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.

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Correct Answer is A

Explanation

A. Magnesium hydroxide is an antacid medication that works by neutralizing gastric acid in the stomach. Therefore, if the medication achieves the desired therapeutic effect, the nurse should expect neutralization of gastric acid, which can alleviate the burning sensation in the esophagus associated with GERD.
B. Magnesium hydroxide does not directly affect stomach motility. Instead, its primary action is to neutralize gastric acid. Therefore, reducing stomach motility is not an expected outcome of magnesium hydroxide administration.
C. Magnesium hydroxide primarily acts within the stomach to neutralize gastric acid and does not significantly affect the pH of the duodenum. Therefore, reduced duodenal pH is not an expected outcome of magnesium hydroxide administration.
D. Pepsin is an enzyme involved in the digestion of proteins and can contribute to tissue damage if refluxed into the esophagus. Although reducing gastric acidity can indirectly decrease the activity of pepsin, magnesium hydroxide does not directly increase the barrier to pepsin.

A. Attention-deficit/hyperactivity disorder B. Diabetes mellitus C. Rheumatoid arthritis D. Hypotension

Correct Answer is B

Explanation

B. Childhood obesity is a significant risk factor for the development of type 2 diabetes mellitus (T2DM) in children and adolescents. Excess adiposity can lead to insulin resistance, a key underlying mechanism in the development of T2DM.
A. While ADHD is a neurodevelopmental disorder that can affect children, it is not typically considered a direct consequence or complication of childhood obesity. However, there may be associations between obesity and ADHD, such as shared genetic factors or lifestyle factors, but causality is not clearly established.
C. Rheumatoid arthritis is an autoimmune disorder characterized by inflammation of the joints. While obesity is a known risk factor for osteoarthritis, particularly in weight-bearing joints, it is not typically associated with rheumatoid arthritis.
D. Hypotension, or low blood pressure, is not typically considered a complication of childhood obesity. In fact, obesity is more commonly associated with hypertension (high blood pressure) due to the increased strain on the cardiovascular system.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

A nurse is teaching a class about long-term effects of childhood obesity. The nurse should include which of the following conditions as a potential complication of childhood obesity?

Correct Answer is B

Explanation

The nurse is caring for a client recently diagnosed with a gastric ulcer. The primary care provider has prescribed pantoprazole. Which statement made by the client reflects a good understanding of this medication?

The nurse is evaluating the medical prescription of carvedilol 6.25 mg PO daily for a client with a history of unstable angina. Which of the following reflects that the medication's action has been effective?

While obtaining a nursing history from a client with inflammatory bowel disease, the nurse recognizes that the client most likely has ulcerative colitis rather than Crohn's disease when the client reports experiencing:

The nurse is teaching a client about dietary management post gastric banding (Lap-band) surgery. Which information does the nurse plan to Include?

The nurse is caring for a client admitted with a first episode of acute cholecystitis. Which of the following may have contributed to this event? She:

The nurse understands that the Intervention proven to provide the most sustained weight loss in the extremely obese population is:

A client newly diagnosed with Crohn's disease asks the nurse what to expect in the future. The best response by the nurse would be:

The nurse is teaching the client about successful strategies for weight loss. Which would the nurse include? (SELECT ALL THAT APPLY)