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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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

Choice A reason: Clay-coloured stool is a symptom of bile duct obstruction. It indicates that bile is not reaching the intestines to help digest food. While this is important to note, it is not the most urgent finding that requires immediate reporting to the healthcare provider.

Choice B reason: A distended, hard, and rigid abdomen is a sign of possible peritonitis or other severe abdominal complications. This finding indicates a medical emergency that requires immediate attention and intervention by the healthcare provider. Prompt reporting is essential to prevent further complications and ensure appropriate treatment.

Choice C reason: Bile-stained emesis suggests that bile is being regurgitated, which is indicative of a blocked or compromised bile duct. However, this finding does not require as urgent reporting as a rigid abdomen, which could indicate a more serious condition.

Choice D reason: Radiating, sharp pain in the right shoulder is often referred pain from gallbladder issues. While this symptom is significant and should be monitored, it does not take precedence over the urgent finding of a distended and rigid abdomen that might indicate a severe complication.

A. Cold intolerance. B. Weight gain. C. Hypoventilation. D. Lethargy.

Correct Answer is C

Explanation

Choice A reason: Cold intolerance is a common symptom of hypothyroidism due to the reduced metabolic rate. While it is important to address this symptom, it does not require immediate intervention compared to respiratory issues.

Choice B reason: Weight gain is also a common symptom of hypothyroidism because of the decreased metabolism. It is significant but not immediately life-threatening, so it does not take priority over more urgent conditions.

Choice C reason: Hypoventilation is the most critical finding because it indicates respiratory depression. This can lead to severe hypoxia and carbon dioxide retention, potentially causing life-threatening complications. Immediate intervention is required to support the client's breathing and prevent respiratory failure.

Choice D reason: Lethargy is a common symptom of hypothyroidism due to the overall slowing of the body's functions. While concerning, it is not as immediately dangerous as hypoventilation, which directly affects the client's ability to breathe effectively.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with cholelithiasis is admitted with jaundice due to obstruction of the common bile duct. Which finding is most important for the nurse to report to the healthcare provider?

Correct Answer is B

Explanation

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

Correct Answer is C

Explanation

When teaching a client with Parkinson's disease, which rationale for the prescription of carbidopa-levodopa should the nurse include?

The nurse is assessing clients in an outpatient diabetic clinic. Which entry provides the best indication that the client is adhering to the prescribed diabetic regimen?

The nurse is planning discharge teaching for a client who has cystitis. Which information should the nurse include in the teaching plan?

A client with Crohn's disease is admitted to the medical unit with a three-day history of abdominal cramping, nausea, and vomiting. Which prescription should the nurse implement first?

A client reports a 2-day history of fever, vomiting, and diarrhea. The healthcare provider prescribes serum electrolyte levels to be obtained. Which laboratory results should the nurse expect?

During a home visit, the nurse should evaluate the effectiveness of a client's treatment for chronic obstructive pulmonary disease (COPD) by assessing for which primary symptom?

While assessing a client following lithotripsy with stent insertion, which data indicates to the nurse that the procedure was successful?