The nurse is assisting with the care of a client.
For each finding, click to specify if the finding is consistent with small bowel obstruction or acute pancreatitis. Each finding may support more than 1 disease process.
Pain level
Social history
Skin findings
Lipase level
WBC count
Abdominal findings
The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A,B"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"A"}}
Pain level:
- Small bowel obstruction: The client reports mid-abdominal pain, which is characteristic of small bowel obstruction as the pain is often crampy and located around the abdomen.
- Acute pancreatitis: Abdominal pain is also a common symptom of acute pancreatitis, typically described as severe and persistent.
Social history:
- Small bowel obstruction: Alcohol consumption is not a typical cause of obstruction.
- Acute pancreatitis: Chronic alcohol use is a major risk factor for acute pancreatitis.
Skin findings:
- Small bowel obstruction: Skin findings are usually unaffected.
- Acute pancreatitis: In severe cases, pancreatic enzymes can leak into the skin, leading to ecchymosis (e.g., Grey Turner's or Cullen's sign). While jaundice can occur in acute pancreatitis due to bile duct obstruction, its absence does not rule out the condition.
Lipase level:
- Small bowel obstruction: Lipase is generally normal.
- Acute pancreatitis: Elevated lipase levels are highly indicative of acute pancreatitis.
WBC count:
- Small bowel obstruction: A mild increase in WBC may occur due to bowel distension. The client’s WBC count is 9,000/mm³, which is within the normal range.
- Acute pancreatitis: WBC levels are often elevated due to inflammation.
Abdominal findings:
- Small bowel obstruction: Tenderness and high-pitched bowel sounds are typical signs.
- Acute pancreatitis: Abdominal tenderness can also be present in acute pancreatitis, but high-pitched bowel sounds are more specific to small bowel obstruction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Muscle spasms: These are not typically associated with DVT.
B. Absent pedal pulse: This suggests arterial occlusion, not venous thrombosis.
C. Numbness of the affected extremity: Numbness is not a classic sign of DVT and might indicate a nerve-related issue.
D. Warmth of the affected extremity. Warmth is a hallmark sign of DVT due to localized inflammation and impaired venous circulation.
Correct Answer is C
Explanation
A. "Insert an indwelling urinary catheter and record the client's output.": This is not relevant to a thoracentesis, which focuses on the pleural cavity, not urinary output.
B. "Set up the equipment using clean technique.": Sterile technique is required to prevent infection during the invasive procedure.
C. "Prepare the client for a chest x-ray following the procedure.": A chest x-ray is performed post-thoracentesis to ensure the lung has re-expanded and to rule out complications like pneumothorax.
D. "Instruct the client to remain flat in bed for 4 to 6 hr after the procedure.": The client does not need to remain flat; instead, they are typically observed for respiratory complications in a sitting or semi-Fowler’s position.
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