The nurse is caring for a client on the third day following abdominal surgery and assesses the absence of bowel sounds, abdominal distention, and the client passing no flatus. These findings indicate the client is experiencing which of the following postoperative complications?

Paralytic ileus

Incisional infection

Health care-associated Clostridium difficile

Fecal impaction

Answer and Explanation

The Correct Answer is A

A. Paralytic ileus is a common postoperative complication characterized by the absence of bowel sounds, abdominal distention, and failure to pass flatus due to a lack of intestinal peristalsis.

B. Incisional infection would typically present with localized symptoms such as redness, warmth, and purulent drainage at the surgical site, not generalized abdominal distention and lack of bowel sounds.

C. Health care-associated Clostridium difficile infection usually presents with diarrhea, not an absence of bowel sounds or abdominal distention.

D. Fecal impaction is more likely to cause localized pain and possible leakage of liquid stool, rather than complete absence of bowel sounds and severe distention.

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Correct Answer is D

Explanation

A. Disagreements about staffing issues should be addressed through appropriate channels, but they do not typically require an incident report.

B. The absence of advanced directives is a concern that needs to be addressed, but it does not constitute an incident that requires reporting.

C. A staff member not arriving for their shift is a staffing issue but does not require an incident report unless it directly affects client care.

D. Missing dentures are considered a loss of personal property, which requires documentation through an incident report to ensure accountability and to initiate a search or compensation process.

A. “Distributive shock occurs due to increased systemic vascular resistance." B. “Distributive shock occurs due to loss of blood volume." C. "Distributive shock occurs due to loss of myocardial contractility." D. Distributive shock occurs due to systemic vasodilation."

Correct Answer is D

Explanation

A. Increased systemic vascular resistance is more characteristic of obstructive or cardiogenic shock rather than distributive shock.

B. Loss of blood volume describes hypovolemic shock, not distributive shock.

C. Loss of myocardial contractility pertains to cardiogenic shock, not distributive shock.

D. Distributive shock is characterized by systemic vasodilation leading to a decrease in systemic vascular resistance and inadequate tissue perfusion.

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The nurse is caring for a client on the third day following abdominal surgery and assesses the absence of bowel sounds, abdominal distention, and the client passing no flatus. These findings indicate the client is experiencing which of the following postoperative complications?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for several clients on a medical-surgical unit. Which of the following client care situations requires the nurse to complete an incident report?

Correct Answer is D

Explanation

A nurse and a newly licensed nurse are providing care for a client who has distributive shock. How should the nurse explain the pathophysiology of distributive shock to the newly licensed nurse?

Correct Answer is D

Explanation

A nurse is assisting in providing care for a client who has obstructive shock. Which of the following diagnoses should the nurse expect?

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A nurse is caring for a client who is 2 days postoperative from abdominal surgery. The client reports discomfort from abdominal distension and flatus. Which of the following suggestions should the nurse include?

A nurse is assisting with preoperative teaching for a client. Which of the following outcomes should the nurse expect?

A nurse is planning to monitor a client for dehydration following several episodes of vomiting and an increase in the client's temperature. Which of the following findings should the nurse identify as an indication that the client is dehydrated?

This surgery is a more extensive procedure than a biopsy. It usually requires opening a body cavity to diagnose and to find out the extent of a disease process.

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