Nokea
Which of the following discharge instructions would be appropriate for a client who has had a laparoscopic cholecystectomy?
- A. Avoid showering for 48 hours after surgery.
- B. Return to work within 1 week.
- C. Leave dressings in place until you see the surgeon at the postoperative visit.
- D. Use acetaminophen (Tylenol) to control any fever.
Correct Answer: B
Rationale: Returning to work within 1 week (B) is reasonable for laparoscopic cholecystectomy, depending on recovery. Showering is typically allowed after 24-48 hours (A is incorrect). Dressings can often be removed sooner (C), and acetaminophen is for pain, not fever control (D).
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The nurse is assessing a client with a casted arm for signs of infection. Which finding is most concerning?
- A. Mild itching under the cast.
- B. Foul odor from the cast.
- C. Warmth at the cast edges.
- D. Slight swelling of fingers.
Correct Answer: B
Rationale: A foul odor from the cast suggests infection, requiring immediate evaluation.
The nurse should include which of the following instructions in the teaching plan for a client with chronic sinusitis?
- A. Avoid the use of caffeinated beverages.
- B. Perform postural drainage every day.
- C. Take hot showers twice daily.
- D. Report a temperature of 102°F (38.9°C) or higher.
Correct Answer: C,D
Rationale: Hot showers help moisten nasal passages and promote sinus drainage, relieving symptoms of chronic sinusitis. Reporting a high fever is critical as it may indicate a worsening infection requiring medical attention. Caffeine restriction is not typically necessary. Postural drainage is more relevant for lung conditions like bronchiectasis.
A client with a fractured right femur has not had any immunizations since childhood. Which of the following biological products should the nurse administer to provide the client with passive immunity for tetanus?
- A. Tetanus toxoid.
- B. Tetanus antigen.
- C. Tetanus vaccine.
- D. Tetanus antitoxin.
Correct Answer: D
Rationale: Tetanus antitoxin provides passive immunity, neutralizing existing toxin in unvaccinated clients.
A confused client with carbon monoxide poisoning experiences dizziness when ambulating to the bathroom. The nurse should:
- A. Put all four side rails up on the bed.
- B. Ask the unlicensed personnel to place restraints on the client's upper extremities.
- C. Request that the client's roommate put the call light on when the client is attempting to get out of bed.
- D. Check on the client at regular intervals to ascertain the need to use the bathroom.
Correct Answer: D
Rationale: Regular checks ensure safety and assist with bathroom needs, addressing dizziness and confusion. Side rails and restraints risk injury or agitation. Relying on a roommate is unreliable.
A 10-year-old client is diagnosed with infectious mononucleosis. Her white blood cell (WBC) count is 19,000/µL. She has a streptococcal throat infection and her spleen is enlarged. She has aching muscles. Which of the following instructions should the nurse include in discharge planning with the client and the essential caregiver? Select all that apply.
- A. Stay on bed rest until the temperature is normal.
- B. Gargle with warm saline while the throat is irritated.
- C. Increase intake of fluids until the infection subsides.
- D. Take aspirin as long as the fever and myalgia persist.
- E. Avoid contact sports while the spleen is enlarged.
Correct Answer: B,C,E
Rationale: Infectious mononucleosis with an enlarged spleen requires avoiding contact sports to prevent splenic rupture, a serious complication. Gargling with warm saline soothes the throat, and increased fluids support recovery and prevent dehydration. Bed rest is not strictly necessary unless fever persists, and aspirin should be avoided in children due to the risk of Reye's syndrome.