The nurse is caring for a client who is 4 hours post-op after an open cholecystectomy. The nurse would expect the client's bowel sounds to be:

Normoactive.

Absent or hypoactive.

Hyperactive.

Borborygmi.

Answer and Explanation

The Correct Answer is B

Choice B rationale

After an open cholecystectomy, bowel sounds are typically absent or hypoactive due to the effects of anesthesia and the manipulation of the intestines during surgery. It takes time for normal bowel function to resume.

Choice A rationale

Normoactive bowel sounds are not expected immediately after abdominal surgery due to the temporary paralysis of intestinal motility caused by anesthesia and surgical manipulation.

Choice C rationale

Hyperactive bowel sounds are uncommon after surgery. They are more often associated with conditions like gastroenteritis or bowel obstruction rather than the immediate postoperative period of an open cholecystectomy.

Choice D rationale

Borborygmi, or loud, rumbling bowel sounds, are not expected after abdominal surgery. These sounds can indicate increased bowel activity, which is not typical in the immediate postoperative phase following an open cholecystectomy.

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Correct Answer is C

Explanation

Choice A rationale

Tenesmus is a frequent urge to defecate, common in ulcerative colitis but not indicative of toxic megacolon. It results from inflammation and irritation of the rectal and colonic mucosa, causing discomfort and straining during bowel movements.

Choice B rationale

Hyperactive bowel sounds are associated with increased gastrointestinal activity, often seen in diarrheal states and early mechanical bowel obstruction but not typically linked to toxic megacolon. Toxic megacolon often presents with reduced or absent bowel sounds due to colonic paralysis.

Choice C rationale

An enlarging abdominal girth indicates distension, a significant sign of toxic megacolon. This condition involves extreme dilation of the colon, which can lead to severe abdominal distension due to trapped gas and stool. This can be life-threatening if not treated promptly.

Choice D rationale

Anal fissures are tears in the anal canal, common in chronic constipation or Crohn’s disease, not typically a sign of toxic megacolon. They cause pain and bleeding during bowel movements but do not indicate toxic megacolon.

A. "You need to learn how to talk to people.We are trying to help you.”. B. "What medications do you take for your mental health problems?" C. "Do you know how long I've been doing this? You do not intimidate me.”. D. "I understand that you are angry, but this behavior will not be tolerated.”.

Correct Answer is D

Explanation

Choice A rationale

This statement is confrontational and does not provide clear boundaries or expectations for acceptable behavior.

Choice B rationale

Asking about medications does not address the inappropriate behavior and may further escalate the situation.

Choice C rationale

This response is defensive and may provoke further aggression from the client.

Choice D rationale

This statement acknowledges the client's feelings while clearly setting a boundary for unacceptable behavior, promoting a safe environment.

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The nurse is caring for a client who is 4 hours post-op after an open cholecystectomy. The nurse would expect the client's bowel sounds to be:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse suspects that the client hospitalized with severe ulcerative colitis, may be developing the complication of toxic megacolon. Which assessment finding supports these suspicions?

Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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