Which dietary advancement should be made first after the return of bowel sounds postoperatively?

Clear liquids

Soft diet

Regular diet

Full liquid diet

Answer and Explanation

The Correct Answer is A

Rationale:
A. After the return of bowel sounds postoperatively, clear liquids (e.g., water, broth, tea, clear juice) are introduced first. This allows the gastrointestinal tract to gradually resume function and ensures the client can tolerate fluids without nausea, vomiting, or distention.

B. A soft diet is introduced later once the client tolerates clear liquids and then full liquids, as it is more complex to digest.

C. A regular diet is not started immediately after surgery; the gut needs gradual reintroduction to food.

D. Full liquids can be given after clear liquids are tolerated, as they are more substantial and include milk-based or blended foods.

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Correct Answer is B

Explanation

Rationale:
A. Replacing lost blood components requires blood products, not isotonic crystalloids.
B. Isotonic crystalloid fluids (e.g., 0.9% sodium chloride, lactated Ringer’s) are administered to restore extracellular fluid volume in clients with fluid volume deficit.
C. While isotonic solutions contain electrolytes, their primary purpose is volume replacement, not rapid electrolyte correction.
D. Correcting metabolic acidosis may require specific interventions; isotonic fluids alone do not address acid-base imbalances.

A. High fat content in the diet B. Rapid reintroduction of carbohydrates C. Excess protein intake D. Vitamin deficiency

Correct Answer is B

Explanation

Rationale:
A. High fat content does not directly cause refeeding syndrome; fat is less likely to trigger the electrolyte shifts seen in this condition.

B. Rapid reintroduction of carbohydrates in malnourished patients stimulates insulin release, which drives phosphate, potassium, and magnesium into cells, leading to potentially life-threatening electrolyte imbalances—the hallmark of refeeding syndrome.

C. Excess protein intake can strain kidney function but is not the primary cause of refeeding syndrome.

D. Vitamin deficiencies, such as thiamine, can worsen complications, but the immediate trigger is the rapid carbohydrate load.

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Which dietary advancement should be made first after the return of bowel sounds postoperatively?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What is the primary reason for administering isotonic crystalloid IV fluids to a client with fluid volume deficit?

Correct Answer is B

Explanation

What is the primary cause of refeeding syndrome in TPN patients?

Correct Answer is B

Explanation

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