Priority Decision: A patient returns to the surgical unit with a nasogastric (NG) tube to low intermittent suction, IV fluids, and a Jackson-Pratt drain at the surgical site following an exploratory laparotomy and repair of a bowel perforation. Four hours after admission, the patient experiences nausea and vomiting. What is a priority nursing intervention for the patient?

Correct Answer: C

Rationale: The correct answer is C: Check the amount and character of gastric drainage and the patency of the NG tube. This is the priority nursing intervention because the patient is experiencing nausea and vomiting, which could indicate potential complications related to the NG tube, such as blockage or displacement. By checking the gastric drainage and NG tube patency, the nurse can assess if the patient's symptoms are related to these issues and take appropriate actions to address them. Choice A is incorrect because assessing the abdomen for distention and bowel sounds is important but not the priority in this situation where the patient is experiencing nausea and vomiting. Choice B is incorrect as inspecting the surgical site and drainage in the Jackson-Pratt drain is also important but not as urgent as checking the NG tube patency in this case. Choice D is incorrect as administering medication should not be the first action taken without first assessing the underlying cause of the symptoms.

Correct Answer: D

Rationale: The correct answer is D: Anti-HAV IgM. IgM antibodies indicate acute infection as they are the first antibodies produced in response to a new infection. In the case of HAV, the presence of Anti-HAV IgM suggests recent exposure to the virus. A: Anti-HBc IgG is not relevant to HAV infection. It indicates past or chronic hepatitis B infection. B: Anti-HBc IgM is specific to hepatitis B infection, not HAV. C: Anti-HAV IgG indicates past exposure or immunity to HAV, not acute infection.

Correct Answer: C

Rationale: Rationale: The correct answer is C because maintaining the patient's airway and preventing aspiration of blood is the top priority in a patient with bleeding esophageal varices. This is crucial to prevent respiratory compromise and potential life-threatening complications. Immediate portal shunting surgery (A) is not the priority as stabilizing the patient comes first. Guaiac testing (B) is not the priority as it does not address the immediate risk of airway obstruction. Monitoring cardiac effects (D) is important but not as critical as ensuring the patient's airway is secure.

Correct Answer: A

Rationale: The correct answer is A: Bile leak. After a laparoscopic cholecystectomy, bile leak is a common complication due to injury to the bile ducts during surgery. This can lead to abdominal pain, infection, and other serious complications. Wound infection (B) is less common in laparoscopic surgeries. Deep vein thrombosis (C) and pulmonary embolism (D) are more associated with prolonged immobility post-surgery, which is less of a concern in laparoscopic cholecystectomy.