Med Surg Pre Class Quiz #2

Which statement by a client with a laryngectomy indicates a need for further discharge teaching? A. "I must avoid swimming." B. "I can clean the stoma with soap and water." C. "I can project mucus when i laugh or cough." D. "I can't put anything over my stoma to cover it."

D. "I can't put anything over my stoma to cover it."

The emergency nurse is preparing to care for a client sustaining facial and neck injuries in a motor vehicle crash. Which of these is the priority at this time? A. Ensure a tracheostomy tray is at the bedside B. Place pressure on areas of hemorrhage C. Assesss the mastoid area for battle sign D. Administer isotonic fluid replacement

A. Ensure a tracheostomy tray is at the bedside

A client has received packing for a posterior nosebleed. In reviewing the client's prescriptions, which of these does the nurse question? A. "Ibuprofen 800 mg every 8 hours as needed for pain." B. "Elevate the head of the bed 45 to 60 degrees." C. "provide humidified air" D. "have suction available at the bedside"

A. Ibuprofen 800 mg every 8 hours as needed for pain."

A client admitted for sleep apnea asks the nurse, "Why does it seem like I wake up every 5 minutes?" What is the nurse's best response? A. "Carbon dioxide builds up while you are not breathing which stimulates your body to wake up and breathe." B. "Because your body isn't getting enough oxygen you wake up and breathe." C."Your tongue may be blocking your throat, and you wake up because you are choking." D. "You really aren't waking up that often. It just feels that way."

A. "Carbon dioxide builds up while you are not breathing which stimulates your body to wake up and breathe."

Which interventions are most appropriate for the nurse to teach a client with a nasal fracture to reduce bleeding from the injury? A. "avoid blowing or picking the nose" B. "drink at least 2000 mL of fluid daily" C. "take the antibiotics for as long as they are prescribed" D. "take in only liquids and eat no solid food for at least a week" E. "change the drip (moustache) dressing as soon as it becomes wet" F. "use acetaminophen for pain rather than aspirin or other NSAIDs"

A. "avoid blowing or picking the nose" F. "use acetaminophen for pain rather than aspirin or other NSAIDs"

With which client does the nurse anticipate complications from obstructive sleep apnea following abdominal surgery? A. 28 yo who is 80 lbs overweight and has a short neck B. 48 yo who has type 1 diabetes and chronic sinusitis C. 58 yo who has GERD for 10 months D. 78 yo who wears upper and lower dentures and has asthma

A. 28 yo who is 80 lbs overweight and has a short neck

A client with laryngeal cancer is admitted to the medical-surgical unit the morning before a scheduled total laryngectomy. Which preoperative intervention can be accomplished by an LPN/LVN working on the unit? A. Administering preoperative antibiotics and anxiolytics B.Assessing the client's nutritional status and need for nutrition supplements C. Having the client sign the operative consent form D. Teaching the client about the need for tracheal suctioning after surgery

A. Administering preoperative antibiotics and anxiolytics

The community health nurse is providing education about risk factors for head and neck cancer? Which of these risks will be included in the teaching session? A. Alcohol and smokeless tobacco use B. Chronic laryngitis and voice abuse C. Marijuana use and exposure to industrial chemicals D. Poor oral hygiene and smoking cigarettes

A. Alcohol and smokeless tobacco use

A client with sleep apnea who has a new order for continuous positive airway pressure (CPAP) with a facemask returns to the outpatient clinic after 2 weeks with a report of ongoing daytime sleepiness. Which action should the nurse take first? A. Ask the client whether the mask fits tightly over the mouth and nose. B. Discuss the use of autotitrating positive airway pressure (APAP). C. Plan to teach the client about treatment with modafinil (Provigil). D. Suggest that a nasal mask be used instead of a full facemask.

A. Ask the client whether the mask fits tightly over the mouth and nose

The charge nurse in the emergency department (ED) is making assignments for the team including a new RN who has just completed a 1-month orientation. Which of these clients would be most appropriate to assign to this nurse? A.Client on warfarin (Coumadin) with epistaxis with brisk bleeding B. Client with facial burns caused by a mattress fire while sleeping C. Client with possible facial fractures after a motor vehicle collision D. Client with suspected bilateral vocal cord paralysis and stridor

A. Client on warfarin (Coumadin) with epistaxis with brisk bleeding

The nurse is caring for a client who has just had radical neck surgery and is receiving mechanical ventilation. Which of these assessments takes priority? A. Observing the dressing for bright-red blood B. Monitoring for decreased level of consciousness C. Evaluating the outcome of pain management strategies D. Analyzing trends of urine output since surgery

A. Observing the dressing for bright-red blood

The nurse is supervising a client during mealtime who has had a recent laryngectomy. Which of these is essential to include in the plan of care? A.Swallow twice to clear the airway B. Thicken all foods to a honey consistency C. Elevate the head of the bed to 45 degrees D. Review the results of the radiographic swallowing study

A. Swallow twice to clear the airway

When reviewing discharge care with the client who has had a laryngectomy, the client states the morphine doesn't work well because he still has shooting pain in the incisional area. Which of these does the nurse suggest be prescribed? A. an NSAID B. Lorazepam C. An increase in morphine dose D. Acetaminophen

A. an NSAID

A client is scheduled for a total laryngectomy. Which statement by the client indicates the need for further teaching about the procedure? A. "I hope I can learn esophageal speech.: B. "I will have to take special care to not aspirate while eating." C. "I won't be able to breathe through my nose any more." D. "It is hard to believe that I will never hear my own voice again."

