A patient has a nasogastric (NG) tube following esophagectomy. Following standards of practice, which of the following postoperative instructions should the nurse question the surgeon about?

Calling the physician for any bright red blood in the NG tube

Keeping the NG tube taped and secured to the patient's nares

Notifying the physician for a temperature under 100.5°F

Irrigating the NG tube with 30 mL of normal saline every 6 hours

Answer and Explanation

The Correct Answer is C

A. It is appropriate to notify the physician if bright red blood is found in the NG tube, as this could indicate bleeding, which requires prompt medical attention.
B. It is standard practice to keep the NG tube taped and secured to the patient’s nares to prevent dislodgement and ensure proper function.
C. A temperature under 100.5°F is generally not a cause for concern postoperatively, unless it is persistent or accompanied by other signs of infection. Typically, a low-grade fever is expected after surgery, but further investigation is only warranted for higher fevers or other concerning symptoms.
D. Irrigating the NG tube every 6 hours with 30 mL of normal saline is standard practice to ensure patency of the tube and prevent clogging.

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Correct Answer is B

Explanation

A. Epigastric discomfort is a common symptom of peptic ulcer disease, but it is not the priority finding. This symptom is usually manageable with appropriate treatment, such as antacids or proton pump inhibitors.
B. Hematemesis (vomiting blood) is a critical finding and indicates active bleeding, which can be life-threatening. This requires immediate attention as it suggests a potential complication, such as ulcer perforation or severe gastric bleeding, that can lead to hypovolemic shock. It is the priority finding because it indicates the need for urgent medical intervention.
C. Constipation is not a priority concern in a patient with peptic ulcer disease unless it is severe and related to medication (such as opioids). While it may be uncomfortable, it does not pose the immediate risk that hematemesis does.
D. Dyspepsia, or indigestion, is another common symptom of peptic ulcer disease. While it can be bothersome, it does not represent an acute, life-threatening issue like hematemesis does.

A. 3% sodium chloride B. Lactated Ringer's C. 0.9% sodium chloride D. Dextrose 10% in water

Correct Answer is D

Explanation

A. 3% sodium chloride is a hypertonic solution used to treat severe hyponatremia and should not be used as a substitute for TPN.
B. Lactated Ringer's is an isotonic solution typically used for fluid resuscitation, but it lacks the necessary components (glucose, amino acids) that are found in TPN.
C. 0.9% sodium chloride is an isotonic saline solution and can be used for hydration, but it does not provide the calories and nutrients that the client is receiving through TPN.
D. Dextrose 10% in water is the best choice in this scenario. It provides glucose for energy and can help maintain blood sugar levels until the next TPN solution is available. It is commonly used as a temporary substitute for TPN to prevent hypoglycemia.

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A patient has a nasogastric (NG) tube following esophagectomy. Following standards of practice, which of the following postoperative instructions should the nurse question the surgeon about?

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Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has peptic ulcer disease. Which of the following findings should the nurse identify as the priority?

Correct Answer is B

Explanation

Correct Answer is D

Explanation

A nurse is reviewing the medical record of a client who has a peptic ulcer. Which of the following findings should the nurse recognize as a risk factor for this condition?

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A patient has a nasogastric (NG) tube following esophagectomy. Following standards of practice, which of the following postoperative instructions should the nurse question the surgeon about?

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