ROSH Gastrointestinal Practice Exam

What initial action should be taken for a patient with a suspected bowel obstruction?

1. Administer broad-spectrum antibiotics

2. Order a type and screen and begin fluid resuscitation

3. Conduct a fast-track surgery review

4. Initiate a nasogastric tube placement

The correct answer is: Order a type and screen and begin fluid resuscitation

In cases of suspected bowel obstruction, the initial action often focuses on stabilizing the patient and addressing potential complications that can arise from the obstruction. Initiating fluid resuscitation is crucial because bowel obstructions can lead to significant fluid shifts, dehydration, and electrolyte imbalances due to vomiting or intravascular volume depletion. By ordering a type and screen and beginning fluid resuscitation, the healthcare provider prepares for potential surgical intervention if indicated, while also ensuring that the patient is hemodynamically stable. This action prioritizes the patient's immediate medical needs, mitigating risks associated with bowel obstruction, such as shock or renal insufficiency. Other choices may seem relevant in different contexts but may not encompass the immediate priorities in managing suspected bowel obstructions as effectively as fluid resuscitation does. This approach allows for better preparation and management as further evaluations or interventions are required.