test question

1.the client had an abdominal aortic aneursym repair two days ago. Which intervention shoudl the nurse implement first?

a.assess the client bowel sounds

b. administer iv prophylactic antibiotic

c.encourage the client to splint the incision

d.ambulate the client in the room with assisstance

2.Which assessment data would require immediate intervention by the nurse for the client who is 6 hrs post-op abdominal aortic aneurysm repair?

a. absent bilateral pedial pulses

b.complaints of pain at the site of the incision

c.distended tender abdomin

d.an elevated temperature of 100*F.

I was going with d on the first one and a in the second one. Any suggestions would be greatly appreciated. Thanks

For the first one I would answer A. On our tests you always assess before you do anything else.

For question 2 I would say : A. Absent pulse not a good thing. B and C I think you be normal and D 100 isnt considered a fever.

Im just in my first semester so Im not sure how right I will be. When you find out please post.

I say "A" for number one and "C" for the second, due to the fact that this could mean internal bleeding.

1.the client had an abdominal aortic aneursym repair two days ago. Which intervention shoudl the nurse implement first?

a.assess the client bowel sounds

b. administer iv prophylactic antibiotic

c.encourage the client to splint the incision

d.ambulate the client in the room with assisstance

2.Which assessment data would require immediate intervention by the nurse for the client who is 6 hrs post-op abdominal aortic aneurysm repair?

a. absent bilateral pedial pulses

b.complaints of pain at the site of the incision

c.distended tender abdomin

d.an elevated temperature of 100*F.

I was going with d on the first one and a in the second one. Any suggestions would be greatly appreciated. Thanks

I would assess first, so my answer to the first question would be A.

No matter what the situ, absent pulses is bad. A for number two

"C" for the second, due to the fact that this could mean internal bleeding.

But they're six hours post-op for abdominal surgery. They're going to been sore and swollen. If the question asked a couple days post-op, I think that if they're distended it's not a good thing, but I think it's expected six hours post-op

1.the client had an abdominal aortic aneursym repair two days ago. Which intervention shoudl the nurse implement first?

a.assess the client bowel sounds

b. administer iv prophylactic antibiotic

c.encourage the client to splint the incision

d.ambulate the client in the room with assistance

2.Which assessment data would require immediate intervention by the nurse for the client who is 6 hrs post-op abdominal aortic aneurysm repair?

a. absent bilateral pedal pulses

b.complaints of pain at the site of the incision

c.distended tender abdomen

d.an elevated temperature of 100*F.

I was going with d on the first one and a in the second one. Any suggestions would be greatly appreciated. Thanks

The first one is A. Two days post-op is enough time for a sleepy bowel to wake up and the Aorta feeds everything in the lower part of your body including the bowels.B would have been done pre-op and the others aren't as important as A.

The second one is C. The abdomen should be tender from the incision, but not distended this could = free blood. A is a concern too, but not more immediate than C. B is a lower priority and D is not considered a fever in most hospitals.

Both are A. In regards to the 2nd question, absent bilateral pedal pulses are more of an immediate concern. Think about your ABCs.

For #1, the question asks for an intervention--is it acceptable to answer A, which is an assessment? I'm pretty new to all this, but that might throw me off.

i think both A's

2.Which assessment data would require immediate intervention by the nurse for the client who is 6 hrs post-op abdominal aortic aneurysm repair?

a. absent bilateral pedial pulses

b.complaints of pain at the site of the incision

c.distended tender abdomin

d.an elevated temperature of 100*F.

I asked my teacher this question and she said without a doubt it's absent bilateral pedal pulses because a distended tender abdomen is expected after surgery. If they were re-bleeding they would have intense back and abdominal pain.

They are both A. An aneurysm can cause hypoactive bowel sounds and we need to ensure that they are active. The second question is A because of the absent pulses.

ABC"S

I say A for both

my rationale is...

post-operatively, could have paralytic ileus (the other answers are less on the hierarchy)

and Airway, Circulation, Breating (#2 - absent bilateral pulses!! - impaired circulation!!!)