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B. Pernicious anemia
Rationale:
Billroth I surgery involves removing one half to two thirds of the stomach
and reanastomosing the remaining segment of the stomach to the
duodenum. With the loss of this much of the stomach, development of
pernicious anemia is not uncommon. Pernicious anemia is a macrocytic
anemia that most commonly is caused by the lack of intrinsic factor. During
a Billroth I procedure, a large portion of the parietal cells, which are
responsible for producing intrinsic factor (a necessary component for
vitamin B12 absorption), are removed. In this anemia, the red blood cell is
larger than usual and hence does not last as long in the circulation as
normal red blood cells do, causing the client to have anemia with resultant
fatigue. Vitamin B12 also is necessary for normal nerve function. Because of
the lack of the necessary intrinsic factor, persons with pernicious anemia
also experience paresthesias, impaired gait, and impaired balance.
Although the symptoms could possibly indicate the other options listed,
pernicious anemia is the most logical based on the surgery the client
underwent.
Give this one a try later!
The nurse is planning to teach a client with gastroesophageal reflux disease (GERD)
about substances to avoid. Which items should the nurse include on this list? Select
all that apply.
A. Coffee
1
B. Chocolate
C. Peppermint
D. Nonfat milk
E. Fried chicken
F. Scrambled eggs
The nurse is caring for a client with ulcerative colitis. Which finding does the nurse
determine is consistent with this diagnosis?
2 A. Hypercalcemia
B. Hypernatremia
C. Frothy, fatty stools
D. Decreased hemoglobin
After undergoing Billroth I gastric surgery, the client experiences fatigue and
complains of numbness and tingling in the feet and difficulties with balance. On the
basis of these symptoms, the nurse suspects which postoperative complication?
A. Stroke
B. Pernicious anemia
C. Bacterial meningitis
D. Peripheral arterial disease
The nurse is doing an admission assessment on a client with a history of duodenal
ulcer. To determine whether the problem is currently active, the nurse should assess
the client for which sign(s)/symptom(s) of duodenal ulcer?
The nurse is monitoring a A. Notify the health care provider (HCP).
client admitted to the
hospital with a diagnosis Rationale:
of appendicitis who is On the basis of the signs and symptoms presented
scheduled for surgery in in the question, the nurse should suspect peritonitis
2 hours. The client begins and notify the HCP. Administering pain medication is
to complain of increased not an appropriate intervention. Heat should never
abdominal pain and be applied to the abdomen of a client with
begins to vomit. On suspected appendicitis because of the risk of
assessment, the nurse rupture. Scheduling surgical time is not within the
notes that the abdomen scope of nursing practice, although the HCP
is distended and bowel probably would perform the surgery earlier than the
sounds are diminished. prescheduled time.
Which is the most
appropriate nursing
intervention?
A. Notify the health care
provider (HCP).
B. Administer the
prescribed pain
medication.
C. Call and ask the
operating room team to
perform surgery as soon
as possible.
D. Reposition the client
and apply a heating pad
on the warm setting to
the client's abdomen.
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