A nurse is planning care for a male client who is postoperative following a hernia repair. Which of the following actions should the nurse include in the plan?
Elevate the client's scrotum on a pillow.
Restrict fluids to 1,200 mL per day.
Place a warm pack on the incisional area.
Encourage the client to sit to void.
The Correct Answer is A
Rationale:
A. Elevate the client's scrotum on a pillow: After hernia repair, scrotal elevation helps reduce swelling and promote venous return, minimizing postoperative edema and discomfort. Supporting the scrotum with a pillow or rolled towel also decreases tension on the incision site, enhancing comfort and healing.
B. Restrict fluids to 1,200 mL per day: Fluid restriction is not indicated for clients following hernia repair unless there is a concurrent condition such as renal or cardiac impairment. Adequate hydration is essential to prevent constipation and promote tissue recovery after surgery.
C. Place a warm pack on the incisional area: Warm packs should be avoided immediately after surgery because they can increase local blood flow and risk of bleeding at the incision site. Cold packs may be used instead to reduce swelling and provide comfort.
D. Encourage the client to sit to void: Male clients are encouraged to stand when voiding to reduce intra-abdominal pressure on the surgical site. Sitting to void may increase pressure on the repaired area, potentially causing discomfort or strain on the incision.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale:
A. "Remove a plug from the socket by pulling the cord.": Pulling a plug out by the cord can damage the wiring and expose live electrical components, increasing the risk of electric shock or fire. The plug should always be removed by grasping the base of the plug itself to ensure safety.
B. "Check for a tingling sensation around the cord.": A tingling sensation indicates faulty wiring or electrical leakage, which poses a serious safety hazard. Rather than checking for it, individuals should immediately stop using any cord that gives off a tingling sensation and report or replace it.
C. "Use three-pronged grounded plugs.": Grounded plugs provide an essential safety feature by redirecting excess electrical current safely into the ground. This reduces the risk of electrical fires and shocks, especially in appliances with metal casings or high power consumption.
D. "Cover extension cords with a rug.": Covering cords traps heat, prevents adequate ventilation, and increases the risk of overheating and fire. Extension cords should remain uncovered and placed in areas where they will not be walked on or damaged.
Correct Answer is D
Explanation
Rationale:
A. Instruct the parent to give the infant water every 3 hr between feedings: Giving water to infants under 6 months can displace nutrient intake and increase the risk of hyponatremia. Breast milk or formula should remain the exclusive source of nutrition at this age.
B. Recommend the parent mix the milk with rice cereal for feedings: Introducing rice cereal at 3 months is not developmentally appropriate and can increase the risk of choking. Cow’s milk lacks the proper nutrient balance, and adding cereal does not correct these deficiencies.
C. Instruct the parent to give 5 mcg of vitamin D daily: While vitamin D supplementation is important for infants, the concern in this scenario is the use of cow’s milk, not vitamin D deficiency. Breastfed infants should receive supplementation, but formula-fed infants typically get adequate vitamin D through fortified formula.
D. Advise the parent to avoid giving cow's milk to the infant prior to 1 year of age: Cow’s milk should not be introduced before 12 months because it lacks iron, vitamin E, and essential fatty acids, and can cause gastrointestinal irritation and occult blood loss.
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