A nurse is providing discharge teaching to a client following a total gastrectomy.
The nurse should instruct the client about which of the following medications?
Vitamin B12.
Ranitidine.
Vitamin K.
Metoclopramide.
The Correct Answer is A
Choice A rationale:
After a total gastrectomy, the client lacks the intrinsic factor necessary for the absorption of vitamin B12 in the terminal ileum. Therefore, vitamin B12 supplementation is essential to prevent pernicious anemia, a condition caused by vitamin B12 deficiency. The absence of intrinsic factor hinders the absorption of vitamin B12 from dietary sources, making it necessary to provide this vitamin through injections or high-dose oral supplements. Vitamin B12 supplementation is a standard practice following a total gastrectomy.
Choice B rationale:
Ranitidine is a histamine-2 (H2) receptor antagonist used to reduce stomach acid production. It is not directly related to vitamin B12 deficiency and is not typically prescribed following a total gastrectomy. Vitamin B12 supplementation, on the other hand, addresses the specific deficiency caused by the absence of intrinsic factor.
Choice C rationale:
Vitamin K is essential for blood clotting and bone health. However, it is not the primary concern following a total gastrectomy. Vitamin B12 deficiency leading to pernicious anemia is the major focus of post-gastrectomy supplementation. While vitamin K may be important for overall health, it is not the immediate priority in this scenario.
Choice D rationale:
Metoclopramide is a medication used to treat gastrointestinal disorders, including gastroparesis and gastroesophageal reflux disease (GERD). It does not directly address the vitamin B12 deficiency resulting from the absence of intrinsic factor. Vitamin B12 supplementation is specifically indicated to prevent pernicious anemia in this context.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The correct answer is B.
Choice A reason: Checking the client’s condition after the procedure involves assessment, which is a critical component of the nursing process. This task requires clinical judgment and knowledge of potential complications, which are responsibilities that cannot be delegated to assistive personnel.
Choice B reason: Assisting with ambulation is a task that can be safely delegated to assistive personnel. It is a basic care task that does not require clinical judgment and can be performed under the supervision of a nurse.
Choice C reason: Witnessing a client’s signature on the consent for the procedure is a legal and ethical responsibility that involves ensuring the client understands the procedure and is giving informed consent. This task requires a level of professional accountability that is beyond the scope of assistive personnel.
Choice D reason: Administering medication, such as atropine 30 minutes before the procedure, is a nursing intervention that requires knowledge of pharmacology and the ability to monitor for adverse effects. This is not within the scope of practice for assistive personnel and must be performed by licensed nursing staff.
Correct Answer is C
Explanation
Choice A rationale:
Baked potato chips are a healthier alternative to regular potato chips because they contain less fat due to the baking process. However, they are still a processed snack and might not be the healthiest option, especially for a school-age group. The high sodium content in many baked chips is also a concern for cardiovascular health.
Choice B rationale:
A milkshake made with whole milk might provide essential nutrients like calcium and protein, but it is also high in calories and can be loaded with sugar, especially if additional sugars or syrups are added. Consuming sugary beverages in excess can contribute to weight gain and dental issues.
Choice C rationale:
"Air-popped popcorn." This is the correct answer. Air-popped popcorn is a healthy whole-grain snack option. It is low in calories, high in fiber, and can be a good source of antioxidants. It is important to note that while air-popped popcorn is healthy, adding excessive butter, salt, or sugar can diminish its nutritional value.
Choice D rationale:
Cheesecake is a rich, high-calorie dessert that is not considered a healthy snack option. It is high in saturated fats, sugars, and calories, making it an occasional treat rather than a suitable healthy snack choice for school-age children.
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