Nokea
The nurse cares for a client who reports dumping syndrome following gastric bypass surgery. To alleviate the symptoms of dumping syndrome, the nurse should recommend that the client. Select all that apply.
- A. Take a dose of their prescribed proton pump inhibitor immediately before meals.
- B. Stay upright for 30 minutes following eating.
- C. Eat high-fiber foods to decrease late dumping syndrome.
- D. Increase their intake of simple carbohydrates to prevent spikes in blood sugar.
- E. Eat five to six small meals a day to avoid overloading the stomach.
Correct Answer: B,C,E
Rationale: Staying upright (B), eating high-fiber foods (C), and consuming small, frequent meals (E) slow gastric emptying, reducing dumping syndrome symptoms. PPIs (A) are unrelated, and simple carbohydrates (D) worsen symptoms.
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The nurse is caring for a client with a hiatal hernia who is being discharged today. The nurse talks to them regarding methods to manage symptoms and promote overall well-being associated with their condition. Which of the following statements from the client indicate that teaching is successful?
- A. I need to wear loose-fitting clothes.
- B. After a meal, I must lie down to avoid dumping syndrome.
- C. I need to eat three large meals a day.
- D. I can go to my favorite Indian restaurant anytime of the week.
Correct Answer: A
Rationale: Wearing loose-fitting clothes (A) reduces pressure on the stomach, helping manage hiatal hernia symptoms. Lying down after meals (B) can worsen reflux, large meals (C) increase symptoms, and spicy foods (D) may exacerbate reflux.
A nasogastric tube has been inserted into a client with bowel obstruction for gastric decompression. The nurse should set the suction on which setting?
- A. Intermittent suction at 70 mmHg
- B. Intermittent suction at 100 mmHg
- C. Continuous suction at 100 mmHg
- D. Continuous suction at 70 mmHg
Correct Answer: A
Rationale: Intermittent suction at 70 mmHg (A) is appropriate for gastric decompression in bowel obstruction to prevent mucosal damage while effectively removing gastric contents.
While caring for a patient who is suspected of having appendicitis, the nurse overhears his conversation with a loved one. Which of the following statements would prompt immediate intervention?
- A. The pain doesn't feel as bad now. I think it was just a stomach ache.
- B. Would you mind getting me an ice pack?
- C. I know I'm not supposed to eat anything right now, but I'm hungry.
- D. I wonder if I can play in the basketball game on Monday.
Correct Answer: A
Rationale: Sudden pain relief (A) in suspected appendicitis may indicate appendix rupture, requiring immediate intervention to prevent complications like peritonitis.
The nurse is caring for a client with a paralytic ileus following an appendectomy. Which intervention would be appropriate for the nurse to take?
- A. Assess the client for hyperkalemia
- B. Prepare for the insertion of a nasogastric tube
- C. Assess the surgical wound for approximation
- D. Instruct the client to chew their food more slowly
Correct Answer: B
Rationale: A nasogastric tube (B) is appropriate for gastric decompression in paralytic ileus to relieve distention and prevent complications. Hyperkalemia (A), wound assessment (C), and chewing instructions (D) are not directly relevant.
The nurse is supervising a student nurse performing an abdominal assessment on a client with gastroenteritis. It would indicate effective technique if the student performs the assessment in which order?
- A. Auscultation, inspection, palpation, percussion
- B. Inspection, palpation, percussion, auscultation
- C. Palpation, percussion, inspection, auscultation
- D. Inspection, auscultation, percussion, palpation
Correct Answer: D
Rationale: The correct order for abdominal assessment is inspection, auscultation, percussion, palpation (D). Auscultation before palpation prevents altering bowel sounds.