The nurse is caring for a client with stable esophageal varices. Which of the following actions is most important?

Maintain a patent airway and prevent aspiration

Monitor the effects of ant-hypertensive medications

Prepare the client for immediate portal shunting surgery

Perform fecal occult testing on all stools

Answer and Explanation

The Correct Answer is B

A. Maintain a patent airway and prevent aspiration: While maintaining a patent airway is always important, esophageal varices do not typically cause aspiration unless they rupture. This choice would be a priority in an acute bleed, not in a stable client.

B. Monitor the effects of antihypertensive medications: Beta-blockers (e.g., propranolol) are commonly prescribed to reduce portal hypertension, preventing variceal rupture. Monitoring the effects of these medications is crucial in maintaining hemodynamic stability.

C. Prepare the client for immediate portal shunting surgery: Surgical shunting is considered for refractory cases with severe, recurrent bleeding. A client with stable varices does not require immediate surgery.

D. Perform fecal occult testing on all stools: Esophageal varices cause upper GI bleeding, which manifests as hematemesis or melena, not occult blood in the stool.

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Correct Answer is A

Explanation

A. Moist and formed: A left-sided ostomy is likely from the descending or sigmoid colon, where stool is more formed and solid because most water has been absorbed.

B. Ribbon-like: Ribbon-like stool is often associated with bowel obstruction or colorectal cancer, not a normal ostomy output.

C. Mucus-coated: Mucus-coated stool is more typical in patients with an ileostomy or colitis, not a long-term colostomy.

D. Loose and liquid: Liquid stool is expected with an ileostomy (right-sided ostomy), where less water is absorbed.

A. The client most likely has a diagnosis of pancreatic cancer." B. "I will carefully assess the newly formed ileostomy stoma every four hours" C. "Following this procedure, the client is at a higher risk for developing malabsorption issues.” D. "The recovery time after a Whipple procedure is long.”

Correct Answer is ["A","C","D"]

Explanation

A. "The client most likely has a diagnosis of pancreatic cancer." The Whipple procedure is primarily performed for pancreatic cancer, particularly in the head of the pancreas.

B. "I will carefully assess the newly formed ileostomy stoma every four hours." The Whipple procedure does not involve creating an ileostomy. It involves removal of the pancreas head, duodenum, gallbladder, and bile duct, with digestive tract reconstruction.

C. "Following this procedure, the client is at a higher risk for developing malabsorption issues." Since a portion of the pancreas is removed, clients may experience malabsorption and pancreatic enzyme insufficiency, leading to steatorrhea and nutrient deficiencies.

D. "The recovery time after a Whipple procedure is long." The Whipple procedure is major surgery with a prolonged recovery period due to the complexity of digestive system reconstruction and the risk of complications like delayed gastric emptying and anastomotic leakage.

E. "With this procedure completed, the client's prognosis is good." Pancreatic cancer has a poor prognosis even after a Whipple procedure. Survival rates remain low, and recurrence is common.

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The nurse is caring for a client with stable esophageal varices. Which of the following actions is most important?

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Naxlex Comprehensive Predictor Exams

A client who has been caring for an ostomy on the left side of the abdomen for several years is admitted to the hospital. Which type of stool can the nurse expect?

Correct Answer is A

Explanation

The nurse and the orientee are receiving a client from the Post Anesthesia Care Unit (PACU) following a Pancreaticoduodenectomy (Whipple) procedure What statements by the orientee indicate that teaching has been effective regarding this type of patient? (Select All that Apply

Correct Answer is ["A","C","D"]

Explanation

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