Nokea
The nurse is conducting a presurgical interview for a patient with laryngeal cancer. The patient states that he drinks approximately six to eight shots of vodka per day. It is imperative that the nurse inform the surgical team so the patient can be assessed for what?
- A. Increased risk for infection
- B. Delirium tremens
- C. Depression
- D. Nonadherence to postoperative care
Correct Answer: B
Rationale: Considering the known risk factors for cancer of the larynx, it is essential to assess the patients history of alcohol intake. Infection is a risk in the postoperative period, but not an appropriate answer based on the patients history. Depression and nonadherence are risks in the postoperative phase, but would not be critical short-term assessments.
You may also like to solve these questions
The nurse is providing patient teaching to a patient diagnosed with acute rhinosinusitis. For what possible complication should the nurse teach the patient to seek immediate follow-up?
- A. Periorbital edema
- B. Headache unrelieved by OTC medications
- C. Clear drainage from nose
- D. Blood-tinged mucus when blowing the nose
Correct Answer: A
Rationale: Patient teaching is an important aspect of nursing care for the patient with acute rhinosinusitis. The nurse instructs the patient about symptoms of complications that require immediate follow-up. Referral to a physician is indicated if periorbital edema and severe pain on palpation occur. Clear drainage and blood-tinged mucus do not require follow-up if the patient has acute rhinosinusitis. A persistent headache does not necessarily warrant immediate follow-up.
The nurse is performing preoperative teaching with a patient who has cancer of the larynx. After completing patient teaching, what would be most important for the nurse to do?
- A. Give the patient his or her cell phone number.
- B. Refer the patient to a social worker or psychologist.
- C. Provide the patient with audiovisual materials about the surgery.
- D. Reassure the patient and family that everything will be alright.
Correct Answer: C
Rationale: Informational materials (written and audiovisual) about the surgery are given to the patient and family for review and reinforcement. The nurse never gives personal contact information to the patient. Nothing in the scenario indicates that a referral to a social worker or psychologist is necessary. False reassurance must always be avoided.
A nurse practitioner has provided care for three different patients with chronic pharyngitis over the past several months. Which patients are at greatest risk for developing chronic pharyngitis?
- A. Patients who are habitual users of alcohol and tobacco
- B. Patients who are habitual users of caffeine and other stimulants
- C. Patients who eat a diet high in spicy foods
- D. Patients who have gastrointestinal reflux disease (GERD)
Correct Answer: A
Rationale: Chronic pharyngitis is common in adults who live and work in dusty surroundings, use the voice to excess, suffer from chronic cough, and habitually use alcohol and tobacco. Caffeine and spicy foods have not been linked to chronic pharyngitis. GERD is not a noted risk factor.
The nurse has noted the emergence of a significant amount of fresh blood at the drain site of a patient who is postoperative day 1 following total laryngectomy. How should the nurse respond to this development?
- A. Remove the patients drain and apply pressure with a sterile gauze.
- B. Assess the patient, reposition the patient supine, and apply wall suction to the drain.
- C. Rapidly assess the patient and notify the surgeon about the patients bleeding.
- D. Administer a STAT dose of vitamin K to aid coagulation.
Correct Answer: C
Rationale: The nurse promptly notifies the surgeon of any active bleeding, which can occur at a variety of sites, including the surgical site, drains, and trachea. The drain should not be removed or connected to suction. Supine positioning would exacerbate the bleeding. Vitamin K would not be administered without an order.
The nurse is caring for a patient who needs education on his medication therapy for allergic rhinitis. The patient is to take cromolyn (Nasalcrom) daily. In providing education for this patient, how should the nurse describe the action of the medication?
- A. It inhibits the release of histamine and other chemicals.
- B. It inhibits the action of proton pumps.
- C. It inhibits the action of the sodium-potassium pump in the nasal epithelium.
- D. It causes bronchodilation and relaxes smooth muscle in the bronchi.
Correct Answer: A
Rationale: Cromolyn (Nasalcrom) inhibits the release of histamine and other chemicals. It is prescribed to treat allergic rhinitis. Beta-adrenergic agents lead to bronchodilation and stimulate beta-3-adrenergic receptors in the smooth muscle of the bronchi and bronchioles. It does not affect proton pump action or the sodium-potassium pump in the nasal cells.