After having a vertical sleeve gastrectomy performed, a 42-year-old male client returns to the surgical nursing unit with a nasogastric tube to low, intermittent suction and a client-controlled analgesia (PCA) machine for pain control. Which nursing action should be included in the post-op plan of care for the first 24 hours?

Teach the client to support the surgical site while deep breathing and coughing

Teach that PCA use may slow the return of bowel function, so the client should not overuse it

Irrigate and reposition the NGT frequently

Offer cups of fruit juices at frequent intervals

Answer and Explanation

The Correct Answer is A

A.   Teach the client to support the surgical site while deep breathing and coughing: This action is appropriate as it helps prevent complications such as atelectasis and pneumonia by promoting lung expansion and clearing secretions. Supporting the surgical site while deep breathing and coughing helps reduce pain and discomfort during these activities.
B.   This is an important teaching point for clients using PCA for pain control after surgery. Opioid medications used in PCA can lead to gastrointestinal motility issues, including constipation. However, pain management is central within the first 24 hours post operation.
C.   Irrigating and repositioning the NGT frequently can increase the risk of complications such as displacement or irritation of the surgical site. NGT care should be performed as needed based on institutional protocols and the client's condition.

D.   The client's diet will likely be advanced gradually, starting with clear fluids and progressing to full liquids and then solid foods as tolerated. Fruit juices may be introduced gradually as part of the liquid diet once the client's gastrointestinal function has recovered sufficiently.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

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

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is ["A","B","D"]

Explanation

A. Daily weighing can help individuals monitor their progress and stay accountable for their weight loss goals. However, it's essential to emphasize that weight can fluctuate due to various factors such as hydration, digestion, and muscle mass changes, so the focus should be on overall trends rather than daily fluctuations.
B. Joining a support group can provide individuals with encouragement, motivation, and accountability during their weight loss journey. It allows them to connect with others who are facing similar challenges and share strategies for success.
D. Keeping a food diary or journal can be a valuable tool for promoting awareness of eating habits, tracking calorie intake, and identifying patterns or triggers for overeating. It helps individuals make informed choices about their diet and can contribute to successful weight loss by promoting accountability and mindfulness.
C. Use large, yellow plates is not typically included in successful weight loss strategies. Plate size and color may have minimal impact on food intake compared to factors such as portion control, food choices, and mindful eating practices.
E. Eating quickly and leaving the table can lead to overeating because it doesn't allow time for the body to register fullness signals.

A. Loops of large bowel become visibly outlined through the abdominal wall B. Intense thirst, parched tongue and dry mucous membranes C. Vomiting of bile-stained gastric contents D. High-pitched, frequent bowel sounds

Correct Answer is A

Explanation

A. Loops of large bowel become visibly outlined through the abdominal wall is a typical late clinical finding of a large bowel obstruction. In fact, visible loops of bowel through the abdominal wall may be observed in cases of a severe bowel obstruction, but it is not typically considered a late finding.

B. Intense thirst, parched tongue, and dry mucous membranes suggest dehydration, which can occur as a result of vomiting, decreased fluid intake, or fluid loss due to the obstruction. However, dehydration may occur earlier in the course of a bowel obstruction and may not be considered a late finding.
C. Vomiting in large bowel obstruction is commonly of fecal contents.
D. High-pitched, frequent bowel sounds is not a typical late clinical finding of a large bowel obstruction. Instead, bowel sounds are usually diminished or absent in cases of bowel obstruction due to decreased peristalsis beyond the site of obstruction.

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is teaching the client about successful strategies for weight loss. Which would the nurse include? (SELECT ALL THAT APPLY)

Correct Answer is ["A","B","D"]

Explanation

The nurse is assessing a client who has a large bowel obstruction. Which late clinical finding would the nurse expect?

Correct Answer is A

Explanation

The nurse is caring for a client recently diagnosed with emphysema. What health maintenance Information would the nurse teach the client? (SELECT ALL THAT APPLY)

The nurse is caring for a client admitted with an obstruction in the duodenum. Which initial clinical manifestation is associated with this condition?

The nurse suspects that the client, hospitalized with severe ulcerative colitis, is experiencing the complication of toxic megacolon. Which assessment finding would support this suspicion?

A client is admitted with a possible small bowel obstruction. The nurse anticipates that the client's care will include: (SELECT ALL THAT APPLY)

The nurse understands that the Intervention proven to provide the most sustained weight loss in the extremely obese population is:

The nurse identifies a client problem of impaired skin integrity related to diarrhea for a client who has ulcerative colitis. The nurse recognizes that teaching about perianal care has been effective when the client:

The client has lived with ulcerative colitis for close to 15 years and has learned to manage it very well. At this point in time, the nurse's discussion with the client about this disease should have a primary focus on which question?