Nokea
The nurse is caring for a client who recently had a partial gastrectomy. Which of the following medications should the nurse anticipate that the primary health care provider (PHCP) will order?
- A. Cyanocobalamin
- B. Metoclopramide
- C. Sucralfate
- D. Hydroxyzine
Correct Answer: A
Rationale: Cyanocobalamin (A) is anticipated post-gastrectomy to prevent vitamin B12 deficiency due to reduced intrinsic factor production.
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The following scenario applies to the next 1 items
The nurse in the emergency department is caring for a 19-year-old male client.
Item 1 of 1
Nurses' Notes
0555: Client presents with abdominal pain, nausea, and some vomiting. The client's parents report that his symptoms started two nights ago and originated in the right lower quadrant. Overnight, his symptoms significantly intensified, and he developed a fever and chills. On assessment, the client's skin is hot and pale. Lung sounds are clear, and apical pulse is regular. Bowel sounds are absent in all quadrants. Abdomen is distended and rigid with guarding. Generalized abdominal pain was reported and rated 8/10 on the Numerical Rating Scale. He states that his abdominal pain increases with cough or movement and is relieved by bending the right hip. Vital signs: T 104°F (40°C), P 116, RR 21, BP 110/76, pulse oximetry reading 96% on room air. He has a medical history of iron deficiency anemia.
Laboratory Results
white blood cell (WBC) count: 21,000 mm3 [5,000–10,000/mm3]
hemoglobin: 13.9 g/dL [14–18 g/dL]
hematocrit: 41.7% [42%–52%]
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, two (2) actions the nurse should take to address that condition, and two (2) parameters the nurse should monitor to assess the client's progress.
- A. Insert a peripheral venous access device (VAD), obtain a stool specimen for culture and sensitivity (C & S), prepare the client for surgery, request an order for a clear liquid diet.
- B. Peritonitis, diverticulitis, appendicitis, gastroenteritis.
- C. Lung sounds, pulse, temperature, hemoglobin and hematocrit.
Correct Answer: B: Appendicitis; A: Insert a peripheral VAD, prepare the client for surgery; C: Temperature, pulse
Rationale: The clinical presentation (right lower quadrant pain, fever, leukocytosis, rigid abdomen) strongly suggests appendicitis (B). Inserting a VAD and preparing for surgery (A) are critical for anticipated appendectomy. Monitoring temperature and pulse (C) tracks infection and hemodynamic status.
The nurse is caring for a client who has just been diagnosed with peritonitis. Which of the following medications should the nurse anticipate the primary health care provider (PHCP) will prescribe?
- A. Pantoprazole
- B. Ciprofloxacin
- C. Lactulose
- D. Loperamide
Correct Answer: B
Rationale: Ciprofloxacin, an antibiotic, is used to treat bacterial peritonitis. Pantoprazole reduces acid, lactulose treats hepatic encephalopathy, and loperamide slows motility, none of which address peritonitis directly.
The nurse is caring for a client receiving total parenteral nutrition (TPN) through a central line. The nurse plans on taking which appropriate action?
- A. Inserting an indwelling urinary catheter.
- B. Weighing the client in the morning before the first void.
- C. Placing a mask on the client before changing the central line dressing.
- D. Establishing continuous cardiac monitoring.
Correct Answer: B
Rationale: Weighing the client daily (B) monitors fluid balance and nutritional status, critical for TPN management. Catheters (A), masks (C), and cardiac monitoring (D) are not routinely required unless indicated.
The nurse is developing a plan of care for a client who had bariatric surgery. Which of the following should the nurse include?
- A. Applying pneumatic compression devices
- B. Inserting an indwelling urinary catheter
- C. Placing the client on strict bed rest
- D. Measuring the abdominal girth
Correct Answer: A
Rationale: Pneumatic compression devices (A) prevent thromboembolism, a key risk post-bariatric surgery due to immobility and obesity. Catheters (B), bed rest (C), and girth measurement (D) are not routinely required.
The nurse is teaching a client about peptic ulcer disease. Which of the following statements should the nurse include?
- A. You should take aspirin if you have mild aches or pains.
- B. You will need to consume liquids one hour after each meal.
- C. It will be important to reduce the stress in your life.
- D. Take your prescribed omeprazole with food.
Correct Answer: C
Rationale: Stress reduction (C) helps manage peptic ulcer disease by reducing acid secretion. Aspirin (A) worsens ulcers, liquids with meals (B) are not restricted, and omeprazole (D) is taken before meals.