A nurse is monitoring a client who is 36 hr postoperative following gastric banding. Which of the following findings should the nurse expect?

The client is tolerating clear liquids.

The client is voiding at least 250 mL/hr.

The client is maintaining bed rest.

The client is consuming 1.000 calories daily.

Answer and Explanation

The Correct Answer is A

Rationale:

A. The client is tolerating clear liquids: After gastric banding, clients typically start with clear liquids within the first 24–48 hours. Tolerating clear liquids at 36 hours post-op is an expected and desired outcome that indicates gastrointestinal recovery and readiness to progress the diet gradually.

B. The client is voiding at least 250 mL/hr: This urine output is abnormally high and could indicate diuresis or overhydration. The expected minimum urine output is around 30 mL/hr, so this value exceeds normal expectations and is not typical postoperatively.

C. The client is maintaining bed rest: Early ambulation is encouraged after bariatric procedures to prevent complications such as deep vein thrombosis or pulmonary embolism. Prolonged bed rest is not expected or recommended.

D. The client is consuming 1,000 calories daily: At 36 hours post-op, clients are still on a very restricted intake—usually clear liquids or small sips—and would not be consuming 1,000 calories. This intake would be excessive and inappropriate at this stage of recovery.

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Correct Answer is A

Explanation

Rationale:

A. “The client exhibits impulsive behavior.” Impulsivity is a hallmark trait of borderline personality disorder (BPD). Clients may engage in risky behaviors such as substance abuse, binge eating, or reckless driving, often in response to emotional instability and fear of abandonment.

B. “The client is overly concerned about minor details.” This behavior is more characteristic of obsessive-compulsive personality disorder, where clients show perfectionism and a rigid adherence to rules, order, and control over details.

C. “The client might act seductively.” Seductive or provocative behavior is commonly seen in histrionic personality disorder. These clients seek attention and approval through exaggerated emotional expression and flirtatiousness.

D. “The client is exceptionally clingy to others.” Clinginess and an excessive need to be taken care of are features of dependent personality disorder. These individuals have difficulty making decisions independently and fear separation or rejection.

A. "The client is a member of the board of directors." B. "The client was intubated without complications." C. "The estimated blood loss was 250 milliliters." D. "There was a total of 10 sponges used during the procedure."

Correct Answer is C

Explanation

Rationale:

A. "The client is a member of the board of directors.": Personal or non-clinical information such as the client’s status or occupation is irrelevant to care delivery and violates confidentiality principles unless directly related to medical decision-making or care needs.

B. "The client was intubated without complications.": While this may be a useful detail in some cases, it is not as clinically relevant as reporting measurable data like blood loss. Intubation is standard for many surgeries, and if no complications occurred, it may not impact ongoing care.

C. "The estimated blood loss was 250 milliliters.": Estimated blood loss is a critical piece of information that affects postoperative care decisions, such as fluid replacement, monitoring for hypovolemia, and vital sign trends. It is an essential component of the PACU-to-floor hand-off.

D. "There was a total of 10 sponges used during the procedure.": Sponge counts are important intraoperatively to ensure none are retained, but this detail is primarily documented in surgical records. It is not routinely included in hand-off reports unless a count discrepancy occurred.

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A nurse is monitoring a client who is 36 hr postoperative following gastric banding. Which of the following findings should the nurse expect?

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