A nurse is caring for a client who is to undergo a subtotal thyroidectomy. Which of the following items should the nurse place at the client’s bedside?

Thoracotomy set

Vacuum assisted wound device

Tracheostomy kit

Tuning fork

Answer and Explanation

The Correct Answer is C

Rationale:

A. Thoracotomy set: A thoracotomy set is used for emergency chest procedures, such as to relieve a pneumothorax or drain the pleural space. It is not relevant to a thyroidectomy, which involves the neck and airway rather than the thoracic cavity.

B. Vacuum assisted wound device: A vacuum-assisted wound device is used for chronic or large open wounds requiring negative pressure therapy. It is not indicated for fresh surgical incisions or preventive airway management following thyroid surgery.

C. Tracheostomy kit: A tracheostomy kit should be readily available at the bedside following thyroid surgery because of the risk of airway obstruction from swelling, bleeding, or damage to the recurrent laryngeal nerve. Immediate airway access may be needed in case of respiratory distress.

D. Tuning fork: A tuning fork is used in auditory and vibration assessments, such as during Rinne and Weber tests. It has no relevance to the immediate post-operative care of a client undergoing a thyroidectomy.

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Correct Answer is ["A","B","C","E"]

Explanation

Rationale:

• Orientation: The client was previously disoriented to time and place, thinking it was 1975 and they were at home. On Day 2, they are alert and fully oriented. This improvement shows enhanced neurological and cognitive status.

• Blood pressure: On Day 1, the client’s BP was 88/50 mm Hg, which indicated hypotension. By Day 2, the BP improved to 132/86 mm Hg. This indicates stabilization of cardiovascular function and better perfusion.

• Temperature: The fever rose to 39.1°C on Day 1 but decreased to 37.7°C on Day 2. This drop suggests the client is responding to treatment and the infectious process is being controlled.

• Hallucinations: On Day 1, the client reported spiders crawling on them, indicating delirium. On Day 2, they deny hallucinations. This improvement shows resolving infection or neuroinflammation.

• WBC count: The WBC count of 14,000/mm³ remains elevated above the normal range and was only assessed on Day 1. Without follow-up labs, it does not indicate improvement.

A. Beefy, red tongue B. Productive cough with thick mucous C. Facial erythema D. Koplik spots

Correct Answer is C

Explanation

Rationale:

A. Beefy, red tongue: A beefy, red tongue is typically associated with scarlet fever, not pertussis. It results from the streptococcal infection and accompanying inflammatory response, which is unrelated to the bacterial cause and symptom pattern of pertussis.

B. Productive cough with thick mucous: Pertussis, or whooping cough, usually causes a paroxysmal, dry, hacking cough followed by a characteristic "whooping" sound on inspiration. It is not commonly associated with a productive cough containing thick mucus, especially in early and peak stages.

C. Facial erythema: Facial erythema can occur during severe coughing fits in children with pertussis due to the forceful and prolonged nature of coughing episodes. The increased intrathoracic pressure during coughing may lead to flushing or redness of the face.

D. Koplik spots: Koplik spots are small, bluish-white lesions on the buccal mucosa and are an early sign of measles, not pertussis. They are not present in bacterial infections like Bordetella pertussis, which affects the respiratory tract.

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A nurse is caring for a client who is to undergo a subtotal thyroidectomy. Which of the following items should the nurse place at the client’s bedside?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is ["A","B","C","E"]

Explanation

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Correct Answer is C

Explanation

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