a nurse is assessing a client who is postoperative following a bowel resection which of the following findings should the nurse report to the provider a nurse is assessing a client who is postoperative following a bowel resection which of the following findings should the nurse report to the provider
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Nursing Elites

ATI RN

ATI Comprehensive Exit Exam 2023 With NGN

1. A nurse is assessing a client who is postoperative following a bowel resection. Which of the following findings should the nurse report to the provider?

Correct answer: D

Rationale: A urine output of 20 mL/hr is below the expected range and indicates potential renal failure, requiring immediate intervention. In postoperative patients, a urine output less than 30 mL/hr suggests inadequate renal perfusion, a concern that needs prompt attention to prevent renal complications. The heart rate of 110/min, temperature of 37.4°C (99.3°F), and respiratory rate of 18/min are within normal ranges for a postoperative client and do not indicate immediate issues.

2. If a client refuses surgery, but the family insists, what should the nurse do in this situation?

Correct answer: B

Rationale: In this situation, the nurse should respect the client's decision and notify the healthcare provider. The client has the right to refuse treatment, and the nurse must advocate for the client's autonomy. Proceeding with the surgery against the client's wishes would violate their autonomy and ethical principles. Trying to mediate between the family and the client may be appropriate, but ultimately, the client's decision should be respected. Encouraging the client to follow their family's wishes disregards the client's autonomy and is not ethically appropriate.

3. If pregnancy does not occur, the corpus luteum shrinks, and the __________.

Correct answer: D

Rationale: If pregnancy does not occur, the corpus luteum will shrink. As a result, the lining of the uterus is discarded through the process of menstruation. This shedding of the uterine lining is what causes menstrual bleeding. Choices A, B, and C are incorrect because they do not describe the physiological response of the body when pregnancy does not occur. The corpus luteum shrinking and the subsequent shedding of the uterine lining are part of the menstrual cycle, not processes related to cell duplication, zygote multiplication, or the duration of the germinal period.

4. Anemia of chronic inflammation is generally classified as:

Correct answer: D

Rationale: Anemia of chronic inflammation is characterized by normochromic and normocytic red blood cells. In chronic inflammation, the body typically produces enough red blood cells, but they are often smaller and paler than normal (normocytic and normochromic). Choices A, B, and C are incorrect because hypochromic and microcytic, hypochromic and macrocytic, and normochromic and microcytic anemias are not typically associated with chronic inflammation.

5. A patient has developed a decubitus ulcer on the coccyx. What defense mechanism is most affected by this homeostatic change?

Correct answer: C

Rationale: In this scenario, a decubitus ulcer on the coccyx indicates a breakdown of the skin's integrity due to prolonged pressure. The skin is the primary defense mechanism of the body against external pathogens. When the skin is compromised, it can lead to infections and other complications. The mucous membrane (Choice A) plays a role in protecting internal surfaces, not the skin. The respiratory tract (Choice B) is involved in breathing and not directly related to the skin's defense. The gastrointestinal tract (Choice D) is responsible for digestion and absorption of nutrients, not the primary defense mechanism against external threats like the skin.

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