While assessing a patient who has just arrived in the post-anesthesia recovery unit (PACU) after a thyroidectomy, the nurse obtains this data. Which is the most important to communicate to the surgeon?
The patient’s voice is weak and hoarse sounding.
The patient is complaining of a 7/10 incisional pain.
The patient’s cardiac monitor shows a heart rate of 112.
The patient is increasingly swelling at the neck.
The Correct Answer is D
This is a critical finding that could indicate bleeding or compromised airway, both of which are potentially life-threatening complications following a thyroidectomy. Immediate intervention may be necessary to prevent further harm to the patient. The other options are important to note and should be addressed, but they do not require immediate intervention as the swelling in the neck does.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Cushing syndrome is a hormonal disorder caused by prolonged exposure to high levels of cortisol hormone in the body. It can cause a variety of physical manifestations, including truncal obesity, thin arms, and legs, decreased axillary and pubic hair, hypertension, glucose intolerance, osteoporosis, and purple striae (stretch marks) on the abdomen.
Out of the options given, the nurse would expect to find purplish-red streaks on the abdomen as an additional manifestation of Cushing syndrome.
Correct Answer is A
Explanation
Clients with acute gastritis are recommended to eat smaller, frequent meals instead of three large meals. This helps to reduce the workload on the digestive system and allows the stomach to heal. Therefore, option A is not a suitable nursing intervention for a client with acute gastritis.
Options b, c, and d are all appropriate nursing interventions for a client with acute gastritis. Observing stool characteristics can help to identify any bleeding or inflammation in the gastrointestinal tract, evaluating intake and output can help to identify any fluid imbalances, and monitoring laboratory reports of electrolytes can help to identify any imbalances that may occur because of vomiting or diarrhea.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today