A client is admitted to the hospital for a hemorrhoidectomy. Postoperatively, which of the following would a client's nurse be most concerned about?

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Question 1 of 5

A client is admitted to the hospital for a hemorrhoidectomy. Postoperatively, which of the following would a client's nurse be most concerned about?

Correct Answer: D

Rationale: The correct answer is D because excessive bloody drainage on the external gauze dressing could indicate hemorrhage, a serious complication post-hemorrhoidectomy. This requires immediate medical attention to prevent further complications. A: Pain at the incision site is expected postoperatively and can be managed with pain medication. B: A white blood count of 6.5 is within the normal range and not a cause for concern. C: Client's refusal of a stool softener is important for bowel movement management but is not the most immediate concern compared to excessive bloody drainage.

Question 2 of 5

The nurse monitors the laboratory results of the patient with protein-calorie malnutrition during treatment. Which result is an indication of improvement in the patient's condition?

Correct Answer: B

Rationale: The correct answer is B because an increase in serum transferrin levels indicates improvement in protein-calorie malnutrition as transferrin is a protein that binds and transports iron, which is essential for various body functions. When protein intake increases, transferrin levels also increase to support iron transport. A: Decreased lymphocytes do not directly reflect improvement in protein-calorie malnutrition. C: Increased serum potassium is not specific to improvement in protein-calorie malnutrition. D: Decreased serum prealbumin levels indicate ongoing malnutrition, not improvement.

Question 3 of 5

What information should be included in the dietary teaching for the patient following a Roux-en-Y gastric bypass?

Correct Answer: A

Rationale: The correct answer is A: Avoid sugary foods and limit fluids to prevent dumping syndrome. After a Roux-en-Y gastric bypass, the patient's stomach size is reduced, making it important to avoid sugary foods that can cause rapid spikes in blood sugar and lead to dumping syndrome. Dumping syndrome occurs when food moves too quickly from the stomach to the small intestine, causing symptoms like nausea, vomiting, diarrhea, and weakness. Limiting fluids can also help prevent this by slowing down digestion. Choices B and C are incorrect as increasing food intake rapidly or maintaining a liquid diet long-term can be harmful post-surgery. Choice D is incorrect because consuming foods high in complex carbohydrates, protein, and fiber can be difficult for the patient to digest due to the altered anatomy.

Question 4 of 5

Regardless of the precipitating factor

Correct Answer: D

Rationale: Step 1: Peptic ulcers are mainly caused by H. pylori infection or NSAIDs use, not directly related to acid injury. Step 2: Ammonia formation in the mucosal wall neutralizes acid, protecting mucosal cells. Step 3: Ammonia is produced by H. pylori urease enzyme, contributing to ulcer formation. Step 4: Acid back diffusion (B) and histamine release (C) are consequences, not direct causes of ulcers. Summary: Ammonia formation (D) is the correct answer as it directly contributes to mucosal injury in peptic ulcers. Acid back diffusion (B) and histamine release (C) are secondary effects of ulcer formation, not the primary cause.

Question 5 of 5

Priority Decision: A postoperative patient has a nursing diagnosis of pain related to effects of medication and decreased GI motility as evidenced by abdominal pain and distention and inability to pass flatus. Which nursing intervention is most appropriate for this patient?

Correct Answer: A

Rationale: Rationale for Correct Answer (A): Ambulating the patient more frequently helps to stimulate GI motility, reduce abdominal distention, and promote passage of flatus. Movement aids in peristalsis, which can alleviate postoperative GI issues. Summary of Incorrect Choices: B: Assessing bowel sounds is important but does not directly address the issue of stimulating GI motility or addressing the patient's pain and distention. C: Placing the patient in a high Fowler's position may improve respiratory function but does not specifically target GI motility or pain relief. D: Withholding opioids may be necessary in some cases, but pain management is crucial for postoperative care. There are other ways to address decreased GI motility without completely withholding pain medications.

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