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A nurse cares for a client who had a partial laryngectomy 10 days ago. The client states that all food tastes bland. How should the nurse respond?
- A. Check if the client is swallowing properly.
- B. This is normal after surgery. What types of food do you like to eat?
- C. I will ask the dietitian to change the consistency of the food in your diet.
- D. Notify the provider about potential nerve damage.
Correct Answer: B
Rationale: A partial laryngectomy can affect taste due to changes in the oral and pharyngeal anatomy. Acknowledging this as normal and exploring food preferences helps address the client's concern while promoting nutritional intake.
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A registered nurse (RN) cares for clients on a surgical unit. Which clients should the RN delegate to a licensed practical nurse (LPN)? (Select all that apply.)
- A. A 32-year-old who had a radical neck dissection 6 hours ago.
- B. A 65-year-old who had a biopsy 2 days ago.
- C. A 55-year-old who needs discharge teaching after a laryngectomy.
- D. A 67-year-old who is awaiting preoperative teaching for laryngeal cancer.
- E. An 80-year-old with esophageal cancer who is awaiting gastric tube placement.
Correct Answer: B,E
Rationale: The RN can delegate stable clients, such as the client 2 days post-biopsy and the client awaiting gastric tube placement, to the LPN. Clients who are 6 hours post-surgery or require teaching cannot be delegated.
A nurse cares for a client after radiation therapy for lung cancer. The client reports a sore throat. Which action should the nurse take first?
- A. Ask the client to gargle with mouthwash containing lidocaine.
- B. Administer prescribed intravenous pain medications.
- C. Explain that soreness is normal and will improve in a couple days.
- D. Assess the client's neck for redness and swelling.
Correct Answer: A
Rationale: Mouthwashes and throat sprays containing a local anesthetic like lidocaine can provide relief from a sore throat after radiation therapy. Intravenous pain medications may be used if local anesthetics are unsuccessful. Explaining that soreness is normal or assessing the neck does not directly address the client's discomfort.
After teaching a client who is prescribed voice rest therapy for vocal cord polyps, a nurse assesses the client's understanding. Which statement indicates the client needs further teaching?
- A. I will stay away from smokers to minimize inhalation of secondhand smoke.
- B. I will whisper quietly to communicate during voice rest.
- C. I will drink at least three quarts of water each day to stay hydrated.
- D. I will use stool softeners to prevent straining.
Correct Answer: B
Rationale: The client with vocal cord polyps must avoid all vocalization, including whispering, to rest the voice fully. Staying hydrated, avoiding secondhand smoke, and using stool softeners are appropriate actions.
A nurse is caring for a client who has sleep apnea and is prescribed modafinil (Provigil). The client asks, 'How will this medication help me?' How should the nurse respond?
- A. This medication will treat your sleep apnea.
- B. This sedative will help you to sleep at night.
- C. This medication will treat your daytime restlessness.
- D. This analgesic will increase comfort while you sleep.
Correct Answer: C
Rationale: Modafinil is used to promote wakefulness in clients with narcolepsy or daytime sleepiness related to sleep apnea, addressing excessive daytime restlessness.
The client with vocal cord polypusis may aspirate. The nurse should teach the client to tuck in his or her chin during swallowing to prevent aspiration.
- A. Tilt the head back as far as possible when swallowing.
- B. Tuck the chin down when swallowing.
- C. Breathe slowly and deeply while swallowing.
- D. Keep the head very still and straight while swallowing.
Correct Answer: B
Rationale: Tucking the chin down during swallowing helps prevent aspiration by closing off the airway. Tilting the head back would increase the chance of aspiration. Breathing slowly or keeping the head still does not specifically reduce aspiration risk.