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 C

Explanation

A. Client exhibits a frequent productive cough: While a productive cough may indicate airway clearance, it does not assess the effectiveness of the incentive spirometer. The primary goal of the incentive spirometer is to improve lung expansion, not to stimulate coughing.

B. Client reports using the incentive spirometer every hour while awake: Regular use of the incentive spirometer is important, but it alone does not fully evaluate its effectiveness. The goal is to improve lung function, and a physical assessment is needed to gauge this.

C. Client's breath sounds are clear to auscultation bilaterally: This is the best indicator of the effectiveness of the incentive spirometer. Clear breath sounds suggest improved lung expansion and ventilation, which is the primary goal of using the device.

D. Client demonstrates proper use of an incentive spirometer: While proper technique is essential for effectiveness, demonstrating correct use does not fully assess whether the desired outcomes are achieved.

A. An 82-year-old client with Alzheimer's disease and a newly fractured femur who has an indwelling urinary catheter and soft wrist restraints applied. B. A 48-year-old marathon runner with a central venous catheter who is experiencing nausea and vomiting due to electrolyte disturbance following a race. C. A 34-year-old admitted today after an emergency appendectomy who has a PIV and indwelling urinary catheter. D. A 63-year-old chain smoker admitted with chronic bronchitis who is receiving oxygen via nasal cannula and has a saline lock PIV.

Correct Answer is A

Explanation

A. The combination of cognitive impairment, physical injury, and restraints poses a high risk for complications such as infection, skin breakdown, and falls. Close monitoring and nursing interventions are critical to ensure safety, comfort, and appropriate care in this patient.

B. While this client may need some care for the electrolyte imbalance and nausea, this situation is more stable compared to the elderly client with Alzheimer's. The RN's role here would focus on managing the electrolyte disturbance and providing symptom relief.

C. Although this client is postoperative and may need some care, the RN's focus would primarily be on pain management and monitoring for infection or complications. However, the client’s condition is relatively stable compared to the elderly client with multiple risks.

D. This client is also stable and may require some ongoing monitoring for respiratory issues. However, the level of care needed is less intensive compared to a client with cognitive issues, restraints, and a recent fracture.

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Naxlex Comprehensive Predictor Exams

The nurse is evaluating the effectiveness of the incentive spirometer implemented in the client's plan of care. Which outcome statement best describes the effectiveness of the incentive spirometer?

Correct Answer is C

Explanation

The charge nurse of a critical care unit is informed at the beginning of the shift that less than the optimal number of registered nurses (RN) will be working that shift. In planning assignments, which client should receive the most care hours by a RN?

Correct Answer is A

Explanation

Exhibits Click to indicate which client goal is being met by each of the client data. Each column must have at least one response selected.

A client's most recent vital signs include heart rate 80 beats/minute and blood pressure 119/70 mm Hg. When the client reports dizziness after rising quickly, which finding should the nurse expect on reassessment?

The nurse is preparing to obtain a rapid coronavirus (COVID-19) test for a client who was exposed to the virus eight days ago. The client is experiencing fever, cough, and shortness of breath. Which action is most important for the nurse to take?

The parent of a child born with a myelomeningocele asks the nurse, "What did I do to deserve this?" Which response is most helpful?