What is a likely finding in the nurse's assessment of a patient who has a large bowel obstruction?

Projectile vomiting

Abdominal distention

Metabolic alkalosis

Referred back pain

Answer and Explanation

The Correct Answer is B

Rationale:
A. Vomiting is more common in small bowel obstruction and is usually less severe in large bowel obstruction.

B. A large bowel obstruction causes accumulation of gas and fecal material proximal to the blockage, leading to significant abdominal distention.

C. Large bowel obstruction may eventually cause metabolic acidosis due to impaired perfusion and tissue hypoxia, not alkalosis.

D. Back pain is not a typical sign of large bowel obstruction; the primary symptom is abdominal discomfort, distention, and constipation.

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Correct Answer is C

Explanation

Rationale:
A. Baked potato is low in sodium if prepared without added salt, making it safe for a client on a diuretic.
B. Milkshake is generally safe unless it contains added sodium; in most cases, it is allowed.
C. Ham is high in sodium, which is contraindicated for a client taking bumetanide, a loop diuretic, as high sodium intake can counteract the diuretic effect and worsen fluid retention.
D. Stewed tomatoes can be included if unsalted; they are generally safe in moderation.

A. Epigastrium B. Umbilical C. Flank D. Subumbilical

Correct Answer is B

Explanation

Rationale:
A. Epigastrium refers to the upper central region of the abdomen, just below the sternum; Cullen’s sign does not appear here.
B. Umbilical region (around the navel) is where Cullen’s sign appears as a bluish discoloration due to subcutaneous fat necrosis or retroperitoneal bleeding associated with acute pancreatitis. This is the correct site.
C. Flank discoloration is known as Grey Turner’s sign, another indicator of retroperitoneal bleeding, but distinct from Cullen’s sign.
D. Subumbilical refers to the area below the umbilicus, not the typical site for Cullen’s sign.

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What is a likely finding in the nurse's assessment of a patient who has a large bowel obstruction?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has cirrhosis and has a prescription for bumetanide. When delivering the client's lunch tray, which of the following items should the nurse identify as contraindicated for the client?

Correct Answer is C

Explanation

In reviewing the medical record for a patient admitted with acute pancreatitis, the nurse sees that the patient has a positive Cullen's sign. Indicate the area in the accompanying figure where the nurse will assess for this change.

Correct Answer is B

Explanation

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