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A nurse is assessing a client who is 1 hr postoperative following roux-en Y gastric bypass surgery. Which of the following findings is the priority for the nurse to report to the provider?

Client report of back pain of 7 on a 0 to 10 scale

Excoriated folds of the client's panniculus

Hypoactive bowel sounds upon auscultation

urine output of 80 mL in the past hour

Answer and Explanation

The Correct Answer is A

Choice A rationale:

Postoperative pain management is crucial for the client's comfort and recovery.

Choice B rationale:

Excoriated folds of the client's panniculus might be related to skin irritation and can be addressed without immediate provider notification.

Choice C rationale:

Hypoactive bowel sounds can be expected after surgery and might not require immediate reporting.

Choice D rationale:

Urine output of 80 mL in the past hour might be influenced by various factors and is not as high a priority as severe pain.

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Correct Answer is A

No explanation

A. Perform a contraction stress test. B. Prepare for delivery of the fetus. C. Increase the client's dietary salt intake to 2 g/day. D. Administer ferrous sulfate to the client. E. Upper abdominal pain rating 4/10 on a scale from 0 to 10

Correct Answer is B

Explanation

Choice A rationale:

A contraction stress test is not appropriate in this context and would not address the potential risks associated with the client's symptoms.

Choice B rationale:

The elevated blood pressure and upper abdominal pain suggest potential preeclampsia, a serious complication of pregnancy that can lead to significant maternal and fetal risks. Delivery may be indicated to prevent further complications.

Choice C rationale:

Increasing dietary salt intake is not recommended for managing elevated blood pressure in pregnancy.

Choice D rationale:

Administering ferrous sulfate is unrelated to the client's symptoms and concerns.

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A nurse is assessing a client who is 1 hr postoperative following roux-en Y gastric bypass surgery. Which of the following findings is the priority for the nurse to report to the provider?

Nursing Test Bank

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