The nurse is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the client to:

Correct Answer: D

Rationale: The correct answer is D: drink liquids only between meals. This is because restricting fluids during meals can worsen dumping syndrome by rapidly emptying the stomach contents into the intestines, causing symptoms like cramping and diarrhea. By advising the client to drink liquids only between meals, it allows for better digestion and absorption of nutrients, reducing the risk of dumping syndrome. Choice A is incorrect because restricting fluid intake can lead to dehydration and other complications. Choice B is incorrect as drinking liquids with meals can exacerbate dumping syndrome symptoms. Choice C is incorrect as not drinking liquids before meals may not effectively manage dumping syndrome and can lead to dehydration.

Correct Answer: C

Rationale: The correct answer is C. The rationale is as follows: The return of bowel function, evidenced by passing gas, is an important indicator of gastrointestinal motility and recovery postoperatively. It indicates that the gastrointestinal system is beginning to function normally, which is a key factor in determining when the nasogastric tube can be safely removed. Choices A and B are too general and do not provide a specific physiological indicator for tube removal. Choice D defers the decision solely to the doctor without considering the client's physiological progress. Therefore, the most appropriate and accurate indicator for tube removal is the return of bowel function and passage of gas, as stated in option C.

Correct Answer: B

Rationale: The correct answer is B: Change the dressing. This is the most appropriate intervention because serosanguineous drainage can indicate the need for a dressing change to prevent infection and ensure proper wound healing. Changing the dressing will also allow for better assessment of the drainage and the incision site. A: Notifying the physician may not be necessary at this stage since serosanguineous drainage is expected in the early postoperative period. C: Circling the amount on the dressing with a pen does not address the need for a dressing change or further assessment of the drainage. D: Continuing to monitor the drainage is important, but changing the dressing is the immediate action needed to ensure proper wound care.

Correct Answer: C

Rationale: The correct answer is C, sweating and pallor, for early signs of dumping syndrome. Dumping syndrome is characterized by rapid emptying of the stomach contents into the small intestine, leading to symptoms like diaphoresis (sweating) and pallor due to vasomotor instability. Abdominal cramping and pain (A) are more commonly associated with gastrointestinal issues, not specific to dumping syndrome. Bradycardia and indigestion (B) are not typical symptoms of dumping syndrome, as it usually presents with tachycardia due to fluid shifts. Double vision and chest pain (D) are not commonly associated with dumping syndrome.

Correct Answer: D

Rationale: The correct answer is D because irrigating the Cantor tube with normal saline solution is inappropriate. Cantor tubes are typically used for gastric decompression or feeding, and irrigating with normal saline can disrupt the balance of electrolytes in the stomach. Choice A is correct as injecting air helps facilitate drainage. Choice B is correct as lubricant aids in tube insertion. Choice C is incorrect as coiling tubing can cause kinks and hinder drainage.