A nurse is providing discharge teaching to a client following a total gastrectomy.
The nurse should instruct the client about which of the following medications?

Vitamin B12.

Ranitidine.

Vitamin K.

Metoclopramide.

Answer and Explanation

The Correct Answer is A

Choice A rationale:

After a total gastrectomy, the client lacks the intrinsic factor necessary for the absorption of vitamin B12 in the terminal ileum. Therefore, vitamin B12 supplementation is essential to prevent pernicious anemia, a condition caused by vitamin B12 deficiency. The absence of intrinsic factor hinders the absorption of vitamin B12 from dietary sources, making it necessary to provide this vitamin through injections or high-dose oral supplements. Vitamin B12 supplementation is a standard practice following a total gastrectomy.

Choice B rationale:

Ranitidine is a histamine-2 (H2) receptor antagonist used to reduce stomach acid production. It is not directly related to vitamin B12 deficiency and is not typically prescribed following a total gastrectomy. Vitamin B12 supplementation, on the other hand, addresses the specific deficiency caused by the absence of intrinsic factor.

Choice C rationale:

Vitamin K is essential for blood clotting and bone health. However, it is not the primary concern following a total gastrectomy. Vitamin B12 deficiency leading to pernicious anemia is the major focus of post-gastrectomy supplementation. While vitamin K may be important for overall health, it is not the immediate priority in this scenario.

Choice D rationale:

Metoclopramide is a medication used to treat gastrointestinal disorders, including gastroparesis and gastroesophageal reflux disease (GERD). It does not directly address the vitamin B12 deficiency resulting from the absence of intrinsic factor. Vitamin B12 supplementation is specifically indicated to prevent pernicious anemia in this context.

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Correct Answer is D,C,B,A

Explanation

In the event of a fire, the nurse should prioritize safety and follow the facility’s emergency protocols, which typically align with the “RACE” acronym: Rescue: d. Transport the client to another area of the nursing unit. Ensure the client is safe from immediate danger. Alarm: c. Activate the facility’s fire alarm system. Alert others in the facility by activating the fire alarm. Confine: b. Close all nearby windows and doors. Prevent the spread of fire by closing doors and windows. Extinguish: a. Use the unit’s fire extinguisher to attempt to put out the fire. If it’s safe to do so, attempt to extinguish the fire using a fire extinguisher. Remember, the safety of the client and the nurse is the top priority. If the fire is too large or the situation too dangerous, the nurse should evacuate and wait for the fire department to handle the situation. Always follow the specific procedures of your healthcare facility.

A. Uneven shoulder and pelvic heights. B. Exaggerated curvature of the sacrum. C. Limited range-of-motion of the hips. D. Mild pain in the hip region.

Correct Answer is A

Explanation

Choice A rationale:

"Uneven shoulder and pelvic heights." This is the correct answer. Uneven shoulder and pelvic heights, along with an asymmetrical appearance of the spine when viewed from the back, are clinical manifestations of scoliosis. Scoliosis is a sideways curvature of the spine that often develops during the growth spurt before puberty. Screening for scoliosis typically involves assessing the alignment of the spine and looking for these asymmetries.

Choice B rationale:

Exaggerated curvature of the sacrum is not a typical sign of scoliosis. Scoliosis primarily affects the upper back and can cause a side-to-side curvature of the spine, not the sacrum.

Choice C rationale:

Limited range-of-motion of the hips is not a specific indicator of scoliosis. Restricted hip movement might suggest other musculoskeletal issues but is not directly related to scoliosis.

Choice D rationale:

Mild pain in the hip region is not a characteristic symptom of scoliosis. While scoliosis can cause discomfort, it typically manifests as back pain, not specifically in the hip region. Pain symptoms can vary widely among individuals and might not be present in all cases of scoliosis.

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A nurse is providing discharge teaching to a client following a total gastrectomy.The nurse should instruct the client about which of the following medications?

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A nurse is providing discharge teaching to a client following a total gastrectomy.
The nurse should instruct the client about which of the following medications?