What is a likely finding in the nurse's assessment of a patient who has a large bowel obstruction?
Referred back pain.
Abdominal distention.
Projectile vomiting.
Metabolic alkalosis.
The Correct Answer is B
Choice A rationale
Referred back pain is not a hallmark of large bowel obstruction. It typically occurs in conditions with retroperitoneal organ involvement, such as renal or pancreatic pathology. Large bowel obstruction presents primarily with abdominal distention and pain localized to the affected bowel segment due to obstruction-induced pressure and stretching.
Choice B rationale
Abdominal distention is a classic sign of large bowel obstruction. Accumulated gas and stool proximal to the obstruction result in bloating and visible distention. This presentation reflects impaired bowel motility, pressure build-up, and reduced passage of contents, commonly seen in large bowel pathology.
Choice C rationale
Projectile vomiting is more indicative of upper GI obstruction, such as pyloric stenosis, due to immediate pressure effects. Large bowel obstructions manifest with late vomiting as distal obstruction delays content passage. Vomiting in this case is less forceful and often accompanied by fecal material.
Choice D rationale
Metabolic alkalosis is more associated with vomiting-related losses of gastric acid, as seen in upper GI pathology. Large bowel obstruction typically leads to metabolic acidosis from ischemia or bacterial overgrowth, not alkalosis, as the obstruction hampers normal bowel function and circulation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
A bland diet reduces gastric irritation by avoiding substances that stimulate acid secretion or exacerbate nausea. It includes foods like rice, bananas, and toast that are easy to digest and less likely to provoke symptoms of nausea or vomiting.
Choice B rationale
Opposing the bland diet recommendation for severe nausea ignores scientific evidence that supports its use. Providing a diet rich in spices or acidic foods can worsen symptoms by irritating the gastrointestinal tract further. .
Correct Answer is C
Explanation
Choice A rationale
Applying a warm pack is inappropriate for controlling active bleeding, as it can exacerbate blood flow to the site, worsening the hemorrhage rather than controlling it effectively.
Choice B rationale
Using a tourniquet above the bleeding site is a last-resort method typically reserved for life-threatening bleeding. It may cause complications such as nerve damage or ischemia, so other measures are prioritized first.
Choice C rationale
Direct pressure or sterile pressure dressing with elevation minimizes blood loss effectively by compressing the damaged vessels, promoting clot formation, and utilizing gravity to reduce the pressure at the wound site. It is the recommended first-line method.
Choice D rationale
Placing an ice pack on the bleeding site may reduce localized blood flow by inducing vasoconstriction but is less effective than direct pressure for stopping active hemorrhage. It is secondary to other control measures.
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