NURSING 115 Pharmacology / vSim - Stan Checketts/Jermaine Jones
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vSim - Stan Checketts/Jermaine Jones
It will be important to reconcile Jermaine Jones's medications prior to discharge. What is
the purpose of this process? (Select all that apply.)
a) Compare current medications to all medications taken.
b) Prevent duplication of medications.
c) Ensure disposal of all home medications.
d) Provide a complete list of new medications.
e) Avoid possible drug interactions.
(correct Answer) - a) Compare current medications to all medications taken.
b) Prevent duplication of medications.
d) Provide a complete list of new medications.
e) Avoid possible drug interactions.
Medication reconciliation refers to the process of comparing a patient's medication
orders to all medications that the patient has been taking. Reconciliation is done to
avoid medication errors, such as omissions, duplications, dosing errors, and drug
interactions.
The nurse is aware that the most common cause of small bowel obstruction is which of
the following?
a) Neoplasms
b) Volvulus
c) Adhesions
d) Hernias
(correct Answer) - c) Adhesions
Most bowel obstructions occur in the small intestine. Adhesions are the most common
cause of small bowel obstruction, followed by hernias and neoplasms. Volvulus (twisting
of the bowel) is another cause, but it is not the most common.
A patient with abdominal distention experiences reflux vomiting, which the nurse knows
can lead to which of the following acid-base disturbances?
a) Metabolic acidosis
b) Metabolic alkalosis
c) Respiratory alkalosis
d) Respiratory acidosis
(correct Answer) - b) Metabolic alkalosis
The reflux vomiting in the loss of hydrogen ions and potassium from the stomach,
leading to reduction of the serum electrolytes chloride and potassium in the blood and
causing metabolic alkalosis.
, The initial symptom of abdominal pain described by the patient in which of the following
ways would lead the nurse to suspect a small bowel obstruction?
a) Sharp, knife-like
b) Colicky, crampy
c) Dull, aching
d) Rebound, squeezing
(correct Answer) - b) Colicky, crampy
The initial symptom is usually crampy pain that is wavelike and colicky due to persistent
peristalsis both above and below the blockage.
The nurse is aware that untreated small bowel obstruction can progress to which type of
shock?
a) None of these
b) Distributive
c) Hypovolemic
d) Cardiogenic
(correct Answer) - c) Hypovolemic
The vomiting that accompanies small bowel obstruction can lead to acute fluid losses,
which can lead to hypovolemic shock. Hypovolemia can occur from the fluid shifts
related to the edema and congestion occurring in the bowel.
The nurse anticipates that the initial treatment for small bowel obstruction will involve
which of the following?
a) Decompression of bowel via nasogastric tube
b) Surgical intervention
c) Insertion of a rectal tube for drainage
d) Colonoscopy and irrigation
(correct Answer) - a) Decompression of bowel via nasogastric tube
Decompression of the bowel through the nasogastric (NG) tube is necessary for all
patients with small bowel obstruction to relieve the pressure and calm the intestine.
Potassium chloride may be administered in the patient with small bowel obstruction and
dehydration to correct hypokalemia. The nurse knows that a patient experiencing
decreased potassium levels would exhibit which of the following signs and symptoms?
a) Hypotension, muscle weakness
b) Increased thirst, polyuria
c) Increased reflexes, tachycardia
d) Hypertension, bradycardia
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