Nokea
The nurse is developing a teaching plan for a client with post-gastrectomy dumping syndrome. Which of the following statements should the nurse make to the client?
- A. Take small sips of water during meals to soften the food for easier digestion.
- B. Symptoms will resolve in about 4-6 weeks as the stomach adjusts post-surgery.
- C. Plan rest periods of 10 minutes after every meal.
- D. Meals should consist of dry foods with low carbohydrates, moderate fat, and high protein content.
Correct Answer: D
Rationale: Dry, low-carbohydrate, moderate-fat, high-protein meals (D) slow gastric emptying, reducing dumping syndrome symptoms. Sips during meals (A), expecting resolution in 4-6 weeks (B), or short rest periods (C) are incorrect.
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The following scenario applies to the next 1 items
The nurse is caring for a client who presents with acute appendicitis
Item 1 of 1
History of Present Illness
19-year-old female admitted with abdominal pain localized to the right lower quadrant. The onset of pain was twelve hours ago, and the client now reports pain is worsening when the client coughs. Endorses nausea and has persistent vomiting.
Vital Signs
• Oral temperature 101° F (38.3°C)
• Pulse 90/minute
• Respirations 18/minute
• Blood Pressure 110/66 mm Hg
• Oxygen saturation 96% on room air
Laboratory Results
• White blood cell count, 11,500 mm3 (5,000-10,000 mm3)
• Creatinine, 0.9 mg/dL (0.6-1.2 mg/dL)
• BUN 26 mg/dL (10-20 mg/dL)
• Potassium 3.3 mEq/L (3.5-5 mEq/L)
Select two (2) findings from the clinical data that require immediate follow-up
- A. Oral temperature 101°F (38.3°C)
- B. White blood cell count, 11,500 mm³
- C. Creatinine, 0.9 mg/dL
- D. Nausea and vomiting
- E. Potassium 3.3 mEq/L
- F. BUN 26 mg/dL
- G. Reports of pain increasing while coughing
Correct Answer: A,D
Rationale: Fever (A) and nausea/vomiting (D) in appendicitis suggest ongoing inflammation or complications, requiring immediate follow-up to prevent rupture or peritonitis.
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.
The primary healthcare provider (PHCP) prescribes the insertion of a nasogastric tube for a client with paralytic ileus. This action is appropriate and does not require follow-up. The nurse understands that the primary purpose of placing this tube is to
- A. Feed the client.
- B. Decompress the stomach.
- C. Irrigate the stomach.
- D. Administer medications.
Correct Answer: B
Rationale: A nasogastric tube in paralytic ileus (B) decompresses the stomach, relieving distention and preventing complications like aspiration.
The nurse is caring for a client who is receiving prescribed metoclopramide for gastroparesis. Which of the following findings require immediate notification to the primary healthcare provider (PHCP)?
- A. Muscle rigidity of the neck
- B. Hyperactive bowel sounds
- C. Frequent diarrhea
- D. Abdominal distention
Correct Answer: A
Rationale: Muscle rigidity of the neck (dystonia) is a serious extrapyramidal side effect of metoclopramide, requiring immediate PHCP notification. Hyperactive bowel sounds, diarrhea, and distention are less urgent or expected with gastroparesis.
You are caring for a client who is in the burn unit with severe burns. Since this is your first client contact with this person, you introduce yourself and tell the client that they will be taken care of by you for this shift. The client greets you and states, 'Why am I getting this stuff that is hanging up here?' as they are pointing to the ordered total parenteral infusion. You should:
- A. Respond to the client stating, 'I don't think you should be getting this. I am going to call your doctor.'
- B. Respond to the client stating, 'This is total parenteral nutrition and you are getting it because your nutritional status is impaired as the result of your burns'.
- C. Respond to the client stating, 'This is total parenteral nutrition and you are getting it because your nutritional status is impaired because you aren't eating enough.'
- D. Respond to the client stating, 'I don't think you should be getting this. I am going to turn it off now.'
Correct Answer: B
Rationale: TPN (B) is used in burn patients to meet high nutritional demands when oral intake is insufficient due to metabolic stress from burns, not just lack of eating (C). Options A and D are inappropriate as they suggest stopping or questioning a valid treatment.