A nurse is caring for a client who has returned from the surgical suite following surgery for a fractured mandible. The client had intermaxillary fixation to repair and stabilize the fracture. Which of the following actions is the priority for the nurse to take?

Relieve the client's pain.

Promote oral hygiene

Ensure adequate nutrition

Prevent aspiration

Answer and Explanation

The Correct Answer is D

A. Relieve the client's pain: While pain management is important for client comfort and recovery, it is not the priority immediately following intermaxillary fixation. Pain relief can be addressed once the more urgent concerns, such as preventing aspiration, are addressed.
B. Promote oral hygiene: Promoting oral hygiene is essential for preventing complications such as infection, but it is not the priority immediately after surgery and intermaxillary fixation. The client's airway and respiratory status should be the primary focus at this time.
C. Ensure adequate nutrition: Ensuring adequate nutrition is important for the client's overall recovery, but it is not the immediate priority after surgery and intermaxillary fixation. The priority is to prevent complications such as aspiration and maintain the client's airway.
D. Prevent aspiration: This is the priority action for the nurse. Intermaxillary fixation restricts the client's ability to open their mouth, increasing the risk of aspiration if vomiting occurs. The nurse should ensure that the client's airway is clear and that measures are in place to prevent aspiration, such as positioning the client appropriately and monitoring for signs of respiratory distress.

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Correct Answer is C

Explanation

Each statement provides valuable information about the child's behavior or physical condition.

A. "Sometimes my child acts bossy with his friends.": This statement indicates a behavioral characteristic of the child that may be typical for a 6-year-old. While it's essential for the child to learn appropriate social behaviors, occasional bossiness is not unusual at this age and may reflect normal developmental stages.
B. "My child often cheats when we play board games.": While honesty is important, cheating during games is a behavior that some children may exhibit during certain developmental stages. It can provide insight into the child's understanding of rules and social interactions but may not necessarily be a cause for significant concern.
C. "The teacher says my child has to squint to see the board.": This statement raises concern about the child's vision and suggests potential visual impairment or difficulty seeing distant objects clearly. Squinting to see the board could indicate nearsightedness or other vision problems that may require further assessment and intervention by an eye care professional.
D. "My child has recently lost both front top teeth.": Losing baby teeth is a normal developmental milestone for children around the age of 6. It typically indicates the natural process of permanent teeth erupting, and it's not typically a cause for concern unless there are complications or abnormalities associated with tooth loss.

A. Hypocalcemia B. Diuretic use C. Family history D. BMI less than 25

Correct Answer is C

Explanation

A. Hypocalcemia: Hypocalcemia, or low levels of calcium in the blood, is not typically associated with an increased risk of urolithiasis. In fact, hypercalcemia, or high levels of calcium, is more commonly linked to the formation of calcium-based kidney stones.
B. Diuretic use: Diuretic medications can increase urine production and may contribute to dehydration, which can predispose individuals to the formation of kidney stones. However, diuretic use alone is not as significant a risk factor as other factors like dehydration or specific dietary habits.
C. Family history: Family history of urolithiasis is a significant risk factor for developing kidney stones. Genetic factors can influence the likelihood of stone formation, and individuals with a family history of kidney stones are at a higher risk of experiencing them themselves.
D. BMI less than 25: Obesity and higher BMI (body mass index) are associated with an increased risk of urolithiasis. Excess body weight can lead to metabolic changes that promote the formation of kidney stones. Therefore, having a BMI less than 25 is less likely to be a risk factor compared to having a higher BMI.

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A nurse is caring for a client who has returned from the surgical suite following surgery for a fractured mandible. The client had intermaxillary fixation to repair and stabilize the fracture. Which of the following actions is the priority for the nurse to take?

Nursing Test Bank

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