the nurse is caring for a client following a billroth ii procedure on review of the postoperative orders which of the following if prescribed should t the nurse is caring for a client following a billroth ii procedure on review of the postoperative orders which of the following if prescribed should t
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Gastrointestinal System Nursing Exam Questions

1. The nurse is caring for a client following a Billroth II procedure. On review of the postoperative orders, which of the following if prescribed, should the nurse question and verify?

Correct answer: A

Rationale: In a Billroth II procedure the proximal remnant of the stomach is anastomosed to the proximal jejunum. Patency of the nasogastric tube is critical for preventing the retention of gastric secretions. The nurse should never irrigate or reposition the gastric tube after gastric surgery, unless specifically ordered by the physician. In this situation the nurse should clarify the order. Coughing and deep breathing exercises, leg exercises, and early ambulation are appropriate postoperative interventions.

2. Small-for-date infants __________ than preterm infants.

Correct answer: C

Rationale: Small-for-date infants more often show evidence of brain damage than preterm infants. This can be attributed to factors such as intrauterine growth restriction and poor nutrition during pregnancy, which can affect the development of the baby's brain. Choices A, B, and D are incorrect because there is no evidence to support that small-for-date infants catch fewer infections, are less likely to die, or have higher intelligence tests compared to preterm infants.

3. A client tests positive for alpha1-antitrypsin (AAT) deficiency and asks the nurse, What does this mean? How should the nurse respond?

Correct answer: C

Rationale: Alpha1-antitrypsin (AAT) deficiency is associated with a higher risk of chronic obstructive pulmonary disease (COPD), especially if the individual smokes. This condition is caused by a recessive gene. Individuals with one allele typically produce enough AAT to prevent COPD unless they smoke. However, those with two alleles are at high risk for COPD even without exposure to smoke or other irritants. Being a carrier of AAT deficiency does not guarantee that one's children will develop the disease; it depends on the AAT levels of the partner. While involving a genetic counselor may be beneficial in the long run, the immediate concern of the client's question should be addressed first.

4. The nurse is administering the first hepatitis A vaccine to an 18-month-old child. When should the child return to the clinic for the second dose of hepatitis A vaccination?

Correct answer: D

Rationale: The second dose of the hepatitis A vaccine is recommended 6 months after the first dose to ensure full immunity.

5. When educating a client who experienced a pneumothorax, which of the following statements should the nurse use?

Correct answer: Notify your provider if you experience a productive cough.

Rationale: After experiencing a pneumothorax, it is crucial for the client to be educated on potential complications. A productive cough can indicate infection or another issue, requiring prompt medical attention. Weakness, returning to work, and wearing a mask in crowded areas are important considerations but not as critical as monitoring for respiratory symptoms post-pneumothorax.

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