A nurse is caring for a client who reports experiencing alteration in sense of smell following surgery for a total laryngectomy. The nurse should address the client's concern through which of the following response?

"Your body will slowly develop an ability to smell through your stoma."

"Breathing through a stoma has altered your sense of smell."

"Your sense of smell will gradually return after several months."

"As your appetite returns, your sense of smell will also return."

Answer and Explanation

The Correct Answer is B

A. "Your body will slowly develop an ability to smell through your stoma." The olfactory system relies on air passing through the nasal passages to detect scents. After a total laryngectomy, the airway is rerouted through a stoma, bypassing the nose entirely. The body does not develop an alternative way to smell through the stoma, making this statement inaccurate.
B. "Breathing through a stoma has altered your sense of smell." A total laryngectomy permanently separates the respiratory and digestive tracts, preventing air from passing through the nose, which is necessary for olfaction. As a result, clients often experience anosmia (loss of smell). This response accurately explains the reason behind the alteration in the client’s sense of smell.
C. "Your sense of smell will gradually return after several months." Unlike temporary post-surgical changes, the loss of smell after a total laryngectomy is typically permanent unless the client learns to use techniques such as the "polite yawning" method (nasal airflow-inducing maneuver) to regain some olfactory function. It does not naturally return over time.
D. "As your appetite returns, your sense of smell will also return." Appetite and sense of smell are closely linked, but appetite improvement does not restore olfaction after a laryngectomy. Since air no longer flows through the nasal passages, the ability to detect smells is significantly impaired or lost.

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Correct Answer is B

Explanation

A. Cultural differences. While cultural beliefs may influence end-of-life decisions, the primary issue in this scenario is not cultural misunderstanding but rather the conflict between the client’s documented wishes and the family's demands. Cultural differences typically pertain to variations in values, traditions, or beliefs, rather than legal and ethical dilemmas regarding patient autonomy.
B. Ethical conflict. The nurse is experiencing moral distress due to a conflict between ethical principles—specifically, the principle of patient autonomy (respecting the client’s right to make their own healthcare decisions) and beneficence (providing care that benefits the client). The client’s living will, a legally binding document, states Do Not Resuscitate (DNR), yet the children are insisting on full resuscitation. The nurse’s distress arises from witnessing actions that contradict the client’s wishes and ethical nursing responsibilities.
C. Competition between groups. There is no indication that different groups, such as healthcare teams or family members, are competing for resources or control. The conflict stems from an ethical dilemma rather than rivalry or organizational disputes.
D. Scarcity, safety, and security. This situation does not involve limited resources, threats to safety, or security concerns. The distress is rooted in the ethical dilemma of honoring the client’s advance directive versus the family’s insistence on aggressive resuscitation measures.

A. Initiate a weight-based continuous heparin infusion. B. Prepare client for a chest tube insertion. C. Administer an analgesic. D. Insert an indwelling urinary catheter. E. Initiate supplemental oxygen.

Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"B"},"E":{"answers":"A"}}

Explanation

Initiate a weight-based continuous heparin infusion: Continuous heparin infusion is typically used for managing or preventing thromboembolic events, such as deep vein thrombosis or pulmonary embolism. In this scenario, the primary concern is a pneumothorax, and there is no indication that the client requires anticoagulation therapy at this time.

Prepare client for a chest tube insertion: Given the diagnosis of a right upper lobe pneumothorax, preparing the client for chest tube insertion is essential. A chest tube is necessary to evacuate air from the pleural space, restore negative pressure, and allow for lung re-expansion, which is critical in managing a pneumothorax.

Administer an analgesic: Administering an analgesic is essential to help manage the client's pain, which is likely due to the pneumothorax. Effective pain management can help reduce anxiety and improve the client's ability to breathe comfortably.

Insert an indwelling urinary catheter: Inserting an indwelling urinary catheter is not essential in this situation. The client has voided a sufficient amount of clear yellow urine, and there is no indication of urinary retention or other complications that would require catheterization.

Initiate supplemental oxygen: Initiating supplemental oxygen is essential for the client, who is exhibiting hypoxia with a pulse oximetry reading of 85% on room air. Providing supplemental oxygen will help improve oxygenation and alleviate respiratory distress.

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A nurse is caring for a client who reports experiencing alteration in sense of smell following surgery for a total laryngectomy. The nurse should address the client's concern through which of the following response?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

A nurse is caring for a client. Exhibits For each potential nursing action, click to specify if the action is essential, nonessential, or contraindicated for the client.

Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"B"},"E":{"answers":"A"}}

Explanation

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