The nurse has reviewed the Vital Signs at 1000.
Which of the following statements should the nurse include when reinforcing teaching to the client following the procedure? Select all that apply.
"Use sunglasses if your eyes are sensitive to light."
"Continue eating foods with protein."
"Remain on bedrest for 3 to 5 days following discharge."
"You need to support your neck when coughing or moving
"You will no longer need to take any medications for your thyroid now that you have had surgery."
Correct Answer : A,B,D
- "Use sunglasses if your eyes are sensitive to light.": After thyroid surgery, especially if the client has Graves’ disease and associated exophthalmos, the eyes may remain sensitive to light. Wearing sunglasses helps protect the eyes from irritation and prevents further discomfort while healing progresses.
- "Continue eating foods with protein.": Maintaining adequate protein intake is important for healing after surgery. Protein supports tissue repair, immune function, and recovery, making it an essential part of the client’s postoperative nutrition plan.
- "Remain on bedrest for 3 to 5 days following discharge.": Prolonged bedrest after thyroid surgery is not recommended. Early ambulation helps prevent complications such as blood clots and promotes recovery. Clients are usually encouraged to resume light activities shortly after surgery.
- "You need to support your neck when coughing or moving.": After thyroidectomy, supporting the neck when coughing, sneezing, or repositioning helps protect the surgical site, reduces strain on the incision, and minimizes discomfort, promoting safer healing.
- "You will no longer need to take any medications for your thyroid now that you have had surgery.": This is incorrect because many clients require lifelong thyroid hormone replacement therapy after a thyroidectomy to maintain normal metabolic function, depending on how much thyroid tissue was removed.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Acute hemolytic: An acute hemolytic reaction typically presents with symptoms like fever, chills, back pain, hypotension, and hematuria. It is caused by the recipient’s immune system attacking incompatible donor red blood cells, not primarily by urticaria and wheezing.
B. Anaphylactic: An anaphylactic reaction is a severe allergic response to blood transfusion and is characterized by symptoms such as urticaria (hives), wheezing, hypotension, and respiratory distress. It requires immediate intervention, including stopping the transfusion and administering emergency medications.
C. Febrile: A febrile reaction is usually marked by fever, chills, and headache during or shortly after a transfusion. It does not typically involve wheezing or significant allergic skin reactions like urticaria.
D. Circulatory overload: Circulatory overload occurs when too much fluid is administered too quickly, leading to symptoms like dyspnea, cough, and pulmonary edema. While it involves respiratory symptoms, it is not associated with urticaria or allergic reactions.
Correct Answer is A
Explanation
A. "I will ask to have you assigned to a female nurse.": Respecting the client’s preference supports her autonomy, comfort, and dignity. Offering to accommodate her request shows sensitivity to her personal, cultural, or religious needs and helps maintain a trusting nurse-client relationship.
B. "I will get a female assistive personnel to provide your bath.": While providing a female assistive personnel for bathing might address part of the concern, it does not fully meet the client's expressed preference for all aspects of nursing care to be provided by a female nurse.
C. "You will need to speak with the nurse manager about this.": Asking the client to manage the reassignment request herself can seem dismissive. It is the nurse’s responsibility to advocate for the client and initiate steps to meet her needs whenever possible.
D. "I care for other female clients and they do not mind having a male nurse.": Comparing the client’s feelings to those of others invalidates her concerns and does not demonstrate respect for her individual preferences, which is essential in client-centered care.
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