Nokea
What is a postoperative nursing intervention for the obese patient who has undergone bariatric surgery?
- A. Irrigating and repositioning the nasogastric (NG) tube as needed
- B. Delaying ambulation until the patient has enough strength to support self
- C. Keeping the patient positioned on the side to facilitate respiratory function
- D. Providing adequate support to the incision during coughing, deep breathing, and turning
Correct Answer: D
Rationale: The correct answer is D because providing adequate support to the incision during coughing, deep breathing, and turning is essential postoperatively to prevent complications such as wound dehiscence or infection in obese patients who have undergone bariatric surgery. Supporting the incision helps reduce stress on the surgical site and promotes proper healing.
Choice A is incorrect because irrigating and repositioning the nasogastric tube is not a specific nursing intervention related to the care of the incision after bariatric surgery.
Choice B is incorrect because delaying ambulation can increase the risk of complications such as deep vein thrombosis and pneumonia in postoperative obese patients.
Choice C is incorrect because keeping the patient positioned on the side to facilitate respiratory function is important, but it is not directly related to supporting the incision during activities that increase intra-abdominal pressure.
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Although HAV antigens are not tested in the blood, they stimulate specific immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies. Which antibody indicates there is acute HAV infection?
- A. Anti-HBc IgG
- B. Anti-HBc IgM
- C. Anti-HAV IgG
- D. Anti-HAV IgM
Correct Answer: D
Rationale: The correct answer is D: Anti-HAV IgM. IgM antibodies indicate acute infection as they are the first antibodies produced in response to a new infection. In the case of HAV, the presence of Anti-HAV IgM suggests recent exposure to the virus.
A: Anti-HBc IgG is not relevant to HAV infection. It indicates past or chronic hepatitis B infection.
B: Anti-HBc IgM is specific to hepatitis B infection, not HAV.
C: Anti-HAV IgG indicates past exposure or immunity to HAV, not acute infection.
Obstructive jaundice is:
- A. Caused by more fragile red blood cells.
- B. Associated with high blood hemobilirubin.
- C. Associated with dark stool due to excess stercobilin.
- D. Associated with dark brown urine.
Correct Answer: C
Rationale: Rationale for Correct Answer C: Obstructive jaundice is caused by blockage in the bile ducts, leading to decreased excretion of bilirubin into the intestine. This results in dark stool due to excess stercobilin, a byproduct of bilirubin breakdown. Other choices are incorrect because: A: Fragile red blood cells cause hemolytic jaundice, not obstructive jaundice. B: Elevated blood hemobilirubin is seen in hemolytic jaundice, not obstructive jaundice. D: Dark brown urine is associated with conditions like hemoglobinuria, not obstructive jaundice.
Which of the following tests is contraindicated for pregnant women?
- A. Barium enema
- B. Barium swallow
- C. Radionuclide imaging
- D. Gallbladder series test
Correct Answer: C
Rationale: The correct answer is C: Radionuclide imaging. This test involves exposing the patient to radiation, which can be harmful to the developing fetus. Pregnant women should avoid unnecessary exposure to radiation to prevent potential harm to the baby.
A: Barium enema and B: Barium swallow involve the use of contrast material that is generally considered safe during pregnancy as it does not expose the fetus to radiation.
D: Gallbladder series test, such as ultrasound or MRI, are also safe for pregnant women as they do not involve radiation exposure.
Care for which of these clients is most appropriate to assign to the LPN/LVN, under the supervision of an RN?
- A. A client with oral cancer who is scheduled in the morning for glossectomy
- B. An obese client returned from surgery following a vertical banded gastroplasty
- C. A client with anorexia nervosa with muscle weakness and decreased urine output
- D. A client with intractable nausea and vomiting related to chemotherapy
Correct Answer: D
Rationale: The correct answer is D because the LPN/LVN can provide care for a client with intractable nausea and vomiting related to chemotherapy under the supervision of an RN. The LPN/LVN can administer prescribed antiemetic medications, monitor the client's response, assess for dehydration, and provide comfort measures. This task falls within the scope of practice for an LPN/LVN and does not require the advanced assessment and intervention skills of an RN.
Choice A is incorrect because a client undergoing a glossectomy for oral cancer requires complex post-operative care that is beyond the scope of practice for an LPN/LVN.
Choice B is incorrect because post-operative care for an obese client following a vertical banded gastroplasty involves monitoring for complications such as leaks or infections, which require the expertise of an RN.
Choice C is incorrect because a client with anorexia nervosa with muscle weakness and decreased urine output may have underlying medical issues that require an RN's assessment and intervention skills
A 55-year-old female client comes to the clinic for a physical examination. Which of the following screening tests would the nurse recommend the client have beginning at the age of 50 and every 10 years after?
- A. Colonoscopy
- B. Ultrasound of the kidney
- C. Mammogram
- D. Pap smear
Correct Answer: A
Rationale: The correct answer is A: Colonoscopy. Beginning at age 50, it is recommended every 10 years to screen for colorectal cancer. This screening test is essential for early detection and prevention of colon cancer. Colonoscopy allows for direct visualization of the colon and removal of any precancerous polyps.
Choice B: Ultrasound of the kidney is not a recommended screening test for a 55-year-old female. Kidney ultrasound is typically used for evaluating specific kidney conditions, not as a routine screening test.
Choice C: Mammogram is typically recommended for breast cancer screening in women starting at age 40, not every 10 years after age 50.
Choice D: Pap smear is used for cervical cancer screening, typically starting at age 21 and continuing every 3-5 years, not every 10 years after age 50.