39. A patient has been diagnosed with small bowel obstruction and admitted to the surgical ward, which nursing intervention has to come first? A. Prevent infection B. Maintained skin and tissue integrity C. Prevent nausea and vomiting D. Maintain fluid and electrolyte imbalance 40. The patient had colonoscopy which showed "cobble-stone'" appearance of GI lining , this is found in which of the following disease A. Ulcerative colitis B. Pancreatitis C. Crohn's disease D. Peritonitis 41. A patient has been newly diagnosed with acute pancreatitis and admitted to medical ward How should the nurse most likely explain pathophysiology of this patient's health problem? A. Toxins have accumulated and inflamed your pancreas B. Bactria likely migrated from intestines into pancreases and cause inflammation C. The enzyme that pancreas produces have damage the pancreas itself D. Chronic alcohol consumption damage functional cells of pancreas 42. Assume you are on duty in Hiwot Fana Specialized University Hospital, a female patient came with a diagnosis of chronic gastritis. She is treated with histamine receptor blocker (cimetidine). What is the mechanism of action of this drug? A. Help to neutralized the stomach acid production B. Reduced stomach acid production C. Inhibiting vague nerve stimulation D. Stimulate mucus production 43. Sr, Tayitu was caring for a patient in the emergency department with complain of acute abdominal pain, associated nausea , and vomiting. When palpating the patient's left lower quadrant, the patient complains pain in the right lower quadrant of the abdomen. For which physical examination did this patient is positive? A. Psoas Sign C. Obturator sign B. Rovsing's sign D. Rebound tenderness 44. A nurse is assessing a patient who has been diagnosed with cholecystitis and has localized abdominal pain. When assessing the characteristics of the patient's pain, the nurse should anticipate that it may radiate to what region? A. Left upper chest C. Inguinal region B. Right shoulder D. Neck or jaw