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ANCC Medical-Surgical Nursing Exam Prep

Category - Medical-Surgical Nursing Practice Test

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Mr. Mitchell, a 61-year-old retired banker, is diagnosed with cancer and has been immunocompromised and malnourished due to decreased intake because of nausea, anorexia, and a feeling of fullness. A Salem sump tube had been draining the stomach and has been discontinued. The initial nursing action to manage malnutrition would be:
  1. Teach the client about total parenteral nutrition (TPN)
  2. Assist with insertion of a PEG tube
  3. Give an antiemetic before serving small, frequent meals
  4. Give an aluminum hydroxide antacid with meals
Explanation
Answer - C - The goal is to promote adequate nutrition through oral intake. Symptom management would be the initial nursing action. Choice A is incorrect because the goal is to resume oral intake. Parenteral nutrition would not be the initial action following removal of the Salem sump. Choice B is incorrect because the goal is to support oral intake. Insertion of a percutaneous endoscopic gastrostomy (PEG) would not be the next step after removal of the Salem sump. Choice D is incorrect because an antacid would not diminish the nausea, anorexia, or the fullness that the client is experiencing.
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