A nurse is caring for a client who is 9 days postoperative following a total laryngectomy. The nurse removes the client's NG tube and initiates oral feedings. Which of the following statements should the nurse make?

"Tuck your chin when you swallow so you won't choke."

"You should have no trouble swallowing fluids."

"I will add a thickener to your liquids to prevent aspiration."

"It is no longer possible for you to choke on or aspirate food."

Answer and Explanation

The Correct Answer is C

A. Tucking the chin when swallowing can help reduce the risk of aspiration in clients with certain conditions, but after a total laryngectomy, clients are at increased risk for aspiration due to altered anatomy and should have thickened liquids to minimize this risk.

B. Clients who have undergone a total laryngectomy may have difficulties with swallowing and are at risk of aspiration. It is not accurate to say they will have no trouble swallowing fluids without proper assessment and adaptation.

C. Adding a thickener to liquids is a recommended intervention to reduce the risk of aspiration in clients who have had a laryngectomy, as thickened fluids are less likely to be aspirated into the lungs compared to thin liquids.

D. Clients who have had a total laryngectomy are still at risk for choking or aspiration due to changes in their swallowing mechanics and altered anatomy. It is important to take preventive measures, such as thickening liquids.

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Correct Answer is B

Explanation

A. A decrease in urinary output can be a sign of decreased blood volume but is less immediate than changes in heart rate.
B. An increase in the heart rate is a common compensatory response to hypovolemia as the body attempts to maintain adequate perfusion to vital organs.
C. A decrease in the respiratory rate is not typically associated with hypovolemic shock; rather, respiratory rate may increase due to compensatory mechanisms.
D. An increase in temperature is not a specific indicator of hypovolemic shock; it could be related to infection or inflammation rather than immediate hypovolemia.

A. Have staff and visitors wear gowns, masks, and gloves while in the client's room. B. Modify the protocol for donning and removing personal protective equipment before entering or leaving the client's room. C. Assign the client to a room with other clients who require droplet precautions. D. Place the client in a private room with a special ventilation system.

Correct Answer is D

Explanation

A. Gowns and gloves are not required for TB precautions; a mask is necessary to protect against airborne transmission.
B. Standard protocols for personal protective equipment (PPE) should be followed, but they do not specifically address the need for specialized precautions in TB care.
C. Clients with TB should not be placed in a room with others, even those requiring droplet precautions, due to the risk of airborne transmission.
D. A private room with a special ventilation system, such as negative pressure, is essential for isolating clients with active TB to prevent airborne transmission.

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A nurse is caring for a client who is 9 days postoperative following a total laryngectomy. The nurse removes the client's NG tube and initiates oral feedings. Which of the following statements should the nurse make?

Nursing Test Bank

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