The nurse is caring for a 52-year-old male patient with a bowel obstruction. Which of these signs would be the earliest indicator to the nurse that the patient is developing symptoms of shock?

Urine output 18 mL/hr.

Blood pressure 88/50 mmHg.

Lethargy.

Pulse 110 bpm.

Answer and Explanation

The Correct Answer is A

Choice A reason: A urine output of 18 mL/hr is significantly lower than the normal range (typically around 0.5-1 mL/kg/hr), indicating possible renal hypoperfusion, an early sign of shock.

Choice B reason: While blood pressure is an important indicator, it may not drop until later stages of shock.

Choice C reason: Lethargy can be a sign of shock, but it is a more subjective and later symptom compared to the objective measure of urine output.

Choice D reason: An elevated pulse is a compensatory mechanism in shock, but it is not as specific an early indicator as a decrease in urine output.

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Correct Answer is D

Explanation

Choice A reason: A sodium level of 138 milliequivalents per liter is within the normal range and does not indicate metastasis.

Choice B reason: A hemoglobin level of 10.5 grams per deciliter is slightly low but does not specifically indicate metastasis.

Choice C reason: A potassium level of 3.4 milliequivalents per liter is within the normal range and does not indicate metastasis.

Choice D reason: A calcium level of 12.5 milligrams per deciliter is elevated, which may indicate metastasis to the bones, a common site for breast cancer metastasis.

A. Allow the client to take her morning vitamins. B. Allow the client to keep her tongue stud in. C. Allow the client to consume clear liquids up to the time of surgery. D. Allow the client to keep her hearing aids in.

Correct Answer is D

Explanation

Choice A reason: It is not recommended for clients to take morning vitamins before surgery due to the risk of aspiration and interference with anesthesia.

Choice B reason: Clients are typically instructed to remove all jewelry, including tongue studs, to prevent complications during surgery.

Choice C reason: Clients are generally required to fast before surgery, which includes not consuming clear liquids, to reduce the risk of aspiration.

Choice D reason: Allowing the client to keep her hearing aids in is important for communication and to reduce anxiety due to hearing impairment.

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The nurse is caring for a 52-year-old male patient with a bowel obstruction. Which of these signs would be the earliest indicator to the nurse that the patient is developing symptoms of shock?

Nursing Test Bank

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