Priority Decision: The nurse admitting a patient for bariatric surgery obtains the following information from the patient. Which finding should be brought to the surgeon's attention before proceeding with further patient preparation?

Correct Answer: B

Rationale: The correct answer is B: History of untreated depression. Before proceeding with further patient preparation for bariatric surgery, it is crucial to address untreated depression as it can significantly impact the patient's mental and emotional well-being post-operatively. Untreated depression can lead to poor compliance with post-operative instructions, medication management issues, and potentially increase the risk of complications. It is essential to involve the surgeon to assess the patient's psychological readiness for surgery and ensure appropriate support and resources are in place. Incorrect choices: A: History of hypertension - While hypertension should be managed pre-operatively, it is not a critical factor that would require immediate attention before further preparation. C: History of multiple attempts at weight loss - This is a common issue in patients undergoing bariatric surgery and does not pose an immediate risk that needs urgent attention. D: History of sleep apnea treated with CPAP - While sleep apnea is a relevant consideration for bariatric surgery, the fact that it is being treated with

Correct Answer: C

Rationale: The correct answer is C. Assessing the onset, location, intensity, duration, and character of the pain is the priority because it helps determine the potential cause of the abdominal pain. This information guides further interventions and informs the healthcare team about the urgency of the situation. Choice A (Measurement of vital signs) can be important but assessing the pain characteristics takes precedence as it directly informs the urgency of the situation. Choice B (Administration of prescribed analgesics) should be delayed until the cause of the pain is identified to prevent masking symptoms that could aid in diagnosis. Choice D (Physical assessment of the abdomen) is important but assessing the pain characteristics comes first to guide the physical assessment and subsequent interventions.

Correct Answer: D

Rationale: The correct answer is D because in the event of leakage from the pouch, it is important to promptly remove it, clean the skin, and apply a new pouch to prevent skin irritation and infection. This step is crucial for maintaining skin integrity and preventing complications. Choice A is incorrect as ileostomy pouches typically need to be changed more frequently, usually every 3-7 days, to prevent skin breakdown and odor. Choice B is incorrect because decreasing fluid intake can lead to dehydration and electrolyte imbalances, which are especially risky for ileostomy patients who have increased fluid losses. Choice C is incorrect because the pouch should not be removed until the stoma and bowel movements have been evaluated and regulated to ensure proper functioning.

Correct Answer: D

Rationale: The correct answer is D because HBV DNA quantitation measures the amount of HBV genetic material in the blood, reflecting viral replication. This helps monitor the effectiveness of therapy in chronic HBV patients. Choice A is incorrect as the test does not specifically indicate ongoing infection. Choice B is incorrect as it refers to co-infection with HDV, which is not the purpose of HBV DNA quantitation. Choice C is incorrect as the test does not differentiate between previous infection and ongoing viral replication, which is crucial in managing chronic HBV.

Correct Answer: D

Rationale: The correct answer is D because patients who undergo liver transplant are put on immunosuppressive medication to prevent rejection. This medication weakens the immune system, making the patient more susceptible to infections. Monitoring closely for signs of infection is crucial to prevent complications. Choice A is incorrect because alcohol intake is not recommended after a liver transplant as it can further damage the new liver. Choice B is incorrect because HBIG (Hepatitis B Immunoglobulin) is typically given to prevent hepatitis B recurrence, not rejection. Choice C is incorrect as elevating the head has no direct correlation with post-liver transplant care.