After having a vertical sleeve gastrectomy performed, a 42-year-old male client returns to the surgical nursing unit with a nasogastric tube to low, intermittent suction and a client-controlled analgesia (PCA) machine for pain control. Which nursing action should be included in the post-op plan of care for the first 24 hours?

Teach the client to support the surgical site while deep breathing and coughing

Teach that PCA use may slow the return of bowel function, so the client should not overuse it

Irrigate and reposition the NGT frequently

Offer cups of fruit juices at frequent intervals

Answer and Explanation

The Correct Answer is A

A.   Teach the client to support the surgical site while deep breathing and coughing: This action is appropriate as it helps prevent complications such as atelectasis and pneumonia by promoting lung expansion and clearing secretions. Supporting the surgical site while deep breathing and coughing helps reduce pain and discomfort during these activities.
B.   This is an important teaching point for clients using PCA for pain control after surgery. Opioid medications used in PCA can lead to gastrointestinal motility issues, including constipation. However, pain management is central within the first 24 hours post operation.
C.   Irrigating and repositioning the NGT frequently can increase the risk of complications such as displacement or irritation of the surgical site. NGT care should be performed as needed based on institutional protocols and the client's condition.

D.   The client's diet will likely be advanced gradually, starting with clear fluids and progressing to full liquids and then solid foods as tolerated. Fruit juices may be introduced gradually as part of the liquid diet once the client's gastrointestinal function has recovered sufficiently.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Correct Answer is ["A","B","C","E"]

Explanation

A. Chocolate can relax the lower esophageal sphincter (LES), allowing stomach acid to reflux into the esophagus and exacerbate symptoms. Therefore, it is advisable for clients with GERD to avoid chocolate.
B. Tomato-based products are acidic and can aggravate GERD symptoms. Tomatoes are naturally acidic, which can contribute to increased acidity in the stomach and exacerbate reflux symptoms.
C. Spicy and high-fat foods, such as hot and spicy pork rinds, can trigger GERD symptoms by increasing stomach acid production and relaxing the LES. Spicy foods can irritate the esophagus and exacerbate symptoms such as heartburn and reflux.
E. Oranges and other citrus fruits are acidic and can irritate the esophagus, exacerbating GERD symptoms. The acidity in oranges can increase stomach acid production and contribute to reflux.
D. Green beans are generally considered safe for individuals with GERD. They are low in fat and acidity, making them less likely to trigger reflux symptoms.

A. Blurred vision, weakness, tingling of extremities B. Hunger, shakiness, confusion C. Thirst, polyuria, abdominal pain D. Tachycardia, oliguria, anxiety

Correct Answer is C

Explanation

C. Thirst, polyuria, and abdominal pain are symptoms commonly associated with hyperglycemia. High blood glucose levels can lead to osmotic diuresis, causing increased urination and thirst. Abdominal pain may occur due to gastrointestinal symptoms related to hyperglycemia, such as bloating or discomfort.
A. Blurred vision, weakness, tingling of extremities are more indicative of hypoglycemia rather than hyperglycemia.
B. Hunger, shakiness, confusion are symptoms of hypoglycemia rather than hyperglycemia.
D. While tachycardia and anxiety can occur with various medical conditions, oliguria is not typically associated with hyperglycemia.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with a new diagnosis of GERD is preparing for discharge from the hospital. Which foods will the nurse teach this client to avoid? (SELECT ALL THAT APPLY)

Correct Answer is ["A","B","C","E"]

Explanation

What symptoms would indicate to the nurse that the client receiving TPN is experiencing hyperglycemia?

Correct Answer is C

Explanation

The nurse determines that instruction regarding prevention of future urinary tract Infections for a female client who has cystitis has not been effective when the client states, "I:

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The nurse is assessing a client who has a large bowel obstruction. Which late clinical finding would the nurse expect?

The nurse identifies a client problem of impaired skin integrity related to diarrhea for a client who has ulcerative colitis. The nurse recognizes that teaching about perianal care has been effective when the client:

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The nurse is caring for a client recently diagnosed with emphysema. What health maintenance Information would the nurse teach the client? (SELECT ALL THAT APPLY)

The nurse teaches the client about his newly-diagnosed benign prostatic hyperplasia (BPH). Which statement made by the client Indicates the need for further education?

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