A nurse is caring for a client who had total hip arthroplasty 1 day ago and is receiving morphine sulfate by PCA pump for pain control. The client reports nausea and vomiting. Which of the following actions is the priority for the nurse to take?

Provide an antiemetic.

Make the client NPO.

Administer a stimulant laxative.

Auscultate bowel sounds.

Answer and Explanation

The Correct Answer is D

A. Provide an antiemetic.

While providing an antiemetic can help alleviate the client's nausea and vomiting, it is not the priority action. Assessment should come first to determine the underlying cause.

B. Make the client NPO.

Making the client NPO might be necessary if there is concern about bowel obstruction or other gastrointestinal issues, but this decision should be based on an initial assessment, such as auscultating bowel sounds.

C. Administer a stimulant laxative.

Administering a stimulant laxative is not appropriate at this stage without first assessing bowel sounds. It could potentially worsen the situation if there is a bowel obstruction.

D. Auscultate bowel sounds.

The priority in this situation is to assess for possible complications such as bowel obstruction or paralytic ileus, which can occur postoperatively and can be exacerbated by opioid use. Auscultating bowel sounds helps determine the presence of normal, hypoactive, or absent bowel sounds, guiding further management.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is B

Explanation

A. Kidney beans

Kidney beans are a good plant-based source of protein. They contain essential amino acids, but plant-based proteins may lack some amino acids found in animal-based sources. While kidney beans contribute to protein intake, they are not considered the best source of protein for wound healing among the given options.

B. Grilled salmon

Grilled salmon is indicated as the best source of protein for wound healing among the options. Salmon is an animal-based source that provides high-quality protein with all essential amino acids. It is also rich in omega-3 fatty acids, which have anti-inflammatory properties and can further support the healing process.

C. Peanut butter

Peanut butter is a source of protein, but it is also high in fats. While it can contribute to protein intake, it may not be as lean a source as grilled salmon. It's important to consider the overall nutritional profile when recommending it for wound healing.

D. Raw spinach

Spinach is a source of protein, but it is considered a plant-based protein. While it can contribute to overall protein intake, plant-based proteins may not provide as much protein per serving as animal-based sources like salmon. It also contains other nutrients, such as iron and vitamins, which are beneficial but not specifically highlighted for wound healing in this context.

A. “Use sugar-free gum if you experience a metallic taste in your mouth.” B. “Drink fluids at mealtime to prevent early satiety.” C. “Foods that are higher in fat can help nausea.” D. “Raw fruits and vegetables will be easier for your body to digest.”

Correct Answer is A

Explanation

A. “Use sugar-free gum if you experience a metallic taste in your mouth.”

This is the appropriate choice. Chemotherapy can cause a metallic taste in the mouth, and using sugar-free gum or candies can help alleviate this taste disturbance.

B. “Drink fluids at mealtime to prevent early satiety.”

This statement is not advisable. Drinking fluids at mealtime may lead to early satiety, making it challenging for the client to consume adequate nutrition. It is generally recommended to drink fluids between meals.

C. “Foods that are higher in fat can help nausea.”

This statement is not accurate. High-fat foods may exacerbate nausea for some individuals undergoing chemotherapy. The focus during periods of nausea is often on easily digestible, low-fat, and bland foods.

D. “Raw fruits and vegetables will be easier for your body to digest.”

This statement is not accurate. Raw fruits and vegetables may be harder to digest, and during chemotherapy, the digestive system can be sensitive. It is generally recommended to choose cooked or processed fruits and vegetables for easier digestion.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A nurse is caring for a client who had total hip arthroplasty 1 day ago and is receiving morphine sulfate by PCA pump for pain control. The client reports nausea and vomiting. Which of the following actions is the priority for the nurse to take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching with a client about diets that help with wound healing. Which of the following foods should the nurse indicate contains the best source of protein?

Correct Answer is B

Explanation

A client who has chronic lymphocytic leukemia is starting chemotherapy treatments and asks if she needs to make any dietary changes. Which of the following statements by the nurse is appropriate?

Correct Answer is A

Explanation

A nurse is reinforcing teaching about bottle-feeding with a client who is postpartum. Which of the following statements by the client indicates a need for further teaching?

A nurse is discussing skeletal and skin traction with a newly licensed nurse. Which of the following statements should the nurse identify as an indication that the newly licensed nurse understands these therapies?

A nurse is helping an older adult client ambulate in the hallway for the first time since admission. The client has brought a standard walker from home. To ensure proper use of the walker and the safety of the client, which of the following actions should the nurse take?

A nurse in a community clinic is collecting data from an older adult client who has a body mass index of 17.5. When evaluating the client for dehydration, the nurse should look for which of the following indications of fluid-volume deficit?

A nurse is reinforcing nutritional teaching with a client who has COPD. Which of the following instructions by the nurse is appropriate?

A nurse is reinforcing teaching with a parent of a child who has eczema. Which of the following instructions should the nurse include in the teaching?

A nurse is caring for a client who is in the oliguric phase of acute kidney injury. Which of the following actions should the nurse take?

A nurse is assisting with meal planning for a client who has hypothyroidism. The nurse should reinforce with the client that she should increase her daily intake of which of the following nutrients?