A client with severe ulcer disease in the distal stomach undergoes a gastrojejunostomy (Billroth II procedure). Which postoperative prescription would the nurse question and verify?

Leg exercises.

Early ambulation.

Irrigating the nasogastric tube.

Coughing and deep-breathing exercises.

Answer and Explanation

The Correct Answer is C

Choice A reason: Leg exercises prevent thrombosis post-gastrojejunostomy, a standard order. Irrigating the NG tube risks anastomosis disruption, making this incorrect, as it’s a safe prescription the nurse wouldn’t question in the client’s postoperative care plan.

Choice B reason: Early ambulation reduces complications like pneumonia after Billroth II surgery. Irrigating the NG tube is risky, making this incorrect, as it’s a standard order the nurse wouldn’t need to verify in the postoperative period.

Choice C reason: Irrigating the nasogastric tube post-gastrojejunostomy risks disrupting the surgical anastomosis, causing leakage. This requires verification, aligning with surgical safety, making it the correct prescription the nurse would question in the client’s postoperative care.

Choice D reason: Coughing and deep-breathing exercises prevent atelectasis post-surgery, a routine order. Irrigating the NG tube is concerning, making this incorrect, as it’s a safe prescription the nurse wouldn’t question in the client’s recovery plan.

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Correct Answer is A

Explanation

Choice A reason: Starting IV fluids is the first action to correct hypotension (72/48) and tachycardia (152) in burn shock, restoring perfusion. This aligns with burn resuscitation protocols, making it the correct action to address the client’s critical hypovolemia and absent pedal pulses immediately.

Choice B reason: Albumin is used later in burn management, not first, as crystalloids like saline restore volume. IV fluids address hypovolemia, making this incorrect, as it’s premature compared to the nurse’s priority of initiating fluid resuscitation in the burn-injured client.

Choice C reason: Checking pulses with Doppler assesses perfusion but delays fluid resuscitation needed for hypotension and shock. IV fluids are urgent, making this incorrect, as it’s secondary to the nurse’s first action of correcting hypovolemia in the burn client’s emergency care.

Choice D reason: Calculating the rule of nines guides fluid volume but is secondary to starting IV fluids for hypotension. Immediate resuscitation is critical, making this incorrect, as it delays the nurse’s priority of addressing the client’s shock state in the burn emergency.

A. Increased urine output. B. Persistent diarrhea. C. Hypotension. D. Tachycardia.

Correct Answer is C

Explanation

Choice A reason: Increased urine output is not typical in untreated hypothyroidism, which slows metabolism and fluid balance. Hypotension from reduced cardiac output is expected, making this incorrect, as it doesn’t align with the nurse’s anticipated findings in a client non-compliant with hypothyroidism therapy.

Choice B reason: Persistent diarrhea is more associated with hyperthyroidism, not hypothyroidism, which causes constipation. Hypotension is a common finding in untreated hypothyroidism, making this incorrect, as it contradicts the expected symptoms in the nurse’s assessment of the non-compliant client.

Choice C reason: Hypotension is expected in untreated hypothyroidism due to decreased metabolic rate and cardiac output. This aligns with endocrine assessment findings, making it the correct finding the nurse would anticipate in a client who hasn’t taken thyroid replacement medication regularly.

Choice D reason: Tachycardia is typical in hyperthyroidism, not hypothyroidism, which causes bradycardia. Hypotension is more consistent with untreated hypothyroidism, making this incorrect, as it doesn’t reflect the slowed metabolism expected in the nurse’s evaluation of the non-compliant client.

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A client with severe ulcer disease in the distal stomach undergoes a gastrojejunostomy (Billroth II procedure). Which postoperative prescription would the nurse question and verify?

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Naxlex Comprehensive Predictor Exams

A client is admitted to the ED with a burn injury. The client’s vital signs are the following: blood pressure: 72/48, heart rate: 152 beats/min, respiratory rate: 26/min. He is pale in color and the nurse is unable to feel his pedal pulses. Which action will the nurse take first?

Correct Answer is A

Explanation

A home health nurse is assessing a client who requires lifelong replacement hormone therapy for hypothyroidism. The client has not been taking his medication regularly. Which of the following findings should the nurse expect?

Correct Answer is C

Explanation

A patient’s blood pressure is 90/72 mm Hg. What is the patient’s pulse pressure?

The nurse cares for a client in the emergency department diagnosed with deep partial thickness burns of the arms and chest. The nurse notes that the client is very restless and anxious. Which action should the nurse take FIRST?

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