The nurse is caring for a client admitted with an obstruction in the duodenum. Which initial clinical manifestation is associated with this condition?

Severe abdominal distention and cramping

Vomiting of fecal material and absent bowel sounds

Ribbon-like stools and mild discomfort

Crampy abdominal pain, wavelike and colicky

Answer and Explanation

The Correct Answer is D

D. The initial clinical manifestation associated with an obstruction in the duodenum is crampy abdominal pain, wavelike, and colicky. This discomfort occurs due to the blockage of the small intestine, leading to spasms and pain as the body tries to move contents past the obstruction.
A. Severe abdominal distention and cramping can occur with various gastrointestinal conditions, including an obstruction in the duodenum. However, this manifestation is not specific to duodenal obstruction and can occur with obstructions at other locations in the gastrointestinal tract.
B. Vomiting of fecal material, known as feculent vomiting, is a hallmark sign of a complete obstruction in the lower gastrointestinal tract.
C. Ribbon-like stools are more commonly associated with conditions affecting the lower gastrointestinal tract, such as colorectal cancer or irritable bowel syndrome (IBS).

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Correct Answer is C

Explanation

C. The expected effect of TPN is to maintain or promote weight gain in clients who are unable to meet their nutritional needs orally. TPN provides essential nutrients directly into the bloodstream, allowing for adequate caloric intake to support energy needs and promote tissue repair and growth.
A. A serum white blood cell count of 16,000/mm3 indicates leukocytosis, which may suggest infection or inflammation rather than a direct effect of TPN.
B. Pre-albumin is a marker of nutritional status, and levels below 10 mg/dl typically indicate malnutrition rather than a positive response to TPN.
D. Negative nitrogen balance occurs when the body loses more nitrogen than it gains, typically due to inadequate protein intake or increased protein breakdown. TPN provides amino acids, which are the building blocks of protein, and aims to promote a positive nitrogen balance to support tissue repair and growth.

A. Urine output 50 mL per hour B. Heart rate 60 beats/minute C. Heart rhythm regular D. Blood pressure 120/90

Correct Answer is B

Explanation

A. While it may have some impact on kidney function indirectly through its effects on blood pressure and heart function, urine output is not the primary parameter used to assess the effectiveness of carvedilol in a patient with a history of unstable angina.
B. Carvedilol, as a beta-blocker, helps reduce heart rate by blocking the effects of adrenaline on the heart. In unstable angina, lowering the heart rate can reduce myocardial oxygen demand, which is beneficial in managing ischemic symptoms
C. Carvedilol primarily affects heart rate and blood pressure but doesn't directly regulate heart rhythm. However, in patients with certain cardiac conditions, like heart failure or left ventricular dysfunction after a heart attack, carvedilol can sometimes help to stabilize heart rhythm indirectly by reducing stress on the heart.
D. Carvedilol is also effective in reducing blood pressure, which is beneficial in patients with unstable angina, as it decreases the workload on the heart and the oxygen demand of the myocardium. A blood pressure reading of 120/90 is within the normal range for an adult and indicates good control of blood pressure.

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The nurse is caring for a client admitted with an obstruction in the duodenum. Which initial clinical manifestation is associated with this condition?

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Naxlex Comprehensive Predictor Exams

A client was started on total parenteral nutrition (TPN) ten days ago. The nurse recognizes that the expected effect of TPN is a:

Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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