Dif cognitive level analyze analysis ref 883 top

DIF: Cognitive Level: Analyze (analysis) REF: 883
TOP: Nursing Process: Evaluation MSC: NCLEX: Health Promotion and Maintenance
5.
A few months after bariatric surgery, a 56-yr-old male patient tells the nurse, “My skin is hanging
off of me. I think I might want to surgery to remove the skinfolds.” Which response by the nurse
is most appropriate?
a. “The important thing is that you are improving your health.”
b. “The skinfolds show everyone how much weight you have lost.”
c. “Perhaps you should talk to a counselor about your body image.”
d. “Cosmetic surgery may be possible once your weight has stabilized.”
ANS: D
Reconstructive surgery may be used to eliminate excess skinfolds after at least a year has passed
since the surgery. The responses, “The important thing is that your weight loss is improving your
health,” and “The skinfolds show everyone how much weight you have lost, “ignore the patient’s
concerns about appearance and implies that the nurse knows what is important. It may be helpful
for the patient to talk to a counselor, however, there is no indication given that the concern about
skinfolds is dysfunctional.
DIF: Cognitive Level: Apply (application) REF: 889
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
6.
After sleeve gastrectomy, a 42-yr-old male patient returns to the surgical nursing unit with a
nasogastric tube to low, intermittent suction and a patient-controlled analgesia (PCA) machine
for pain control. Which nursing action should be included in the postoperative plan of care?
a. Offer sips of fruit juices at frequent intervals.
b. Irrigate the nasogastric (NG) tube frequently.
c. Remind the patient that PCA use may slow the return of bowel function.
d. Support the surgical incision during patient coughing and turning in bed.
ANS: D
The incision should be protected from strain to decrease the risk for wound dehiscence. The
patient should be encouraged to use the PCA because pain control will improve the cough effort
and patient mobility. NG irrigation may damage the suture line or overfill the stomach pouch.
Sugar-free clear liquids are offered during the immediate postoperative time to decrease the risk
for dumping syndrome.
DIF: Cognitive Level: Apply (application) REF: 888
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
7.
The nurse will be teaching self-management to patients after gastric bypass surgery. Which
information will the nurse plan to include?
a. Drink fluids between meals but not with meals.
b. Choose high-fat foods for at least 30% of intake.
c. Developing flabby skin can be prevented by exercise.
d. Choose foods high in fiber to promote bowel function.
ANS: A

Intake of fluids with meals tends to cause dumping syndrome and diarrhea. Food choices should
be low in fat and fiber. Exercise does not prevent the development of flabby skin.