The patient who is morbidly obese has just undergone gastric bypass surgery. Which immediate post-operative intervention has the greatest priority?

Change the surgical dressing.

Auscultate bowel sounds.

Reposition the NG tube if patient is nauseated.

Elevate the head of the bed at least 30 degrees.

Answer and Explanation

The Correct Answer is D

A.   While monitoring the surgical site is important, changing the dressing is not the highest priority immediately post-operatively. The initial focus should be on assessing the patient's stability and managing any complications rather than performing a dressing change.
B.   Assessing bowel sounds is important to evaluate gastrointestinal function, particularly after gastrointestinal surgery. However, this can be done after ensuring that the patient is stable and that their airway, breathing, and circulation are prioritized. While important, it is not the immediate priority.
C.   If the patient has a nasogastric (NG) tube in place and is experiencing nausea, this may require attention, as it can indicate a blockage or discomfort. However, repositioning the NG tube may not be the first intervention to prioritize in the immediate post-operative setting.
D.   This intervention is critical for multiple reasons. Elevating the head of the bed helps reduce the risk of aspiration, improves breathing by enhancing lung expansion, and aids in reducing pressure on the surgical site. After abdominal surgery, especially in obese patients, elevating the head can also promote comfort and facilitate early ambulation.

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Correct Answer is C

Explanation

A. Sucralfate works by forming a protective barrier over the ulcer and is best taken on an empty stomach. Antacids can interfere with the effectiveness of sucralfate if taken simultaneously. It’s usually recommended to wait at least 30 minutes to 1 hour after taking sucralfate before taking an antacid.
B. Sucralfate should be stored at room temperature, away from moisture and heat, but it does not need to be refrigerated. This guidance is essential to ensure that the medication maintains its effectiveness.
C. Sucralfate is typically taken 1 hour before meals and at bedtime to optimize its protective effect on the stomach lining and ulcers. This timing allows it to coat the ulcer effectively before food intake.
D. Sucralfate tablets should be swallowed whole and not crushed or chewed, as doing so may affect how the medication works. This instruction helps ensure that the sucralfate can properly adhere to the ulcer surface.

A. History of bulimia B. Drinks green tea C. Has a glass of wine with dinner each day D. History of NSAID use

Correct Answer is D

Explanation

A. Bulimia involves episodes of binge eating followed by purging and can lead to a range of gastrointestinal issues, including esophageal damage and electrolyte imbalances. However, it is not a direct risk factor for the development of peptic ulcers. While it can affect the digestive system, it does not inherently increase the risk of ulcers.
B. Green tea is generally considered to have health benefits and is not typically associated with an increased risk of peptic ulcers. In some cases, it may even provide protective effects against gastric ulcers due to its antioxidant properties.
C. Moderate alcohol consumption can have varying effects on gastric mucosa. While excessive alcohol consumption is a risk factor for developing ulcers, moderate consumption, such as a glass of wine with dinner, is not typically considered a significant risk factor.
D. This is a well-established risk factor for peptic ulcer disease. Nonsteroidal anti-inflammatory drugs (NSAIDs) can irritate the gastric lining and inhibit the production of protective mucus, leading to an increased risk of developing ulcers.

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The patient who is morbidly obese has just undergone gastric bypass surgery. Which immediate post-operative intervention has the greatest priority?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing teaching to a client who has peptic ulcer disease and a new prescription for sucralfate tablets. Which of the following information should the nurse provide?

Correct Answer is C

Explanation

A nurse is reviewing the medical record of a client who has a peptic ulcer. Which of the following findings should the nurse recognize as a risk factor for this condition?

Correct Answer is D

Explanation

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