The nurse is caring for a patient with a bowel resection. Which of the following would indicate that the patient's gastrointestinal tract is resuming normal function?

Correct Answer: B

Rationale: The presence of flatus (gas) is a positive sign that the patient's gastrointestinal tract is resuming normal function after a bowel resection surgery. Flatus production indicates that peristalsis and normal bowel motility are returning, allowing gas to move through the intestine. This is an important milestone in the postoperative recovery process, as it suggests the return of normal bowel function. The other options provided are not indicative of the return of normal gastrointestinal function.

Correct Answer: D

Rationale: A normal corneal light reflex, also known as the Hirschberg test, is assessed by shining a light into the patient's eyes and observing the reflection of the light on the corneas. In a normal response, the light should be reflected at the same spot in both eyes. If the light is off-center in one eye compared to the other, it could indicate a deviation in the alignment of the eyes, known as strabismus. Therefore, choice D, "Light is reflected at the same spot in both eyes," is the correct indicator of a normal corneal light reflex.

Correct Answer: B

Rationale: The classic diagnostic sign for pericarditis is the presence of a pericardial friction rub upon auscultation. This sound is caused by the inflamed pericardial layers rubbing against each other during the cardiac cycle. While precordial pain is a common symptom of pericarditis, it is not a specific diagnostic sign. Hypotension and rapid/labored respirations may occur in severe cases or complications but are not definitive diagnostic signs for pericarditis.

Correct Answer: B

Rationale: Strabismus, or misalignment of the eyes, is a common condition in newborns due to the lack of binocularity. Binocularity refers to the ability of both eyes to focus simultaneously on a single point, which is not fully developed in newborns. As a result, it is normal for a newborn's eyes to appear misaligned at times. This lack of coordination between the eyes typically resolves as the infant's visual system matures and they develop the ability to focus both eyes together. Therefore, the presence of strabismus in a newborn is usually considered a normal finding related to the immature visual development rather than a sign of pathology such as congenital cataracts, absence of red reflex, or pupil reactivity issues.

Correct Answer: B

Rationale: The principle of fluid balance in the body dictates that fluid intake should be approximately equal to the urine output, under normal circumstances. This balance ensures that the body maintains proper hydration levels and that the kidneys are functioning effectively in filtering and excreting waste products. Significant deviations between fluid intake and urine output can indicate potential issues with hydration status or kidney function, making it essential for healthcare professionals like Nurse Jeremy to closely monitor and evaluate these values.