A patient has a nasogastric (NG) tube following esophagectomy. Following standards of practice, which of the following postoperative instructions should the nurse question the surgeon about?

Calling the physician for any bright red blood in the NG tube

Keeping the NG tube taped and secured to the patient's nares

Notifying the physician for a temperature under 100.5°F

Irrigating the NG tube with 30 mL of normal saline every 6 hours

Answer and Explanation

The Correct Answer is C

A. It is appropriate to notify the physician if bright red blood is found in the NG tube, as this could indicate bleeding, which requires prompt medical attention.
B. It is standard practice to keep the NG tube taped and secured to the patient’s nares to prevent dislodgement and ensure proper function.
C. A temperature under 100.5°F is generally not a cause for concern postoperatively, unless it is persistent or accompanied by other signs of infection. Typically, a low-grade fever is expected after surgery, but further investigation is only warranted for higher fevers or other concerning symptoms.
D. Irrigating the NG tube every 6 hours with 30 mL of normal saline is standard practice to ensure patency of the tube and prevent clogging.

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Correct Answer is A

Explanation

A. A fever following an upper gastrointestinal endoscopy can be a sign of a serious complication, such as perforation, which could cause peritonitis. The nurse should promptly assess the client for other signs of perforation, such as abdominal pain, rigidity, or changes in vital signs. This is a critical and potentially life-threatening situation that requires immediate attention.
B. While it is important to ensure accurate temperature readings, a fever of 101.8°F in a post-procedural patient is concerning and warrants further investigation rather than just retaking the temperature. It may indicate a complication such as infection or perforation.
C. Administering acetaminophen to reduce the fever is not the first step. The nurse should prioritize investigating the underlying cause of the fever, as it could indicate a more serious complication like perforation, which would not be resolved by medication alone.
D. Bathing the client with tap water is not appropriate. A fever after a procedure should be investigated thoroughly rather than treated symptomatically without understanding the cause. The nurse should focus on assessing for complications first.

A. Notifying the healthcare provider if they are experiencing a moon phase. B. Taking the steroid medication as prescribed. C. Notifying the healthcare provider if the blood glucose level is over 150 mg/dL. D. Taking this medication on an empty stomach.

Correct Answer is B

Explanation

A. "Moon phase" is not a correct term related to prednisone use. The term "moon face" refers to the round, puffy face that can result from prolonged steroid use, which is a side effect, but it is not something the patient needs to notify the healthcare provider about unless it is accompanied by other severe symptoms.
B. Taking the steroid medication as prescribed is essential. Prednisone is a corticosteroid, and missing doses or abruptly stopping the medication can lead to complications such as adrenal insufficiency. It's important for the client to adhere to the prescribed regimen to manage inflammation and minimize the risk of side effects.
C. Steroids like prednisone can cause increased blood glucose levels, so it's important for the client to monitor blood glucose more frequently. If blood glucose levels exceed 150 mg/dL, they should notify their healthcare provider, but this is not the immediate management strategy for this scenario.
D. Prednisone should be taken with food to reduce gastrointestinal irritation, not on an empty stomach. Taking it without food can increase the risk of stomach upset and ulcers, particularly in patients with inflammatory bowel disease.

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A patient has a nasogastric (NG) tube following esophagectomy. Following standards of practice, which of the following postoperative instructions should the nurse question the surgeon about?

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Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

A client diagnosed with type II diabetes is prescribed prednisone for an acute exacerbation of inflammatory bowel disease. Which management strategy should the nurse discuss with the client?

Correct Answer is B

Explanation

A client is admitted to the nursing unit with a diagnosis of gastric ulcer. Which assessment finding by the nurse supports the client's diagnosis of gastric ulcer?

A patient with right lower-lobe pneumonia has been treated with IV antibiotics for 3 days. Which assessment data obtained by the nurse indicates that the treatment is effective?

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Which of the following statements about strictureplasty is correct?

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