An adult client who had bariatric surgery two months ago has developed a postoperative stricture. For the past week, the client has experienced nausea, vomiting, and anorexia, and is admitted to the hospital for fluid resuscitation. At this time the client denies feeling any pain. Which intervention should the nurse implement?

Keep the client NPO.

Administer daily vitamin supplements.

Provide protein-enriched shakes.

Encourage small frequent meals.

Answer and Explanation

The Correct Answer is A

Choice A reason: Keeping the client NPO (nothing by mouth) is essential to prevent further irritation of the gastrointestinal tract and to allow the postoperative stricture to heal. When the client is experiencing significant symptoms like nausea and vomiting, keeping them NPO can help manage these symptoms and prevent complications such as aspiration or worsening of the stricture.

Choice B reason: Administering daily vitamin supplements may be necessary for long-term nutritional management, especially after bariatric surgery. However, in the immediate setting of nausea, vomiting, and a postoperative stricture, this is not the priority intervention.

Choice C reason: Providing protein-enriched shakes may be beneficial for maintaining nutrition in the long term, but it is not appropriate when the client is experiencing nausea, vomiting, and anorexia. Oral intake should be limited until the symptoms subside and the stricture is addressed.

Choice D reason: Encouraging small frequent meals may be beneficial for managing long-term nutritional needs after bariatric surgery, but it is not appropriate during an acute episode of nausea, vomiting, and anorexia. The client should be kept NPO to prevent further complications and allow for proper healing.

Nursing Test Bank

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Correct Answer is D

Explanation

Choice A reason: Crackles or coarse rales are typically associated with fluid in the airways, such as in cases of congestive heart failure or pneumonia, but they do not directly indicate a pleural effusion.

Choice B reason: A pleural friction rub is associated with pleuritis, where the inflamed pleurae rub against each other. It does not indicate decreased air flow in a specific lobe.

Choice C reason: Low pitched, sonorous rhonchi are related to secretions in the larger airways and are not specific to a pleural effusion or decreased air flow in one lobe.

Choice D reason: Diminished breath sounds in the left upper lobe are consistent with a pleural effusion, as the fluid can reduce air flow and sound transmission in that area. This finding directly correlates with the x-ray results showing decreased air flow in the entire left upper lobe.

A. Decrease foods high in fat or trans fats. B. Eliminate caffeine and chocolate. C. Augment intake of dairy products. D. Increase intake of insoluble fibber.

Correct Answer is D

Explanation

Choice A reason: Decreasing foods high in fat or trans fats is generally good for overall health, but it is not specifically related to managing diverticulosis. Focusing on fibber intake is more important for this condition.

Choice B reason: Eliminating caffeine and chocolate might be helpful for certain digestive issues, but it is not directly related to diverticulosis management. The primary concern for diverticulosis is to ensure adequate fibber intake to promote regular bowel movements and prevent complications.

Choice C reason: Augmenting the intake of dairy products is not directly beneficial for diverticulosis and could potentially cause discomfort in individuals who are lactose intolerant. It is not a recommended dietary modification for this condition.

Choice D reason: Increasing the intake of insoluble fibber is crucial for managing diverticulosis. Insoluble fibber helps to increase stool bulk and promote regular bowel movements, which can reduce the risk of diverticula formation and prevent flare-ups of diverticulitis. Foods rich in insoluble fibber include whole grains, vegetables, and fruits.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The chest x-ray for a client who is admitted for pneumonia shows a pleural effusion with decreased air flow in the entire left upper lobe. After auscultating the left upper lobe, which breath sounds documented by the nurse verify the x-ray findings?

Correct Answer is D

Explanation

The nurse plans to provide diet instructions to a client who was recently diagnosed with diverticulosis. Which dietary modification should the nurse include in the teaching plan?

Correct Answer is D

Explanation

The nurse is developing a teaching plan for a client with peripheral arterial disease (PAD) who has a history of a myocardial infarction (MI) and smokes two packs of cigarettes daily. Which instruction has the greatest priority?

A female college student comes to the school's health clinic reporting urinary frequency and burning with right lower back pain. Which intervention should the nurse implement first?

The nurse is caring for a client with emphysema who is mildly dyspneic after ambulation. Which instruction should the nurse provide to the client to improve gas exchange?

The nurse is assessing a client who is newly diagnosed with hypothyroidism. Which assessment finding requires immediate intervention?

The nurse is preparing a prescription for enoxaparin 40 mg subcutaneous (sub) daily. Enoxaparin is available in a pre-filled cartridge labelled, "60 mg per 0.6 mall" How many mL should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

A client with hyperthyroidism tells the home health nurse, "I stopped taking my antithyroid medication and now I feel anxious. I can feel my heart racing and pounding." Which assessment is most important for the nurse to obtain?

In planning care for a client with chronic ulcerative colitis, which long-term goal is most important for the nurse to include?

The nurse is assessing a client who was admitted yesterday with peripheral artery disease (PAD) and an ulcer on the lateral malleolus. Which finding is most important for the nurse to report to the healthcare provider?