An adult female client has a body mass index of 34.5 kg/m2 and has expressed interest in bariatric surgery. What characteristic of the client's health status may exclude her from being an appropriate surgical candidate?
The client quit smoking 6 months ago.
The client has a strong family history of obesity.
The client drinks six to eight cans of beer daily.
The client has poorly controlled type 2 diabetes.
The Correct Answer is C
Choice A reason: The client quitting smoking 6 months ago is not a factor that would exclude her from being an appropriate surgical candidate. In fact, smoking cessation is a requirement for bariatric surgery, as smoking increases the risk of complications such as infection, thrombosis, and poor wound healing.
Choice B reason: The client having a strong family history of obesity is not a factor that would exclude her from being an appropriate surgical candidate. Family history is one of the genetic factors that can contribute to obesity, but it does not determine the eligibility for bariatric surgery. Other factors such as BMI, comorbidities, lifestyle, and motivation are more important.
Choice C reason: The client drinking six to eight cans of beer daily is a factor that would exclude her from being an appropriate surgical candidate. Alcohol abuse is a contraindication for bariatric surgery, as it can cause liver damage, malnutrition, dehydration, and addiction transfer. The client would need to abstain from alcohol for at least 6 months before and after the surgery.
Choice D reason: The client having poorly controlled type 2 diabetes is not a factor that would exclude her from being an appropriate surgical candidate. Type 2 diabetes is one of the comorbidities that can qualify a client for bariatric surgery, as it can improve or resolve after the surgery. However, the client would need to have a good glycemic control before the surgery to reduce the risk of complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Securing the drain to the client's bed sheet is not the best action for the nurse to take. This could cause the drain to be pulled or dislodged if the client moves or changes position. The nurse should secure the drain to the client's gown or abdominal binder, using a safety pin or a clip.
Choice B reason: Removing the JP drain when the drainage has ceased, covering the opening with sterile gauze, is not the correct action for the nurse to take. The nurse should not remove the drain without a physician's order, as this could cause complications such as infection, bleeding, or bile leakage. The nurse should monitor the amount and color of the drainage, and report any changes to the physician.
Choice C reason: Expelling the air from the JP bulb after emptying to re-establish suction is the correct action for the nurse to take. The JP drain works by creating a negative pressure that draws fluid from the surgical site. The nurse should empty the bulb when it is half full, and squeeze it until it collapses before closing the plug. This ensures that the suction is maintained and prevents the fluid from flowing back into the drain.
Choice D reason: Measuring the drainage every hour for the first 8 hr postoperative is not the correct action for the nurse to take. This is too frequent and unnecessary, as the drainage is expected to decrease over time. The nurse should measure the drainage every 8 to 12 hr, or as ordered by the physician, and record the volume and color. The nurse should also report any signs of infection, such as fever, pain, or foul odor.
Correct Answer is D
Explanation
Choice A reason: Excessive stomach acid secretion is not the correct answer because it is not a diagnostic test, but a possible cause of peptic ulcer disease. Peptic ulcers are sores that develop in the lining of the stomach or duodenum due to damage from stomach acid and digestive enzymes.
Choice B reason: An incompetent pyloric sphincter is not the correct answer because it is not a diagnostic test, but a possible complication of peptic ulcer disease. The pyloric sphincter is a muscular valve that controls the passage of food from the stomach to the small intestine. If it becomes damaged or weakened, it can cause gastric outlet obstruction, which is a blockage of the stomach.
Choice C reason: A metabolic acid-base imbalance is not the correct answer because it is not a diagnostic test, but a possible consequence of peptic ulcer disease. Peptic ulcers can cause bleeding, perforation, or gastric outlet obstruction, which can affect the acid-base balance of the body. For example, vomiting can cause metabolic alkalosis, which is a condition where the blood is too alkaline.
Choice D reason: An infection with Helicobacter pylori is the correct answer. Helicobacter pylori is a type of bacteria that can infect the stomach and duodenum and cause inflammation and ulcers. It is the most common cause of peptic ulcer disease. The health care provider can order a diagnostic test to detect the presence of Helicobacter pylori in the client's stomach or blood, such as a urea breath test, a stool antigen test, or a blood antibody test.
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