The practical nurse (PN) notices that one of the unlicensed assistive personnel (UAP) working in the long- term care facility consistently records subnormal temperatures when using a tympanic thermometer.

Which action should the PN take first?

Choice A rationale:

Assigning a client who is one day postoperative for a laparoscopic cholecystectomy to the practical nurse (PN) is appropriate. This procedure is minimally invasive, and the client is likely stable, requiring routine postoperative care such as wound assessment, pain management, and monitoring for any signs of complications.

Choice B rationale:

An older client who is one day postoperative with a colostomy for colon cancer may have complex postoperative needs, including colostomy care, monitoring for complications, and pain management. This level of care is usually within the scope of the registered nurse (RN) rather than a practical nurse (PN).

Choice C rationale:

An older adult who is scheduled for foot amputation due to diabetes complications is likely to have complex care needs, including wound care, diabetes management, and potential complications. This client would require the expertise of an RN rather than a PN.

Choice D rationale:

An adult with alcoholism, cirrhosis, and hepatic encephalopathy may have complex medical and psychosocial issues that require specialized nursing care. This client's condition is not appropriate for a practical nurse (PN) to manage, and the care should be provided by an RN or other specialized healthcare provider.

The correct answer is Choice D.

Choice A rationale: Depression assessment is important in bariatric care, but postoperative priorities focus on physiologic risks—venous thromboembolism, pulmonary complications, bleeding, and leaks—heightened by obesity, diabetes, hypertension, and immobility; psychosocial screening is longitudinal.

Choice B rationale: Urinary incontinence is not a typical complication of gastroplasty. Immediate risks include venous thromboembolism, pulmonary issues, hemorrhage, anastomotic leak, and infection; prioritizing VTE prophylaxis and respiratory support offers morbidity reduction.

Choice C rationale: Early post-gastroplasty nutrition requires staged progression: clear liquids to pureed, tiny portions, high-protein focus, vitamin-mineral supplementation. Offering meal variety risks overeating, nausea, vomiting, dumping syndrome, and staple-line stress or disruption.

Choice D rationale: Sequential compression devices augment venous return, reduce stasis, and lower deep vein thrombosis and pulmonary embolism risk in obese, diabetic, hypertensive surgical patients with limited mobility; evidence-based venous thromboembolism prophylaxis.