A client who had bariatric surgery 2 months ago is admitted because of vomiting and inability to tolerate food and liquids. The client is pain free. Which intervention should the nurse include in the client's plan of care?

Maintain the client on an NPO status.

Determine if the client is over-hydrating to feel satiated.

Administer daily vitamin supplements.

Encourage positive self accolades for dietary adherence.

Answer and Explanation

The Correct Answer is A

A. Maintain the client on an NPO status: After bariatric surgery, vomiting and the inability to tolerate food and liquids could indicate complications such as gastric outlet obstruction or stenosis. Maintaining NPO status allows the gastrointestinal system to rest while the cause of the symptoms is investigated and treated.

B. Determine if the client is over-hydrating to feel satiated: While over-hydration can cause discomfort, the immediate concern is the client's inability to tolerate food and liquids, which may suggest a more serious issue.

C. Administer daily vitamin supplements: While vitamin supplementation is essential after bariatric surgery to prevent deficiencies, it does not directly address the current issue of vomiting and inability to tolerate food and liquids.

D. Encourage positive self accolades for dietary adherence: Though reinforcing positive behavior is important in long-term weight loss management, it is not the priority at this moment. The immediate focus is addressing the client's symptoms and ensuring they are medically managed.

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Correct Answer is D

Explanation

A. Ask family members to remain with the client in the evenings from 1700 to 2100: While family presence can offer comfort, it is not always feasible and doesn’t directly address the environmental management needed for sundowning behaviors.

B. Administer a prescribed PRN benzodiazepine at the onset of a confused state: Though medications may help in acute cases, routine pharmacologic management is not the first-line intervention due to risks like oversedation and increased fall risk in older adults.

C. Postpone administration of nighttime medications until after 2300: Delaying medications may interfere with sleep hygiene and the efficacy of routine medications that aid in rest or symptom management.

D. Ensure that the client is assigned to a room close to the nurses' station: Proximity to staff allows for more frequent monitoring and faster intervention during episodes of confusion, helping prevent injury and manage behaviors associated with sundowning.

A. If I experience any difficulty with breathing I will report it. B. Drinking grapefruit juice will increase the effects of the medication. C. Monitoring for changes in stool color is important. D. I should take the medication with antacids.

Correct Answer is D

Explanation

A. If I experience any difficulty with breathing I will report it: Difficulty breathing is a serious side effect of itraconazole, which can cause respiratory issues such as shortness of breath. The client should report this immediately, making this statement appropriate.

B. Drinking grapefruit juice will increase the effects of the medication: Grapefruit juice increases the effects of many medications, including itraconazole, by inhibiting the enzyme responsible for metabolizing the drug.

C. Monitoring for changes in stool color is important: Itraconazole can cause liver toxicity, and monitoring stool color is important as it can indicate liver issues, such as jaundice. The client’s awareness of this potential side effect is appropriate.

D. I should take the medication with antacids: This statement requires correction because antacids can reduce the absorption of itraconazole. The medication should be taken with an acidic drink like cola, not with antacids, to ensure proper absorption.

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A client who had bariatric surgery 2 months ago is admitted because of vomiting and inability to tolerate food and liquids. The client is pain free. Which intervention should the nurse include in the client's plan of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

An older adult client is admitted to the psychiatric unit for assessment of a recent onset of dementia. The nurse notices that in the evening this client often becomes restless, confused, and agitated. Which intervention is most important for the nurse to implement?

Correct Answer is D

Explanation

A client receives a prescription for itraconazole. Which statement made by the client requires additional instruction by the nurse?

Correct Answer is D

Explanation

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