A patient who had surgery earlier in the day using general anesthesia asks whether he can have something to eat. The diet order indicates clear liquids can be taken. Before giving a Jell O to the patient, the nurse should check for the presence of:
palpable peripheral pulses.
clear lung sounds.
adequate urinary drainage.
bowel sounds in all quadrants.
The Correct Answer is D
A. Palpable peripheral pulses. Palpable pulses are important for circulatory assessment but are not relevant in determining whether the patient can eat after surgery.
B. Clear lung sounds. Clear lung sounds are important for respiratory status, but they are not the primary factor in determining whether a patient can start clear liquids.
C. Adequate urinary drainage. Urinary drainage is important for monitoring kidney function postoperatively but is not a primary factor in whether a patient can eat clear liquids.
D. Bowel sounds in all quadrants. The presence of bowel sounds indicates that the gastrointestinal system is functioning well enough to begin processing liquids, making this an important assessment before offering fluids or food.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Place a walker at the side of the bed. A walker may not be necessary for all patients and should only be used if prescribed by the healthcare provider.
B. Allow the patient to sit with the head of bed raised to the high Fowler’s position. This helps with postural adjustment but is not the best first step before dangling the legs.
C. Assist the patient to sit and dangle his or her legs on the side of the bed. Gradual movement from lying to sitting to standing helps prevent orthostatic hypotension, which is common after surgery.
D. Assist the patient from a supine position to a standing position. Moving too quickly can cause dizziness, falls, and syncope due to orthostatic hypotension.
Correct Answer is ["A","B","C","D"]
Explanation
A. Gather an emesis basin, tissues, and a small towel. Nausea and vomiting are common postoperative effects; having supplies ready helps with patient comfort.
B. Lower the bed for easy transfer of the patient. Lowering the bed facilitates a safe and smooth transfer from the stretcher to the bed.
C. Place an IV pole at the head of the bed. The IV should be positioned for easy access and monitoring.
D. Fan fold the sheets on the near side of the bed. Fan folding the sheets makes it easier to transfer the patient into bed without unnecessary movement.
E. Collect extra dressing supplies and place them on the bedside table. Dressing supplies should be kept sterile and only opened when needed to prevent contamination.
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