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A client is being discharged to home after prostatectomy for treatment of benign prostatic hyperplasia. Which point should the nurse plan to teach the client as part of the discharge teaching?
- A. Mowing the lawn is allowed after 1 week.
- B. Avoid lifting more than 50 pounds for 4 to 6 weeks after surgery.
- C. Drink at least 15 glasses of water a day to minimize clot formation.
- D. Notify the primary health care provider if fever, increased pain, or an inability to void occurs.
Correct Answer: D
Rationale: Notifying the primary health care provider about fever, increased pain, or inability to void is critical to detect complications like infection or urinary obstruction. Mowing the lawn is too strenuous too soon, lifting more than 20 pounds is prohibited, and 15 glasses of water daily is excessive; 6 to 8 glasses are sufficient.
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The nurse has completed instructions with a client with atrial fibrillation who will be taking warfarin sodium indefinitely. Which statement by the client indicates the need for further teaching?
- A. I need to use a soft toothbrush.
- B. I need to avoid drinking alcohol while taking this medication.
- C. I can continue to take my NSAIDs as previously prescribed.
- D. I should carry identification regarding the medication being taken.
Correct Answer: C
Rationale: Warfarin increases bleeding risk, and NSAIDs can exacerbate this, especially causing GI bleeding, so they should be avoided without provider approval. Using a soft toothbrush, avoiding alcohol, and carrying medication identification are correct to prevent bleeding and ensure safety.
The nurse is caring for a client who is scheduled to have a thyroidectomy and provides instructions to the client about the surgical procedure. Which statement by the client indicates an understanding of the nurse's instructions?
- A. I will definitely have to continue taking antithyroid medication after this surgery.
- B. I need to place my hands behind my neck when I have to cough or change positions.
- C. I need to turn my head and neck front, back, and side to side every hour for the first 12 hours after surgery.
- D. I will immediately report to the emergency room if I experience tingling of my toes, fingers, and lips after surgery.
Correct Answer: B
Rationale: One way of reducing incisional tension is to teach the client how to support the neck when coughing or being repositioned. The removal of the thyroid does not mean that the client will be taking antithyroid medications postoperatively. The client is taught that after thyroidectomy tension needs to be avoided on the suture line because hemorrhage may develop. Likewise, during the postoperative period, the client should avoid any unnecessary movement of the neck; that is why sandbags and pillows are frequently used to support the head and neck. If a client experiences tingling in the fingers, toes, and lips, it is probably a result of injury to the parathyroid gland during surgery, resulting in hypocalcemia. These signs and symptoms need to be reported immediately.
Allopurinol has been prescribed for a client to treat gouty arthritis. The nurse teaches the client to anticipate which prescription if an acute attack occurs?
- A. Doubling the dose of the allopurinol
- B. Stopping the allopurinol and taking acetylsalicylic acid (aspirin)
- C. Stopping the allopurinol and taking a nonsteroidal anti-inflammatory drug
- D. Adding colchicine or a nonsteroidal anti-inflammatory drug to the treatment plan
Correct Answer: D
Rationale: Allopurinol helps prevent an attack of gouty arthritis, but it does not relieve the pain. Therefore, another medication such as colchicine or a nonsteroidal anti-inflammatory drug must be added if an acute attack occurs. Because acute attacks may occur more frequently early during the course of therapy with allopurinol, some health care providers recommend taking the two products concurrently during the first 3 to 6 months.
The nurse is creating a teaching plan for the client with Raynaud's disease. Which instruction should the nurse include?
- A. Daily cool baths will provide an analgesic effect.
- B. A high-protein diet will minimize tissue malnutrition.
- C. Vitamin K administration will prevent tendencies toward bleeding.
- D. Keeping the hands and feet warm and dry will prevent vasoconstriction.
Correct Answer: D
Rationale: Raynaud's disease is a vasospasm of the arterioles and arteries of the upper and lower extremities. The use of measures to prevent vasoconstriction is helpful for the management of Raynaud's disease. The hands and feet should be kept dry. Gloves and warm fabrics should be worn in cold weather, and the client should avoid exposure to nicotine and caffeine. The avoidance of situations that trigger stress is also helpful. Taking daily cool baths, maintaining a high-protein diet, and administering vitamin K are not components of the treatment for this disorder.
The nurse assesses cranial nerve XII in the client who sustained a stroke. Which action should the nurse ask the client to perform?
- A. Extend the arms.
- B. Extend the tongue.
- C. Turn the head toward the nurse's arm.
- D. Focus the eyes on an object held by the nurse.
Correct Answer: B
Rationale: Cranial nerve XII (hypoglossal) controls tongue movement, so extending the tongue tests its function. Other actions test different nerves or motor functions, not relevant to cranial nerve XII.