Wednesday, June 1, 2011

NCLEX Exam Practice Question of the Week - 06/01/11


Question: A nurse is caring for a child after spinal fusion for scoliosis treatment. The child complains of abdominal discomfort and begins to have episodes of vomiting. On further assessment, the nurse notes abdominal distention. Based on these findings, the nurse should take which action?

1. Notify the physician.
2. Administer an antiemetic.
3. Increase the intravenous fluids.
4. Place the child in a Sims' position.

Answer: 1

Rationale: Scoliosis is a three-dimensional spinal deformity that usually involves lateral curvature, spinal rotation resulting in rib asymmetry, and hypokyphosis of the thorax. A complication after surgical treatment of scoliosis is superior mesenteric artery syndrome. This disorder is caused by mechanical changes in the position of the child's abdominal contents, resulting from lengthening of the child's body. The disorder results in a syndrome of emesis and abdominal distention similar to that which occurs with intestinal obstruction or paralytic ileus. Postoperative vomiting in children with body casts or children who have undergone spinal fusion warrants attention because of the possibility of superior mesenteric artery syndrome. Options 2, 3, and 4 are incorrect.

Test-taking Strategy: Use the process of elimination. Eliminate option 3 first because it should not be implemented unless prescribed by the physician. Eliminate option 4 next because this child requires logrolling, and Sims' position may cause injury after surgery. From the remaining options, note the assessment signs and symptoms in the question. These should alert you that notification of the physician is necessary. Review the manifestations of superior mesenteric artery syndrome if you had difficulty with this question.

Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process--Implementation
Content Area: Child Health--Neurological/Musculoskeletal
Reference: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-child nursing (3rd ed., p. 1418). St. Louis; Saunders

This week’s NCLEX exam practice question came from:

2 comments:

  1. The digestive system has two basic jobs: absorb nutrients so they can be used as energy, cell production, storage and other biologically imperative activities, and obstruct unwanted particles such as viruses, bacteria and other harmful microbes before they enter the blood systems. Your digestive system is lined by a mucosal membrane with tightly packed cells which act as the gatekeeper for these particles.

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  2. Perfect!!! What I can say in this article is very important to be written as it may help everybody to get awareness. Good job done.

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