After successfully losing 0.5 to 1 pound weekly for several months, a client at the clinic has not lost any weight for the last month. The nurse should first:

explore whether the client has made any changes to diet or exercise pattern.

discuss bariatric surgery with the client.

review diet and exercise guidelines with the client.

instruct the client to record weight weekly.

Answer and Explanation

The Correct Answer is A

A. Before taking further action, the nurse should investigate whether there have been any changes in the client's diet, exercise routine, or lifestyle that may have contributed to the plateau in weight loss. Understanding any modifications made by the client can provide valuable insights into potential factors affecting their weight loss progress.
B. Bariatric surgery is a significant decision that requires careful consideration and evaluation of various factors. It is not appropriate to jump to this option without first exploring other potential reasons for the lack of weight loss.
C. While it's essential to review diet and exercise guidelines periodically to ensure the client is following appropriate recommendations, this option may not address the underlying cause of the recent lack of weight loss.
D. Regular weight monitoring is an important component of weight management and can provide valuable information about the client's progress. However, instructing the client to record weight weekly alone may not address the underlying reason for the lack of weight loss.

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Correct Answer is D

Explanation

D. In paralytic ileus, there is a lack of bowel motility, resulting in absent or diminished bowel sounds on auscultation and absent passage of flatus. The bowel sounds may be hypoactive or completely absent due to the lack of peristalsis. Additionally, the client may experience abdominal distention and discomfort due to the accumulation of gas and fluid in the intestines.
A. Pencil-thin stools are more commonly associated with conditions such as colorectal cancer or rectal strictures. In paralytic ileus, where there is a lack of bowel motility, the stools are typically absent rather than thin.
B. Fecal-smelling breath is not a typical finding in paralytic ileus. While it may occur in conditions associated with severe constipation or bowel obstruction, it is not specific to paralytic ileus.
C. Passage of mucus and blood in stools is not a characteristic finding of paralytic ileus. It is more commonly associated with conditions such as inflammatory bowel disease or colorectal cancer.

A. Teach the client to support the surgical site while deep breathing and coughing B. Teach that PCA use may slow the return of bowel function, so the client should not overuse it C. Irrigate and reposition the NGT frequently D. Offer cups of fruit juices at frequent intervals

Correct Answer is A

Explanation

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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After successfully losing 0.5 to 1 pound weekly for several months, a client at the clinic has not lost any weight for the last month. The nurse should first:

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client diagnosed with a paralytic ileus. What would be an expected assessment finding?

Correct Answer is D

Explanation

Correct Answer is A

Explanation

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