A nurse is monitoring a client who is 36 hrs postoperative following gastric banding. Which of the following findings should the nurse expect?
The client is voiding at least 250 mL/hr.
The client is maintaining bed rest.
The client is tolerating clear liquids.
The client is consuming 1.000 calories daily.
The Correct Answer is C
A. The client is voiding at least 250 mL/hr. This amount is excessive and not typical. The expected urine output for an adult is at least 30 mL/hr, so 250 mL/hr could indicate overhydration or diuretic use, which is not expected postoperatively.
B. The client is maintaining bed rest. Early ambulation is encouraged after surgery to prevent complications like deep vein thrombosis and promote recovery. Bed rest 36 hours post-op is not expected unless medically indicated.
C. The client is tolerating clear liquids. After gastric banding, clients typically start with clear liquids and gradually progress to more solid foods. Tolerating clear liquids at 36 hours post-op is an expected and positive finding.
D. The client is consuming 1,000 calories daily. At this stage post-op, calorie intake is significantly restricted, often much lower than 1,000 calories. Intake gradually increases as the diet progresses from liquids to solids.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Rubeola (measles). Rubeola is transmitted through airborne particles and requires airborne precautions, including the use of an N95 respirator and placement in a negative pressure room. Droplet precautions would not provide sufficient protection due to the small particle size and long-range transmission.
B. Varicella (chickenpox). Varicella requires both airborne and contact precautions because it spreads via airborne respiratory droplets and direct contact with lesions. A client with varicella must be isolated in a negative pressure room and healthcare workers should use full PPE.
C. Tuberculosis. Tuberculosis is caused by Mycobacterium tuberculosis and is spread through airborne droplet nuclei, which remain suspended in the air for extended periods. It requires airborne precautions, including an N95 respirator and isolation in a specialized room.
D. Pertussis (whooping cough). Pertussis is a highly contagious bacterial infection that spreads through large respiratory droplets during coughing or sneezing. Droplet precautions are required, which include wearing a surgical mask when within 3 feet of the client and practicing proper hand hygiene to prevent transmission.
Correct Answer is C
Explanation
A. The client is voiding at least 250 mL/hr. This amount is excessive and not typical. The expected urine output for an adult is at least 30 mL/hr, so 250 mL/hr could indicate overhydration or diuretic use, which is not expected postoperatively.
B. The client is maintaining bed rest. Early ambulation is encouraged after surgery to prevent complications like deep vein thrombosis and promote recovery. Bed rest 36 hours post-op is not expected unless medically indicated.
C. The client is tolerating clear liquids. After gastric banding, clients typically start with clear liquids and gradually progress to more solid foods. Tolerating clear liquids at 36 hours post-op is an expected and positive finding.
D. The client is consuming 1,000 calories daily. At this stage post-op, calorie intake is significantly restricted, often much lower than 1,000 calories. Intake gradually increases as the diet progresses from liquids to solids.
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