The practical nurse (PN) is planning evening shift rounds for a group of postoperative clients who all had surgery earlier that day. Which client should the PN check first?

A preschooler who had an emergency appendectomy for appendicitis.

An adult with osteomyelitis who had a necrotic bone fragment removed in the foot.

A post-menopausal client with breast cancer who had a right breast lumpectomy.

An adolescent with type 1 diabetes (DM) who had an open cholecystectomy.

Answer and Explanation

The Correct Answer is A

A. A preschooler who had an emergency appendectomy should be checked first. Children are at higher risk for complications due to their size and the stress of emergency surgery, so close monitoring is essential.
B. An adult with osteomyelitis post-surgery is important to monitor but is generally at lower immediate risk compared to a young child following emergency surgery.
C. A post-menopausal client with breast cancer who had a lumpectomy is also a priority, but the immediate postoperative period for a child in emergency surgery takes precedence.
D. An adolescent with type 1 diabetes who had cholecystectomy requires careful monitoring, but the child’s higher risk in the immediate postoperative phase makes them the priority.

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Correct Answer is B

Explanation

A. Suggesting a less strenuous activity is not necessary as physical activity is beneficial in managing pre-diabetes.
B. Reassuring the parents that increased physical activity reduces the risk for diabetes encourages healthy habits and supports the child’s desire to participate in sports.
C. Increasing caloric intake should be balanced and appropriate for the child's needs but isn't the primary focus in this context.
D. Adjusting insulin doses is important for children with diabetes, but the focus here is on encouraging physical activity to manage pre-diabetes, not insulin adjustments.

A. Your healthcare provider has left specific instructions to ambulate on the first postoperative day. B. I know you feel angry about the pain of ambulation, but this is a necessary part of getting well. C. I will be back in 30 minutes to help you get out of bed and walk around the room today. D. You must ambulate to avoid complications which could cause more discomfort than ambulating.

Correct Answer is C

Explanation

A. Stating that the healthcare provider left specific instructions may come across as confrontational and does not address the client's emotional state. The focus should be on empathetic communication rather than emphasizing authority.
B. While acknowledging the client’s feelings is important, this response may not de-escalate the situation. It focuses on the necessity of ambulation rather than addressing the client's anger and offering support.
C. Offering to return in 30 minutes provides the client with a sense of control and acknowledges their feelings. It is a supportive and respectful approach that allows time for the client to calm down and prepares them for ambulation.
D. Explaining that ambulation is necessary to avoid complications can sound directive and may not help in managing the client's anger. It is more effective to acknowledge the client's feelings and offer to help at a later time.

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The practical nurse (PN) is planning evening shift rounds for a group of postoperative clients who all had surgery earlier that day. Which client should the PN check first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The parents of a child with pre-diabetes report to the practical nurse (PN) that the child wants to join a soccer team. Which action is best for the PN to implement?

Correct Answer is B

Explanation

When the practical nurse (PN) attempts to assist an 18-year-old client with a mild mental disability to ambulate on the first postoperative day after an appendectomy, she becomes angry and yells at the PN, "Get out of here! I'll get up when I'm ready!" Which response is best for the PN to make?

Correct Answer is C

Explanation

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