The nurse is caring for a patient with multiple traumatic injuries following an occupational accident where the patient fell from a 30ft high ladder. Upon assessment, the-nurse hears bowel sounds in the chest. What should the nurse do next?

Determine when the patient last ate and call for spiritual advisor

Assess vital signs and immediately notify the trauma surgeon

Request an order for a chest x-ray and stop IV fluids

Medicate the patient's pain and obtain consent for surgery

Answer and Explanation

The Correct Answer is B

A) Determine when the patient last ate and call for spiritual advisor:
While it is important to gather a comprehensive history, including when the patient last ate, and to provide emotional support such as calling a spiritual advisor, these actions are not the priority in this situation. The immediate concern is the patient's physical condition and addressing the potential trauma to the chest and abdominal organs. Bowel sounds in the chest suggest a serious injury, such as a diaphragmatic rupture, which requires immediate surgical intervention.

B) Assess vital signs and immediately notify the trauma surgeon:
Hearing bowel sounds in the chest is a strong indication of a diaphragmatic injury, possibly a rupture, which can lead to the bowel being displaced into the chest cavity. This is a life-threatening emergency that can result in respiratory distress, impaired organ function, and infection. The nurse should assess vital signs to determine if the patient is stable or in shock and then immediately notify the trauma surgeon to facilitate urgent surgical intervention. Immediate surgical repair is necessary to prevent further complications such as respiratory compromise or sepsis.

C) Request an order for a chest x-ray and stop IV fluids:
A chest x-ray may be ordered later to confirm the presence of diaphragmatic injury or other chest trauma, but the priority action is to notify the trauma surgeon immediately. Stopping IV fluids is not appropriate in this situation; the patient likely needs continued fluid resuscitation, especially if they are in shock or have significant blood loss from their traumatic injuries.

D) Medicate the patient's pain and obtain consent for surgery:
Pain management is important for the patient’s comfort, but surgical intervention should not be delayed while obtaining consent. The trauma surgeon should be notified immediately, and surgery should be expedited without waiting for consent. In trauma cases, consent for life-saving procedures may be implied if the patient is unconscious or unable to provide consent due to the urgency of the situation.

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Correct Answer is ["13.7"]

Explanation

Given:

Ordered dose of Furosemide: 1 mg/kg

Patient weight: 121 lbs

Concentration of Furosemide: 40 mg/10 mL (4 mg/mL)

Step 1: Convert patient weight from pounds to kilograms:

1 pound (lb) = 0.453592 kilograms (kg)

Patient weight in kg = 121 lbs x 0.453592 kg/lb = 54.877832 kg

Step 2: Calculate the total dose of Furosemide:

Total dose (mg) = Ordered dose (mg/kg) x Patient weight (kg)

Total dose (mg) = 1 mg/kg x 54.877832 kg

Total dose (mg) = 54.877832 mg

Step 3: Calculate the volume to be administered:

Volume (mL) = Total dose (mg) / Concentration (mg/mL)

Volume (mL) = 54.877832 mg / 4 mg/mL

Volume (mL) = 13.719458 mL

Step 4: Round to the nearest tenth:

Volume (mL) ≈ 13.7 mL

A. there are no obvious symptoms or problems B. radiation therapy is ineffective because the ovaries are located so deep within the pelvis C. the causative cancer cell is resistant to chemotherapy or radiation D. ovarian cancer occurs primarily among women over age 70 that also have other complicating health problems

Correct Answer is ["A"]

Explanation

A) There are no obvious symptoms or problems: Ovarian cancer is often referred to as the "silent killer" because it tends to develop without noticeable symptoms in the early stages. When symptoms do appear, they are often vague and nonspecific, such as bloating, abdominal discomfort, or changes in bowel habits. By the time ovarian cancer is diagnosed, it is frequently at an advanced stage, making it more difficult to treat effectively. This lack of early, clear symptoms contributes significantly to the high death rate associated with the disease.

B) Radiation therapy is ineffective because the ovaries are located so deep within the pelvis: While ovarian cancer is located deep within the pelvis, radiation therapy can still be effective for certain types of tumors. However, the primary reason for high death rates is not the location of the ovaries, but the late-stage diagnosis and difficulty in detecting the cancer early.

C) The causative cancer cell is resistant to chemotherapy or radiation: While some ovarian cancer cells may exhibit resistance to treatment, this is not the main reason for the high mortality rate. The real issue is the lack of early detection, as ovarian cancer is often diagnosed when it has already spread beyond the ovaries. Early-stage ovarian cancer may be more responsive to treatment, but by the time symptoms are noticeable, the cancer is often advanced, which limits the effectiveness of chemotherapy and radiation.

D) Ovarian cancer occurs primarily among women over age 70 that also have other complicating health problems: Although the incidence of ovarian cancer increases with age, particularly after age 60, it is not the primary factor contributing to high death rates. Many women diagnosed with ovarian cancer are relatively healthy except for the cancer itself.

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The nurse is caring for a patient with multiple traumatic injuries following an occupational accident where the patient fell from a 30ft high ladder. Upon assessment, the-nurse hears bowel sounds in the chest. What should the nurse do next?

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Naxlex Comprehensive Predictor Exams

A patient is ordered 1 mg/kg of furosemide IV push. The patient weights 121 lbs. The medication is supplied 40 mg/10 mL. How many mL should the nurse administer? (round to the nearest tenth)

Correct Answer is ["13.7"]

Explanation

In educating clients about ovarian cancer the nurse emphasizes death rates for ovarian cancer are high because:

Correct Answer is ["A"]

Explanation

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