A female client who had bariatric surgery two weeks ago returns to the emergency department and is readmitted to the hospital because she reports experiencing nausea, vomiting, abdominal cramps, and severe diarrhea. Which intervention(s) should the nurse include in the plan of care? Select all that apply.

Plan meals with low fiber.

Separate fluids from meals.

Eliminate acidic food choices.

Offer comfort foods.

Provide small, frequent meals.

Answer and Explanation

Correct Answer : A,B,E

A. Plan meals with low fiber: After bariatric surgery, the digestive system can be more sensitive, and high-fiber foods may cause discomfort. Planning low-fiber meals helps reduce irritation and minimize symptoms like diarrhea and cramping.

B. Separate fluids from meals: This is an important intervention because drinking fluids during meals can increase the risk of dumping syndrome, leading to nausea, vomiting, and diarrhea. Fluids should be consumed between meals to help avoid these symptoms.

C. Eliminate acidic food choices: Acidic foods (like citrus, tomatoes, some sauces) can irritate the sensitive gastric pouch and small intestine after bariatric surgery, potentially exacerbating symptoms of nausea, abdominal cramps, and discomfort.

D. Offer comfort foods: Comfort foods are not appropriate for this client, as they may be high in fat, sugar, or calories, which could exacerbate symptoms after bariatric surgery. Instead, nutritious and easily digestible foods should be offered.

E. Provide small, frequent meals: Offering small, frequent meals helps reduce the strain on the digestive system, making it easier for the client to tolerate food. Large meals can cause discomfort and increase the risk of complications such as dumping syndrome.

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Correct Answer is D

Explanation

A. Frequency that the child uses a rescue inhaler during the week: While it is important to know how often the child uses a rescue inhaler, it does not provide immediate, critical information to assess the severity of the current asthma attack.

B. Type of inhaler the child typically uses on a regular basis: While knowing the type of inhaler the child uses regularly can provide insight into their asthma management, it is not the most critical information at this moment, the current treatment is he most urgent.

C. Type of allergen exposure or trigger for the current episode: Understanding the trigger for the current asthma episode is helpful for long-term management but is not as urgent in the immediate assessment of the child’s condition during an acute exacerbation.

D. Last dose and type of rescue inhaler used by the child: This information helps assess whether the child has received appropriate treatment and whether additional or different interventions are needed immediately to address the asthma exacerbation, helps guide further treatment decisions.

A. Facilitate a consultation for speech therapy. B. Arrange for daily home care assistance. C. Use pictures and gestures to communicate. D. Initiate passive range of motion exercises.

Correct Answer is A

Explanation

A. Facilitate a consultation for speech therapy: Aphasia and difficulty swallowing are common after a CVA. A speech therapist can assess and provide interventions to address both speech and swallowing issues, improving communication and reducing the risk of aspiration or choking.

B. Arrange for daily home care assistance: While home care assistance may be necessary later, the immediate priority is addressing the client's communication and swallowing difficulties through therapy and clinical interventions.

C. Use pictures and gestures to communicate: This is helpful for the client’s communication, but it should be seen as an adjunct to speech therapy, not a substitute. Speech therapy provides targeted interventions to improve both speech and swallowing.

D. Initiate passive range of motion exercises: Although range of motion exercises are important for preventing joint contractures and promoting mobility, addressing the client’s swallowing and communication issues is a more immediate priority.

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Naxlex Comprehensive Predictor Exams

A parent brings their child, who has a history of asthma, to the emergency room. The child is wheezing and speaking one word between each breath. The child is anxious, tachycardic, and has labored respirations. Which assessment is most important for the nurse to obtain?

Correct Answer is D

Explanation

An older adult client is referred to a rehabilitation facility following a cerebrovascular accident (CVA). The client is aphasic with left sided paresis and is having difficulty swallowing. Which intervention is most important for the nurse to include in the client's plan of care?

Correct Answer is A

Explanation

A pre-school age child with a congenital heart defect is brought to the clinic by the parent because of a fever and an earache. During the assessment, the parent asks the nurse why the child is at the 5th percentile for weight and height for age. Which response is best for the nurse to provide?

The nurse is assisting the healthcare provider with a thoracentesis for a client who has emphysema. Which equipment should the nurse have at the bedside in the event the procedure is ineffective?

A woman and her live-in significant other come in the emergency department following a motor vehicle collision. Which finding should alert the nurse to assess for the possibility of domestic violence?

The nurse is setting up the equipment to assist with a sigmoidoscopy while the practical nurse (PN) positions the client in a flat prone position. Which action should the nurse implement?

The healthcare provider prescribes dalteparin 200 units/kg SUBQ once a day for a client who weighs 154 lb. The medication is available in 25,000 units/mL vial. How many mL should the nurse administer? (Enter numerical value only. If rounding is required, round to the nearest tenth.)

The nurse is caring for a client with the sexually transmitted infection (STI) syphilis. The client reports having sex with someone who had many partners. Which response should the nurse provide?