories, which could exacerbate symptoms after bariatric surgery. Instead, nutritious and easily digestible foods should be offered.

E. Provide small, frequent meals: Offering small, frequent meals helps reduce the strain on the digestive system, making it easier for the client to tolerate food. Large meals can cause discomfort and increase the risk of complications such as dumping syndrome.

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Naxlex Comprehensive Predictor Exams

Correct Answer is []

Explanation

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

Explanation

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