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As a result of a gastric resection, the client is at risk for development of dumping syndrome. The nurse should prepare a plan of care for this client based on knowledge that this problem stems primarily from which of the following gastrointestinal changes?
- A. Excess secretion of digestive enzymes in the intestines.
- B. Rapid emptying of stomach contents into the small intestine.
- C. Excess glycogen production by the liver.
- D. Loss of gastric enzymes.
Correct Answer: B
Rationale: Dumping syndrome occurs due to rapid emptying of stomach contents into the small intestine, causing osmotic and vasomotor symptoms. The other options are not primary causes.
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The nurse is conducting a postoperative assessment of a client on the first day after renal surgery. Which of the following findings would be most important for the nurse to report to the physician?
- A. Temperature, 99.8°F (37.7°C).
- B. Urine output, 20 mL/hour.
- C. Absence of bowel sounds.
- D. A 2€ x 2€ area of serosanguineous drainage on the flank dressing.
Correct Answer: B
Rationale: Urine output of 20 mL/hour is critically low, indicating potential renal compromise or obstruction, requiring immediate physician notification.
A nurse has two clients that have an order to receive a blood transfusion of packed red blood cells at the same time. The first client's blood pressure dropped from the preoperative value of 120/80 mm Hg to a postoperative value of 100/50. The second client is 58 years old and is hospitalized because he developed dehydration and anemia following pneumonia. After checking the patency of their I.V. lines and vital signs, which should the nurse do next?
- A. Call for both clients' blood transfusions at the same time.
- B. Ask the nurse to verify the compatibility of both units at the same time.
- C. Call for and hang the first client's blood transfusion.
- D. Ask another nurse to call for and hang the blood for the second client.
Correct Answer: C
Rationale: The first client's significant blood pressure drop (120/80 to 100/50) indicates potential hypovolemia or bleeding, making their transfusion a priority to restore volume and oxygen-carrying capacity. The second client's condition is less urgent. The nurse should call for and hang the first client's transfusion first.
The nurse is caring for a client with herpes simplex virus who is experiencing an outbreak. Which medication does the nurse anticipate that the primary healthcare provider (PHCP) will prescribe?
- A. Metronidazole
- B. Acyclovir
- C. Imiquimod
- D. Fluconazole
Correct Answer: B
Rationale: Acyclovir is an antiviral medication used to treat herpes simplex virus (HSV) infections. Choice A (metronidazole) is used for bacterial and parasitic infections, Choice C (antibiotic) is for topical treatment of genital warts, and Choice D (fluconazole) is an antifungal for yeast infections.
Bone resorption is a possible complication of Cushing's disease. Which of the following interventions should the nurse recommend to help the client prevent this complication?
- A. Increase the amount of potassium in the diet.
- B. Maintain a regular program of weight-bearing exercise.
- C. Limit dietary vitamin D intake.
- D. Perform isometric exercises.
Correct Answer: B
Rationale: Weight-bearing exercise promotes bone density, counteracting bone resorption caused by excess cortisol in Cushing's disease.
The nurse is planning care for a client on complete bed rest. The plan of care should include all except which of the following:
- A. Turning every 2 hours
- B. Passive and active range-of-motion exercises
- C. Use of thromboembolic disease support (TED) hose
- D. Maintaining the client in the supine position
Correct Answer: D
Rationale: Maintaining the client in the supine position is not recommended, as it promotes stasis and pressure ulcers. Turning every 2 hours, range-of-motion exercises, and TED hose prevent complications like thrombophlebitis and skin breakdown during bed rest.