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 D

Explanation

A. Jaundice is typically related to liver dysfunction and would not be a primary symptom of a hiatal hernia.
B. Anorexia is not a primary symptom of a sliding hiatal hernia, although some patients may experience reduced appetite due to discomfort.
C. Stomatitis (inflammation of the mouth) is not typically associated with a hiatal hernia.
D. Pyrosis, or heartburn, is a primary symptom of a sliding hiatal hernia, which occurs when stomach acid refluxes into the esophagus due to the hernia. This can lead to the sensation of heartburn or acid reflux.

A. Administer a broad-spectrum antibiotic to prevent infection. B. Notify the healthcare provider immediately and wait for further instructions. C. Obtain a culture specimen of the drainage, apply a sterile dressing over the site, and monitor for any signs of infection. D. Remove the sutures immediately to prevent further drainage.

Correct Answer is C

Explanation

A. Administering a broad-spectrum antibiotic is not the first action in this case. The first priority is to assess the situation and obtain a culture of the drainage to identify any infection before initiating antibiotics.
B. While notifying the healthcare provider is important, it is more important to take an initial action by obtaining a culture specimen. Waiting without taking action could delay appropriate care.
C. The best first action is to obtain a culture of the drainage to identify any potential infection, apply a sterile dressing, and continue to monitor the site for further signs of infection. Culturing the drainage helps guide the appropriate treatment.
D. Removing the sutures is not the appropriate action. The sutures should not be removed unless there is clear indication, as this could disrupt the integrity of the catheter placement.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse understands that the primary symptoms of a sliding hiatal hernia are associated with reflux. Therefore, the nurse should assess the client with a hiatal hernia for which of the following symptoms?

Correct Answer is D

Explanation

The nurse is changing the subclavian dressing of a client who is receiving total parenteral nutrition. When assessing the catheter insertion site, the nurse noticed the presence of a yellow drainage from around the sutures that are anchoring the catheter. Which actions should the nurse take first?

Correct Answer is C

Explanation

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