B. "I will have to take special care to not aspirate while eating."

The standard perioperative laryngectomy plan of care includes these interventions. Which intervention will be most important for the nurse to accomplish preoperatively? A. Educate the client about ways to avoid aspiration when swallowing after the surgery. B. Establish a means for communicating during the immediate postoperative period, such as a Magic Slate or an alphabet board C. Discuss appropriate clothing to wear that will help cover the laryngectomy stoma and decrease social isolation after surgery. D. Teach the client and significant others about how to suction and perform wound care of the stoma.

B. Establish a means for communicating during the immediate postoperative period, such as a Magic Slate or an alphabet board

The nurse is caring for the client who has had an open reduction and internal fixation (ORIF) with titanium plates to repair a LeFort III fracture. Which of these activities will the nurse include in the teaching plan? A.Individuals with a titanium plate should not have an MRI and should carry a wallet card stating this. B. It is important to have good oral hygiene using an irrigating device such as Waterpik. C. Let the health care team know if you are experiencing any pain. D. We will be checking behind your ear for any bruising to assess for additional trauma.

B. It is important to have good oral hygiene using an irrigating device such as Waterpik.

A client about to undergo radiation therapy for head and neck cancer (pharyngeal) asks what side effects are expected from this therapy. Which side effects does the nurse teach the client to expect? A. scalp and eyebrow alopecia B. taste sensation loss or changes C. increased risk for sinus infections D. increased risk for skin breakdown E. moderate weight gain F. increased risk for cavities

B. taste sensation loss or changes D. increased risk for skin breakdown F. increased risk for cavities

The nurse is assessing a client who underwent nasoseptoplasty 24 hours ago. Which finding requires immediate intervention by the nurse? A. Ecchymosis B. Edema C. Excessive swallowing D. Sore throat

C. Excessive swallowing

The nurse in the radiation therapy department is teaching the client about use of fluoride gel trays during radiation treatments. How will the nurse explain the purpose of wearing fluoride gel trays during radiation therapy of the mouth? A. They will keep the mouth moist during treatments B. They prevent yellow teeth after treatment C. They prevent radiation scatter from metal in the mouth D. They will protect the taste buds on the tongue

C. They prevent radiation scatter from metal in the mouth

The nurse is planning care for the non-English-speaking client who is on complete voice rest after head and neck surgery. The nurse must verify the client's allergies prior to medication administration. What alternative method of communication is best for the nurse to use? A. Alphabet board B. picture board C. translation phone service D. word board

C. translation phone service

A client's mother asks what is the most important thing she will need to know to care for her son, who is having an inner maxillary fixation for a mandibular fracture. Which of these does the nurse communicate as the priority? A. "Make sure he gets enough calories each day." B. "He can only consume milk and ice cream until the wires come off." C. "He must brush his teeth every 2 hours." D. "Make sure he always carries the wire cutters with him."

D. "Make sure he always carries the wire cutters with him."

The nurse is caring for a client with facial trauma who has recently developed restlessness. Which of these is the nurse's first priority? A. Assess for bleeding on the drip moustache dressing. B. Provide ventilation with a manual resuscitation bag. C. Perform the abdominal thrust maneuver. D. Apply oxygen

D. Apply oxygen

The nurse assesses that the flap created after laryngectomy in the immediate post-operative period appears dusky in color. What is the nurse's first action? A. Apply moist heat over the flap site B. Massage the flap site vigorously C. Place a tight dressing over the flap D. Assess flow to the area using a Doppler device

D. Assess flow to the area using a Doppler device

The nurse enters the room while the client is eating breakfast and recognizes that the client has an upper airway obstruction with signs of hypoxemia. What is the nurse's first action? A. Attempt to remove the obstruction B. Call the rapid response team C. Apply oxygen by non-rebreathing mask D. Perform the abdominal thrust maneuver

D. Perform the abdominal thrust maneuver

The nurse is caring for a client with laryngeal trauma. Which sign/symptom does the nurse determine is most critical to report to the provider? A. Aphonia B. Hoarseness C. Loud snoring D. Stridor

D. Stridor

The nurse manager at a long-term-care facility is planning care for a client who is receiving radiation therapy for laryngeal cancer. Which of these tasks is appropriate to delegate to a nursing assistant? A. Administering throat-numbing lozenges B. Assessing the mouth for inflammation and infection C. Teaching about skin care while receiving radiation D. Washing the skin with plain soap and water

D. Washing the skin with plain soap and water