RN Adult Medical Surgical Online Practice 2023 A Questions and solutions

NGN *0900:Client presents with abdominal pain in the upper left quadrant for the past 2 days. States pain became worse this morning and is radiating to the back. Rates pain as 8 on a scale of 0 to 10.Hypoactive bowel sounds; reports nausea, no vomiting; client is passing flatus.Febrile, oriented to person, place, and time.Tachypnea with diminished breath sounds.Sinus tachycardia.Client voids 300 mL of clear, amber urine. *0930:Client vomited 100 mL brown liquid. The client is experiencing manifestations of pancreatitis as evidenced by the amylase and lipase. Rational: Drop Down 1: Pancreatitis is correct. The client's laboratory results and physical assessment indicate the client is experiencing manifestations of pancreatitis. Clients who have pancreatitis experience an increase in pancreatic enzymes, amylase, and lipase. Paralytic ileus, adult respiratory distress syndrome (ARDS), cardiogenic shock, and a cerebral vascular accident (CVA) are incorrect. The client is not experiencing manifestations of paralytic ileus because they have bowel sounds and are passing flatus. The client is not experiencing manifestations of ARDS because there is no indication the client is in respiratory distress. The client is not experiencing manifestations of cardiogenic shock because there is no indication from the client's medical record that there is a risk for cardiogenic shock. The client is not experiencing manifestations of a CVA because there is no indication from the client's medical record that there is a risk for a CVA. Drop Down 2: Amylase and lipase is correct. The client's laboratory results and physical assessment indicate the client is experiencing manifestations of pancreatitis. Clients who have pancreatitis experience an increase in pancreatic enzymes, amylase, and lipase. Oxygen saturation, urine output, platelet levels, and blood pressure are incorrect. These findings do not indicate pancreatitis. A nurse is caring for a client who is postoperative. Client admitted to medical-surgical unit from PACU. Client reports incisional pain as 2 on a scale of 0 to 10. Client appears restless and frequently asks for water. Bilateral lower extremities cool with +1 pedal pulses. Urine output is 40 mL for the past 2 hr. Moderate amount of bright red drainage noted on surgical incision dressing. Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress. Answer: *Insert a large-gauge *IV.Initiate a fluid challenge. *Hypovolemia *Urine output *Blood pressure Rational: The nurse should insert a large-gauge IV and initiate a fluid challenge because the client is most likely experiencing hypovolemia as evidenced by the client's restlessness, tachycardia, hypotension, decreased pulses, cool extremities, and decreased urine output. The nurse should monitor the client's urine output and blood pressure to evaluate the effectiveness of treatment.