The nurse is caring for a client in the preoperative period and documenting rationale for a palliative surgical procedure. Which rationale is most appropriate?
The physician needs additional information to plan medical treatment.
The client wishes to improve body structures and elects a procedure.
The physician is repairing a deformity from birth or disease process.
The client and physician are focusing on symptom relief, not a cure.
The Correct Answer is D
Choice A reason: Palliative surgery prioritizes symptom relief, not diagnostic data collection. Procedures like biopsies aim to gather information for medical planning, not alleviate symptoms. Palliative surgery addresses issues like pain or obstruction in terminal conditions, improving quality of life without curing, making this choice incorrect for palliative rationale.
Choice B reason: Elective procedures for improving body structures, like cosmetic surgery, are not palliative. Palliative surgery focuses on symptom relief in serious illnesses, not aesthetic enhancements. This choice is irrelevant, as palliative care aims to manage symptoms like pain or obstruction, not improve physical appearance or structure.
Choice C reason: Repairing deformities from birth or disease is linked to reconstructive surgery, not palliative care. Palliative surgery relieves symptoms like pain or obstruction without addressing the underlying cause, unlike corrective procedures, making this choice inappropriate for the rationale of a palliative surgical procedure.
Choice D reason: Palliative surgery relieves symptoms, such as pain or obstruction, in conditions where a cure is not feasible, like terminal cancer. It focuses on improving quality of life, not curing the disease, making this the most appropriate rationale for a palliative surgical procedure in the preoperative context.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Dilated and reactive pupils are unrelated to albuterol’s effect. Albuterol, a bronchodilator, relaxes bronchial smooth muscles to improve airflow in emphysema. Pupil changes may indicate neurological or systemic issues but are not a direct indicator of albuterol’s effectiveness in relieving bronchoconstriction and respiratory distress.
Choice B reason: Decreased respiratory rate indicates albuterol’s therapeutic effect in emphysema. Albuterol relaxes constricted airways, improving airflow and reducing the work of breathing. This leads to a slower, more effective respiratory rate, reflecting better oxygenation and relief of bronchospasm, making it the primary sign of therapeutic success.
Choice C reason: Urine output of 50 mL/hr is normal but unrelated to albuterol’s effect. Albuterol targets bronchial smooth muscles to relieve bronchoconstriction in emphysema, improving respiratory function. Urine output reflects renal function, not airway improvement, making it an irrelevant indicator of albuterol’s therapeutic effectiveness in this context.
Choice D reason: A heart rate of 100 beats/minute may occur as a side effect of albuterol’s beta-adrenergic stimulation but is not the primary therapeutic indicator. Albuterol aims to improve airflow and reduce respiratory distress, evidenced by a decreased respiratory rate, not tachycardia, which is a secondary effect.
Correct Answer is C
Explanation
Choice A reason: Hypoactive bowel sounds in two quadrants suggest reduced peristalsis, indicating persistent postoperative ileus rather than resolution. Normal peristalsis produces active bowel sounds across all quadrants, making this an incorrect indicator of returned gastrointestinal motility in a postoperative client.
Choice B reason: Requesting food indicates appetite but not necessarily peristalsis. Appetite can return before gastrointestinal motility, driven by neurological and hormonal factors. Passage of flatus directly confirms intestinal motility, making appetite a less accurate indicator of peristalsis restoration in this context.
Choice C reason: Passage of flatus is the most accurate indicator of returned peristalsis, as it reflects gastrointestinal motility. Gas movement through the intestines, expelled as flatus, confirms resolution of postoperative ileus, indicating normal bowel function, making this the best sign of recovery.
Choice D reason: Abdominal distention suggests gas accumulation, indicating persistent ileus rather than returned peristalsis. Gas buildup occurs when motility is impaired, causing bloating. Passage of flatus confirms gas movement and restored motility, making distention an incorrect indicator of recovery.
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