The nurse is aware that in both the very young and the older adult surgical patient, the risk is much higher for:

nausea and vomiting.

delayed healing

anorexia.

hydration issues.

Answer and Explanation

The Correct Answer is B

A. Nausea and vomiting. Nausea and vomiting can occur after surgery due to anesthesia and other factors. However, it is more common in patients of all ages who undergo certain types of surgery. Though these groups may be more susceptible, this is not the most specific risk.

B. Delayed healing. Both very young and older adult patients are at higher risk for delayed healing. In the very young, the immune system and cell regeneration processes are still developing, while in older adults, decreased circulation, chronic conditions, and slower cellular regeneration can impair wound healing.

C. Anorexia. Anorexia is not specific to surgical patients. While appetite loss can occur postoperatively, it is not as universally problematic in young or older surgical patients as delayed healing.

D. Hydration issues. Hydration issues can occur in all patients, especially following surgery, but they are particularly critical for the very young (due to smaller body mass and high fluid turnover) and the elderly (due to decreased kidney function and total body water). However, this is not as universally prevalent as delayed healing.

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Correct Answer is C

Explanation

A. Distract the client by giving him reading material. Distraction may not address the underlying anxiety and could delay processing the client's concerns about the surgery.

B. Suggest that he take a walk around the unit. While walking can help with anxiety in some patients, it does not directly address the client's expressed concern about the surgery itself.

C. Ask him to describe his concerns. The nurse should acknowledge the patient's feelings by encouraging them to express their concerns. This helps reduce anxiety and provides valuable information for further support.

D. Refer him to the spiritual care team. While spiritual care may be beneficial later, it’s essential to first address the patient’s immediate concerns before referring them to other services.

A. Ill and the patient has depressed reflexes. B. IV and the patient will not depend on the anesthesia machine of oxygenations. C. Il and the surgical environment should be kept quiet. D. and the patient's hearing is amplified.

Correct Answer is C

Explanation

A. Stage III and the patient has depressed reflexes. Stage III of anesthesia is the surgical stage, where the patient is under deep anesthesia, and reflexes are typically depressed. However, tensed muscles and irregular respirations may indicate that the patient is still in an earlier stage of anesthesia (stage II).

B. Stage IV and the patient will not depend on the anesthesia machine for oxygenation. Stage IV is the deepest level of anesthesia, where respiratory and cardiovascular functions are severely depressed. It does not match the description of tensed muscles and irregular respirations, which are more characteristic of an earlier stage (stage II).

C. Stage II and the surgical environment should be kept quiet. Stage II of anesthesia is the excitement stage, where patients may exhibit tensed muscles, irregular respirations, and uncoordinated movements. The surgical environment should be kept quiet to minimize stimuli that could cause agitation or further excitement in this stage.

D. Stage I and the patient's hearing is amplified. Stage I is the stage of anesthesia where the patient is still conscious and responsive to stimuli. The description of tensed muscles and irregular respirations does not match this stage. Additionally, the patient’s hearing would not be amplified in stage I, but rather in stage II or as they begin to emerge from anesthesia.

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The nurse is aware that in both the very young and the older adult surgical patient, the risk is much higher for:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is scheduled to undergo abdominal surgery and tells the nurse that he is very anxious about the operation. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

The circulating nurse notes that the anesthetized patient has tensed muscles and irregular respirations. The nurse is aware that the patient has reached stage:

Correct Answer is C

Explanation

A similarity of roles for the scrub person and the circulating nurse is that they both:

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