A nurse is providing discharge teaching to a client who is 1 day postoperative following a right modified radical mastectomy. Which of the following instructions should the nurse include in the teaching?

Begin ball squeezing exercises.

Avoid using the affected arm for eating.

Use deodorant under the affected arm.

Wear a bra with wire support.

Answer and Explanation

The Correct Answer is A

A. This is the correct answer. Gentle hand exercises, such as ball squeezing, help promote circulation and prevent lymphedema in the affected arm.

B. Avoiding use of the affected arm for eating is incorrect. Gradual movement is encouraged to prevent stiffness and maintain mobility.

C. Using deodorant under the affected arm is not recommended until healing is complete, as it may cause irritation or infection.

D. A bra with wire support should be avoided initially due to discomfort and potential interference with healing.

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Correct Answer is D

Explanation

A. Watery stool is not a typical sign of paralytic ileus; instead, bowel sounds are absent or hypoactive.

B. Oliguria (low urine output) is not directly related to paralytic ileus.

C. Dizziness is not a primary symptom of paralytic ileus.

D. This is the correct answer. Abdominal distention occurs due to the accumulation of gas and fluid in the intestines, which are unable to move due to ileus.

A. Infuse the transfusion over 5 hr. B. Hang the transfusion with dextrose 5% in 0.9% sodium chloride. C. Use a 20-gauge IV catheter to transfuse the blood. D. Monitor vital signs every hour throughout the transfusion.

Correct Answer is A

Explanation

A. This is the correct answer. Older adults are at risk for fluid overload, so infusing blood over 4-5 hours (instead of the usual 2-4 hours) is safer.

B. Blood products must be infused with 0.9% sodium chloride (normal saline) only. Dextrose-containing solutions cause hemolysis.

C. A 20-gauge catheter is acceptable, but a larger bore (18-gauge) is preferred for faster infusion.

D. Vital signs should be monitored before the transfusion, 15 minutes after starting, then every 30-60 minutes, and at completion.

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A nurse is providing discharge teaching to a client who is 1 day postoperative following a right modified radical mastectomy. Which of the following instructions should the nurse include in the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is A

Explanation

A nurse is providing discharge teaching to a client who is 1 day postoperative following a right modified radical mastectomy. Which of the following instructions should the nurse include in the teaching?

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