A nurse is caring for a patient who is 9 days postoperative following a total laryngectomy. The nurse removes the patient’s NG tube and initiates oral feedings.
Which of the following statements should the nurse make?
“You should have no trouble swallowing fluids.”.
“It is no longer possible for you to choke on or aspirate food.”.
“I will add a thickener to your liquids to prevent aspiration.”.
“Tuck your chin when you swallow so you won’t choke.”.
The Correct Answer is D
Choice A rationale
After a total laryngectomy, patients may have difficulty swallowing fluids due to changes in the anatomy of the throat.
Choice B rationale
It is not accurate to say that it is no longer possible for the patient to choke on or aspirate food after a total laryngectomy. While the risk of aspiration is reduced because the airway and digestive tract are separated, the patient can still experience choking on food if it is not properly swallowed.
Choice C rationale
Adding a thickener to liquids can help prevent aspiration, but this is typically more relevant for patients with dysphagia or other swallowing disorders, not specifically for patients post- laryngectomy.
Choice D rationale
Tucking the chin when swallowing, also known as the chin-tuck maneuver, can help prevent aspiration by narrowing the entrance to the airway. This can be a useful technique for patients after a laryngectomy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Phenytoin is an antiepileptic medication used to control seizures. It’s important for the patient to understand that they should not switch brands of this medication without consulting their healthcare provider. Different brands of phenytoin can have different effects, and switching could potentially lead to changes in seizure control.
Choice B rationale
Regular dental appointments are important for patients taking phenytoin. This medication can cause gum overgrowth (gingival hyperplasia), so good oral hygiene and regular dental check- ups are essential.
Choice C rationale
It’s crucial for patients to notify their doctor before taking any other medications. Phenytoin can interact with many other drugs, altering their effectiveness or increasing side effects.
Therefore, the patient’s statement indicates an understanding of the need for caution when considering additional medications.
Choice D rationale
Phenytoin is a long-term medication for controlling seizures. It’s not something that patients can stop taking once they feel better. Abruptly stopping the medication can lead to withdrawal
seizures. Therefore, the patient’s statement, “I’ll be glad when I can stop taking this medicine,” indicates a need for further teaching about the importance of continuing the medication as prescribed.
Correct Answer is A
Explanation
Choice A rationale
Celecoxib, like other NSAIDs, can increase the risk of serious gastrointestinal (GI) adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Black, tarry stools can be a sign of GI bleeding.
Choice B rationale
Dry mouth is not typically associated with celecoxib use.
Choice C rationale
Polyuria, or excessive urination, is not typically associated with celecoxib use.
Choice D rationale
Bone pain is not typically a side effect of celecoxib. Celecoxib is used to relieve pain from various conditions, including osteoarthritis.
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