A postoperative client following a thyroidectomy suddenly develops difficulty breathing, stridor, and an increase in swelling of the anterior neck area. What should the nurse do first?

Activate the hospital’s emergency or rapid response system.

Place a heart monitor on the client and observe for dysrhythmias.

Ask the charge nurse to come see the client immediately.

Check the client’s blood pressure and heart rate.

Provide a calm and assuring environment for the client.

Place the emergency cart at the bedside.

Answer and Explanation

The Correct Answer is A

Choice A reason: The first priority in this situation is to ensure the client’s airway is secure. Difficulty breathing and stridor indicate a potential airway obstruction, which can be life-threatening. Activating the hospital’s emergency or rapid response system ensures that the client receives immediate medical attention from a team equipped to handle such emergencies. This step is crucial to prevent respiratory arrest and other complications.

Choice B reason: While placing a heart monitor on the client and observing for dysrhythmias is important, it is not the immediate priority in this scenario. The client’s airway and breathing take precedence over monitoring heart rhythms. Once the airway is secured and breathing is stabilized, then monitoring for dysrhythmias can be considered.

Choice C reason: Asking the charge nurse to come see the client immediately is a reasonable action, but it is not the most effective first step. The charge nurse may not have the necessary equipment or expertise to handle an acute airway obstruction. Activating the emergency or rapid response system ensures that a specialized team responds quickly.

Choice D reason: Checking the client’s blood pressure and heart rate is important for overall assessment, but it is not the immediate priority when there is a potential airway obstruction. Ensuring the client can breathe is the most critical action. Vital signs can be checked once the airway is secured.

Choice E reason: Providing a calm and assuring environment for the client is beneficial for reducing anxiety, but it does not address the immediate threat to the client’s airway. While maintaining a calm environment is important, the nurse must first ensure the client’s airway is open and breathing is adequate.

Choice F reason: Placing the emergency cart at the bedside is a preparatory step that can be useful, but it is not the first action to take. The nurse should first activate the emergency or rapid response system to get immediate help. The emergency cart can be brought to the bedside by the responding team.

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Correct Answer is A

Explanation

Choice A Reason:

Occasional palpitations are a common symptom of supraventricular tachycardia (SVT) with a non-sustained ventricular response. Palpitations are sensations of a rapid, fluttering, or pounding heartbeat, which occur due to the irregular and fast heart rate characteristic of SVT. These palpitations can be intermittent and may vary in intensity, often causing discomfort and anxiety in patients.

Choice B Reason:

Weakness can be associated with SVT, but it is not as specific or common as palpitations. Weakness may occur due to the reduced cardiac output and decreased perfusion to the muscles during episodes of rapid heart rate. However, it is not the primary symptom that nurses would anticipate in patients with SVT.

Choice C Reason:

Shortness of breath is another symptom that can occur with SVT, especially during prolonged episodes. The rapid heart rate can lead to decreased efficiency in blood circulation, causing the patient to feel breathless. While shortness of breath is a significant symptom, palpitations are more directly associated with the diagnosis of SVT.

A. 1 cup of milk B. 1/2 cup of regular ice cream C. 1 slice of bread D. 1 cup of sugar-free yogurt

Correct Answer is A

Explanation

The correct answer is a) 1 cup of milk.

Choice A reason: One cup of milk contains approximately 15 grams of carbohydrates. Milk is a good source of carbohydrates, protein, and calcium, making it a suitable option for maintaining blood glucose levels during exercise. It is important for individuals with diabetes to monitor their carbohydrate intake to manage their blood sugar levels effectively.

Choice B reason: Half a cup of regular ice cream contains around 15 grams of carbohydrates. However, ice cream also contains high levels of sugar and fat, which may not be the healthiest option for regular consumption, especially for individuals with diabetes. While it can be included occasionally, it is better to choose healthier carbohydrate sources.

Choice C reason: One slice of bread typically contains about 15 grams of carbohydrates. Bread, especially whole grain or whole wheat varieties, can be a good source of carbohydrates for individuals with diabetes. It provides fiber, which helps in maintaining stable blood sugar levels.

Choice D reason: One cup of sugar-free yogurt does not contain 15 grams of carbohydrates. Sugar-free yogurt usually has fewer carbohydrates compared to regular yogurt. It is important to read the nutritional labels to determine the exact carbohydrate content. Regular yogurt, on the other hand, can be a good source of carbohydrates.

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A postoperative client following a thyroidectomy suddenly develops difficulty breathing, stridor, and an increase in swelling of the anterior neck area. What should the nurse do first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which symptom will the nurse anticipate in a patient diagnosed with supraventricular tachycardia (SVT) with a non-sustained ventricular response?

Correct Answer is A

Explanation

A nurse is providing teaching to a client who has diabetes mellitus about carbohydrate intake needs when exercising. Which of the following foods should the nurse include as containing a 15 g serving of carbohydrates?

Correct Answer is A

Explanation

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