An intubated patient is receiving continuous enteral feedings through a Salem sump tube at a rate of 60ml/hr. Gastric residuals have been 30-40ml when monitored Q4H. You check the gastric residual and aspirate 220ml. What is your first response to this finding?
- A. Notify the doctor immediately.
- B. Stop the feeding, and clamp the NG tube.
- C. Discard the 220ml, and clamp the NG tube.
- D. Give a prescribed GI stimulant such as metoclopramide (Reglan).
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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Stephen is a 62 y.o. patient that has had a liver biopsy. Which of the following groups of signs alert you to a possible pneumothorax?
- A. Dyspnea and reduced or absent breath sounds over the right lung
- B. Tachycardia, hypotension, and cool, clammy skin
- C. Fever, rebound tenderness, and abdominal rigidity
- D. Redness, warmth, and drainage at the biopsy site
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
You're caring for Beth who underwent a Billroth II procedure (surgical removal of the pylorus and duodenum) for treatment of a peptic ulcer. Which findings suggest that the patient is developing dumping syndrome, a complication associated with this procedure?
- A. Flushed, dry skin.
- B. Headache and bradycardia.
- C. Dizziness and sweating.
- D. Dyspnea and chest pain.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client with ulcerative colitis has an order to begin salicylate medication to reduce inflammation. The nurse instructs the client to take the medication:
- A. 30 minutes before meals
- B. On an empty stomach
- C. After meals
- D. On arising
Correct Answer: C
Rationale: The correct answer is C: After meals. Salicylate medications for ulcerative colitis should be taken after meals to minimize gastrointestinal irritation and enhance absorption. Taking the medication on an empty stomach (Choice B) may increase the risk of gastrointestinal side effects. Taking it 30 minutes before meals (Choice A) may not provide enough protection for the stomach lining. Taking it on arising (Choice D) is not recommended as it may not coincide with the peak absorption times of the medication.
Brenda, a 36 y.o. patient is on your floor with acute pancreatitis. Treatment for her includes:
- A. Continuous peritoneal lavage.
- B. Regular diet with increased fat.
- C. Nutritional support with TPN.
- D. Insertion of a T tube to drain the pancreas.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client who has ulcerative colitis has persistent diarrhea. He is thin and has lost 12 pounds since the exacerbation of his ulcerative colitis. The nurse should anticipate that the physician will order which of the following treatment approaches to help the client meet his nutritional needs?
- A. Initiate continuous enteral feedings
- B. Encourage a high protein, high-calorie diet
- C. Implement total parenteral nutrition
- D. Provide six small meals a day.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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