Nokea
A nurse plans care for a client who has acute pancreatitis and is prescribed nothing by mouth (NPO). With which health care team members should the nurse collaborate to provide appropriate nutrition to the client? (Select all that apply.)
- A. Registered dietitian
- B. Nursing assistant
- C. Clinical pharmacist
- D. Certified herbalist
- E. Health care provider
Correct Answer: A,C,E
Rationale: Clients who are prescribed NPO while experiencing an acute pancreatitis episode may need enteral or parenteral nutrition. The nurse should collaborate with the registered dietitian, clinical pharmacist, and health care provider to determine the best nutritional intervention. The nursing assistant and certified herbalist would not assist with this clinical decision.
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After teaching a client who is prescribed pancreatic enzyme replacement therapy, the nurse assesses the client's understanding. Which statement made by the client indicates a need for additional teaching?
- A. The capsules can be opened and the powder sprinkled on applesauce if needed.
- B. I will take the enzymes with a small sip of water.
- C. The best time to take the enzymes is immediately after I have a meal or a snack.
- D. I will not mix the enzyme powder with food or liquids that contain protein.
Correct Answer: C
Rationale: The enzymes should be taken immediately before eating meals or snacks. If the client cannot swallow the capsule, they can be opened and the powder sprinkled on applesauce or similar foods. The client should wipe their lips carefully after drinking the enzyme preparation because the liquid could damage the skin. Protein items will be dissolved by the enzymes if they are mixed together.
A nurse assesses a client who is recovering from an open Whipple procedure. Which action should the nurse perform first?
- A. Assess the client's endotracheal tube with 40% FiO2.
- B. Insert an indwelling Foley catheter to gravity drainage.
- C. Place the client's nasogastric tube to low intermittent suction.
- D. Start lactated Ringer's solution through an intravenous catheter.
Correct Answer: A
Rationale: Using the ABCs, airway and oxygenation status should always be assessed first, so checking the endotracheal tube is the first action. Next, the nurse should start the IV line (circulation). After that, the Foley catheter can be inserted, and the nasogastric tube can be set.
A nurse cares for a client who reports free air pain after a laparoscopic cholecystectomy. Which action should the nurse take?
- A. Assist the client with early ambulation.
- B. Apply a cold compress to the abdomen.
- C. Provide a warm beverage to relieve pain.
- D. Encourage coughing and deep breathing every hour.
Correct Answer: A
Rationale: The client who has undergone a laparoscopic cholecystectomy may report free air pain due to retention of carbon dioxide in the abdomen. The nurse assists the client with early ambulation to promote absorption of the carbon dioxide. Cold compresses and drinking a warm beverage would not be helpful. Coughing and deep breathing are important postoperative activities, but they are not related to discomfort from carbon dioxide.
A nurse prepares to discharge a client with chronic pancreatitis. Which question should the nurse ask to ensure safety upon discharge?
- A. Do you have a one- or two-story home?
- B. Can you check your own pulse rate?
- C. Do you prepare your own meals?
- D. Do you have access to alcohol?
Correct Answer: A
Rationale: A client recovering from chronic pancreatitis should be limited to one floor until strength and activity increase. The client will need a bathroom on the same floor for frequent defecation. Assessing pulse rate and preparation of meals is not specific to chronic pancreatitis. Although the client should be encouraged to stop drinking alcohol, assessing alcohol availability is not adequate to assess safety.
A nurse assesses a client who is recovering from a Whipple procedure. Which assessment finding alerts the nurse to urgently contact the health care provider?
- A. Drainage from a fistula
- B. Pain in the incision site
- C. Nasogastric (NG) tube drainage
- D. Fever of 100.5°F (38.1°C)
Correct Answer: A
Rationale: Drainage from a fistula is a serious complication following a Whipple procedure, indicating potential leakage from surgical anastomoses, which requires urgent medical attention. Pain in the incision site and NG tube drainage are expected postoperative findings, and a mild fever may not be immediately concerning unless accompanied by other symptoms.