Two weeks following a Billroth II (gastrojejunostomy), a client develops nausea, diarrhea, and diaphoresis after every meal. When the nurse develops a teaching plan for this client, which expected outcome statement is the most relevant?

Client describes a schedule for antacid use with other prescribed medications.

Client selects a pattern of small meals alternating with fluid intake.

Client expresses a willingness to reduce nicotine intake.

Client agrees to participate in a variety of stress reduction techniques.

Answer and Explanation

The Correct Answer is B

A.   Client describes a schedule for antacid use with other prescribed medications: While antacids might be part of the management plan, they do not address the underlying issue of rapid gastric emptying.
B.   This is the most relevant outcome for a client who has developed post-Billroth II dumping syndrome, characterized by nausea, diarrhea, and diaphoresis after meals. Small, frequent meals with fluid intake between meals can help regulate blood sugar levels and reduce the rapid emptying of stomach contents into the small intestine, which is a primary cause of dumping syndrome.
C.   Smoking can affect overall health but is not directly related to dumping syndrome.
D.   Stress management is important for overall well-being but does not directly address the physiological changes causing dumping syndrome.

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Correct Answer is A

Explanation

A. This is the most likely intervention to avert cardiomegaly and improve myocardial contractility. By reducing blood pressure, the heart doesn't have to work as hard to pump blood, which can help prevent the heart from enlarging (cardiomegaly) and improve its ability to contract effectively.
B. While rest and oxygen can help manage symptoms of heart failure, they do not directly address the underlying issue of increased cardiac workload and hypertrophy.
C. Monitoring heart rate and rhythm is important for assessing the patient's condition, but it does not prevent cardiomegaly or improve contractility.
D. Nitroglycerin is used to treat acute symptoms of heart failure, such as chest pain, but it is not a long- term solution for preventing cardiomegaly or improving contractility.

A. Plan to assess the client's cognition after returning to his room. B. Confirm that this is an effective technique to help with ambulation. C. Reorient the client to his present location and circumstances. D. Assist the client to a carpeted area where he can walk more easily.

Correct Answer is B

Explanation

A. While assessing cognition is important for understanding the client’s overall functioning, the immediate issue of "freezing" during ambulation is more related to motor symptoms rather than cognitive impairment. "Freezing" in Parkinson's disease is a common motor symptom where the client feels as if their feet are glued to the floor.
B. The technique of pretending to step over an imaginary object (like a crack) is known to be a helpful strategy for managing "freezing" in Parkinson's disease. This technique provides a cognitive cue that can help the client initiate movement and overcome the freezing episodes. Confirming that this is an effective technique acknowledges the client's strategy and supports their efforts to improve mobility.

C. Reorienting the client to their location and circumstances can be helpful in situations where confusion or disorientation is an issue. However, in the case of "freezing" during ambulation, this response does not directly address the motor symptoms associated with Parkinson's disease. The problem here is more about movement initiation rather than orientation.
D. Moving to a carpeted area might help with traction and reduce the risk of slipping, but it does not directly address the issue of "freezing" episodes. The freezing phenomenon in Parkinson's disease is related to motor control rather than the type of flooring. While providing a safer walking environment is beneficial, it doesn’t target the underlying motor symptoms as directly as addressing the client’s technique.

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Two weeks following a Billroth II (gastrojejunostomy), a client develops nausea, diarrhea, and diaphoresis after every meal. When the nurse develops a teaching plan for this client, which expected outcome statement is the most relevant?

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Naxlex Comprehensive Predictor Exams

A client is admitted with heart failure (HF) and left ventricular hypertrophy. Which intervention is most likely to avert development of cardiomegaly and improve myocardial contractility?

Correct Answer is A

Explanation

The nurse assists a client with Parkinson's disease (PD) to ambulate in the hallway. The client appears to "freeze" and then carefully lifts one leg and steps forward. The client tells the nurse of pretending to step over a crack on the floor. How should the nurse respond?

Correct Answer is B

Explanation

Acute soft tissue injuries provide the nurse with a variety of teaching opportunities. Which instruction should the nurse provide to a client with a soft tissue injury?

A middle-aged client reports a sudden onset of seeing flashing lights and floating spots. Which is the best nursing action?

When learning to use an insulin pen, a client with diabetes dials 28 units of regular insulin instead of 24 units, the prescribed dose. Which action should the nurse take?

Two weeks following a Billroth II (gastrojejunostomy), a client develops nausea, diarrhea, and diaphoresis after every meal. When the nurse develops a teaching plan for this client, which expected outcome statement is the most relevant?

The nurse observes a client who begins to exhibit continuous jerking movements, is unable to speak, and is incontinent of urine during the event. Which action is most important for the nurse to take?