A nurse is caring for a client who had a hysterectomy and resumed a regular diet earlier in the day. The client is now reporting nausea and has vomited once. Which of the following actions should the nurse take first?

Check the client's pain level

Assess for bowel sounds and ask the client if she has passed any flatus

Put the client on a clear liquid diet

Administer an antiemetic

Answer and Explanation

The Correct Answer is B

Rationale:
A. While pain assessment is important, nausea and vomiting post-hysterectomy may indicate gastrointestinal issues that need immediate evaluation.
B. Assessing bowel sounds and asking about flatus helps determine if the gastrointestinal tract is functioning properly, which is critical before advancing diet or administering medications. This should be the first action.
C. Changing the diet to clear liquids may be appropriate but only after assessing GI status.
D. Administering an antiemetic can help symptoms but should follow assessment to rule out underlying issues such as ileus or obstruction.

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Correct Answer is B

Explanation

Rationale:
A. Carbonated beverages can increase gastric pressure and promote reflux; they should be avoided.
B. Chocolate and coffee both relax the lower esophageal sphincter and can worsen GERD symptoms. Avoiding them demonstrates appropriate understanding of dietary recommendations.
C. Peppermint can also relax the lower esophageal sphincter and may worsen GERD symptoms, despite its soothing sensation.
D. Large meals increase stomach pressure and should be avoided; small, frequent meals are preferred for GERD management.

A. "The occupational therapist is showing me how to use a 'sock puller to help me get dressed." B. "I will need my husband to assist me in getting off the low toilet seat at home." C. I will need to keep a pillow between my legs at night." D. "I need to remember not to cross my legs. It's such a habit

Correct Answer is B

Explanation

Rationale:
A. Using assistive devices like a sock puller is appropriate and helps the client maintain hip precautions while performing activities of daily living.
B. Using a low toilet seat increases the risk of hip dislocation by causing excessive hip flexion. The client should use a raised toilet seat to avoid bending the hip more than 90 degrees. This statement indicates a need for further teaching.
C. Keeping a pillow between the legs, especially when sleeping, helps prevent hip adduction and dislocation.
D. Avoiding leg crossing is an important hip precaution to maintain proper alignment and prevent dislocation.

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A nurse is caring for a client who had a hysterectomy and resumed a regular diet earlier in the day. The client is now reporting nausea and has vomited once. Which of the following actions should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse instructs the client with gastroesophageal reflux disease (GERD) regarding dietary measures. Which action demonstrates that the client has understood the recommended dietary changes?

Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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