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

WBC count

Lipase level

Social history

Abdominal findings

Skin findings

Answer and Explanation

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

Pain Level: Severe mid-abdominal pain can appear in both small bowel obstruction and acute pancreatitis. SBO typically presents with crampy, colicky pain related to peristaltic waves. Pancreatitis pain is usually epigastric and radiates to the back, but severe abdominal pain alone does not exclude either condition.
WBC Count: A WBC of 9,000/mm³ is within normal range but can still be seen early in SBO or pancreatitis. In both disorders, leukocytosis may develop as inflammation or ischemia progresses. Normal WBC does not rule either condition out and is compatible with both at presentation.
Lipase Level: The lipase level of 40 units/L is within normal limits, making acute pancreatitis unlikely because pancreatitis almost always shows lipase elevation to ≥3× normal. A normal lipase is expected in small bowel obstruction, as SBO does not directly affect pancreatic enzyme release.
Social History: The client drinks 1–2 glasses of wine daily, which is a known chronic risk factor for pancreatitis. Alcohol use does not contribute to small bowel obstruction, which is more related to adhesions, hernias, or tumors. Thus, this finding supports pancreatitis more strongly.
Abdominal Findings: Tenderness with high-pitched bowel sounds indicates a hyperactive bowel attempting to push against an obstruction. Such “tinkling” or high-pitched sounds are characteristic of small bowel obstruction and develop as gas and fluid accumulate. Pancreatitis more commonly shows hypoactive or absent bowel sounds with diffuse tenderness.
Skin Findings: The absence of jaundice or discoloration is compatible with SBO, which typically does not produce skin changes. Acute pancreatitis may produce ecchymoses (Grey Turner or Cullen signs) or jaundice in biliary involvement, so normal skin findings make pancreatitis less likely.

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Correct Answer is A

Explanation

A. Maintain hip abduction when turning the client: After a total hip arthroplasty, maintaining hip abduction prevents dislocation of the prosthesis. Positioning devices such as abduction pillows help keep the hip in a safe alignment during movement and turning.

B. Turn the client every 4 hr for 48 hr while on bed rest: Turning every 4 hours may be insufficient to prevent pressure injuries, and prolonged strict bed rest is generally discouraged. Early mobilization as tolerated is preferred to reduce complications such as DVT and pneumonia.

C. Have the client use an incentive spirometer every 4 hr: Incentive spirometry is important for preventing postoperative pulmonary complications, but it is not specific to hip replacement care. The priority is protecting the surgical site and joint integrity.

D. Instruct the client to bend from the hip when retrieving items from the floor: Bending at the hip increases the risk of hip dislocation. Clients should be taught to use a reacher or bend at the knees while keeping the hip in neutral alignment.

A. Rash B. Dyspnea C. Polyuria D. Bradycardia

Correct Answer is D

Explanation

A. Rash: A rash is not a typical manifestation of digoxin toxicity and is more often linked to allergic reactions or dermatologic conditions. While any new rash should be assessed, it does not specifically signal excessive digoxin levels.

B. Dyspnea: Shortness of breath can occur in many cardiac or pulmonary conditions, especially heart failure, but it is not a primary indicator of digoxin toxicity. Dyspnea alone does not reliably reflect rising digoxin concentrations.

C. Polyuria: Increased urine output is usually associated with diuretic use or endocrine disorders rather than digoxin. Digoxin does not stimulate urine production, so polyuria would not indicate toxicity.

D. Bradycardia: Digoxin slows conduction through the AV node, and excessive levels can significantly depress heart rate. A notable drop in pulse can signal toxicity and requires immediate intervention to prevent dangerous arrhythmias.

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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.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is contributing to the plan of care for a client following a total hip arthroplasty. Which of the following interventions should the nurse recommend?

Correct Answer is A

Explanation

A nurse is caring for a client who is taking digoxin. Which of the following findings should the nurse identify as an indication of digoxin toxicity?

Correct Answer is D

Explanation

A nurse is reinforcing teaching with a client who is to begin taking lansoprazole. Which of the following statements by the client indicates an understanding of the teaching?

A nurse is assisting with discharge teaching for a client who requires oropharyngeal suctioning at home. The nurse should ensure that which of the following equipment is available for use at home?

A nurse is admitting a client who reports excessive thirst, fever, and periods of confusion. The nurse suspects the client is experiencing heat exhaustion. Which of the following electrolyte imbalances should the nurse expect?

The nurse is collecting data on the client. Which of the following findings require follow-up?Select all that apply.

A nurse is contributing to the plan of care for a client who has hypernatremia. Which of the following interventions should the nurse recommend to include in the plan?

A nurse is reinforcing teaching with a 30-year-old client who is concerned about cervical cancer. Which of the following statements should the nurse make?

A nurse is assisting in the care of a client following a tonsillectomy who is alert and has an SpO2 of 93% on room air. Which of the following actions should the nurse take?

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.