Nursing and Mrs. Newman

Mrs. Newman has been experiencing brusqueness and a change in her vowelise, provided she did non seek medical help until she began to have trouble swallowing. by and by being seen by her healthc be hand overr, she is send off for outpatient mathematical operation for a direct laryngoscope to obtain a culture and claim a biopsy. Mrs. Newman arrives at the outpatient give outing(a) department at 630 am and is escorted to her room. The admitting hold up begins her assessment 1. Which question is most(prenominal) of import for the suckle to necessitate Mrs. Newman? A) curb you had anything to swallow or drink since midnight?B) Are you taking any medications? C) Have you smoked any cigargonttes in the plump 24 hours? D) When was the last clock you drank any alcohol? The accession go for completes the admission assessment and starts an IV. Mrs. Newman is taken to the direct room for the biopsy. Sifter the procedure, Mrs. Newman is admitted into the PACU. 2. Which interjection give the PACU hold up institute first? A) Check the health rush providers prescriptions B) Monitors Mrs. Newmans round OX C) Contain Mrs. Newmans vital signs D) Assess Mrs. Newmans gag physiological re bring through with(predicate) After 2 sidereal days Mrs.Newman calls the oncologist and reluctantly agrees to a total laryngectomy. Mrs. Newman comes to the oncology office to meet with the oncology apply extraizations to dissertate the preoperative and po cylinder blockerative care. Mrs. Newman tells them that she is very scared slightly having this surgery. She says that she has no questions most the medical aspects of the procedure, provided states she is refer about how her life lead change. She tells the fellate she realizes she inquire to have the surgery but is ambivalent and doesnt pick out is she will be fitted to go through with it after all. . Which nur palaver hinderance is most helpful to vitiate Newman? A) Refer def overthrow Newman to a psychologist to discuss her fears about having this surgery B) Give Mrs. Newman writings provided by the Ameri wad cancer society C) shoot Mrs. Newman if she would like to talk to some one who has had this surgery D) classify Mrs. Newman iota is OK to be scared and strike her hands Mrs. Newman is concerned about tattleing in the country and western club and asks the ONS how long do you think it will be before I can sing with my band once more 4. How should the ONS react?A) Request that the oncologist visit with Mrs. Newman and explain the procedure to her again B) develop that her vocal cords will be polish offd, and that she will not be able to sing C) Reassure her that she will be able to sing with the band, but her voice may be diametric D) Ask Mrs. Newman if she understands what a total laryngectomy is The ONS has given ad-lib and written information to Mrs Newman answered any questions and is completing the physiologic assessment 5. Which question is important fo r the confine to ask Mrs. Newman?A) When did you first notice any hoarseness in your voice? B) How long did you say have you been notification w/the band? C) How much alcohol do u drink a week? D) What foods are difficult for you to wallow? Mrs. Newman reports that she drinks occasionally, mainly on the weekends with friends. The cling to is more concerned that Ms Newman smokes one get of cigarettes a day. She discusses this issue with spoil Newman, who says Dont worry about my smoking. I will never smoke another cigarette again 6. How should the protect respond to help Mrs.Newman in her attempt to stop smoking? A) I know it will be hard and I am very rarefied of u B) You will kit be able to smoke after urn surgery C) anyone else in urn dwelling ho mathematical function smoke D) What steps is u going to take to stop smoking? Mrs. Newman discusses the surgery with her family and a char from a laryngectomy assume group. Mrs. Newman decides to go ahead and he a total larygec tomy. 7. A referral to which member of the indiciplinary aggroup will be most important for mars Newman prior(prenominal) to surgery A) Case mangerB) Social doer C) Physical therapist D) Speech therapist The vocabulary therapist discusses with mars Newman alternative tech inquest for restoring her dustup after surgery. Selection of the best techniques varies from individual to person depending on their age and personal preferences. Esophageal oral communication is popular among laryngectomies because it costs less and can provide a more normal unplumbeding voice than some of the other options. 8. Which statement describes esophageal oral communication?A) Generator held to the neck creates vibrations those form destination communication when the leaf node speaks B) Swallowed give vent used to create around and words in a controlled belch C) Vibration and sound are used to form words by occluding a valve over the stoma D) A hold device delivers tone via a plastic piping that is inserted into the mouth After discussing her options with a speech therapist mars Newman demonstrates her ability to use esophageal speech she comments I used to hear my son and his friends coerce like this. Wont he be surprised? Two days later, mars Newman is admitted to the infirmary accompanied by her husband and her two big(a) children.She is in the preoperative holding area. 9. Which interventions will the keep back follow up? A) ask mars Newman if she has any concerns about the upcoming surgery B) rede the surgeon that mars Newman has been admitted to the hospital C) Reassure mars Newman that her family can preventative with her until surgery D) Retrained if mars Newman has any problems hearing or writing Mrs. Newman shares with the restrain that she is scared that no one will help her if she needs help and that she will not be able to talk anymore. 10. Which intervention should the bind apply? A) Assure Mrs.Newman that somebody will be with her at all times B) can a bell that she can ring as another means of communication C) Show her how to work the nurses call light and have her perform a return demonstration D) severalise her that seasons her fears are reassert she should not try to worry. Following a septette hour surgery mars Newman was first dictated in the PACU, before being transferred to the intensive care unit. 11. Which nursing intervention should the ICU nurse implement? A) Discourage expectorateing for the first 24 hrs B) Notify the health care provider during roundsC) Determine when mars Newman trustworthy her last antibiotic D) Assist mars Newman to rinse w/warm spicy water The nurse is completing the shift assessment and notes that Mrs. Newman has white and unforgiving brown patchy areas on her tongue and oral mucosa. 12. Which natural process should the nurse implement? A) Document this finding and take no challenge B) Notify the health care provider during rounds C) Determine when Mrs. Newman lift upd her last antibiotic D) Assist Mrs. Newman to gargle with warm water, salty water Because of the cancer mars Newman is at pretend for potential complications, such as neck would fistulous withers and carotid arty blowout 13.When anticipating these possible complications, the nurse should place which equipment at miss newness bedside? A) Several packages of unfruitful 44 gauze B) Two non unimaginative hemostats C) A syringe filled w/ atomic number 20 glaciate D) The intensive care unit dart cart While assessing mars Newman, the nurse notices that Mrs. Newmans business line pressure is 92/60 and her pulse is 112. Mrs. Newman reports feeling very tired. 14 What satisfy should the nurse implement first? A) Check mars Newmans pervious vital signs B) Suction mars Newman tracheotomy C) Administer oxygen via nasal cannula D) Slip a gloved hand under the clients neckThe nurse also calls the nurses station and requests a blood profile stat 15 which laboratory result consistent w/blood l oss through hemorrhaging A) A haematocrit 40 % B) Erythrocyte sedimentation rate 8 mm/hr C) Red blood cell count 5. 2 million/mm3 D) Hemoglobin 11. 3g/dl. Mrs. Newmans gag reflex has returned and she is preparing to eat her first meal. 16 which action should the nurse implement A) Place cold packs around the clients neck prior to alimentation B) Remind her to place the food on the front of the tongue and flex her head half-witted to swallow C) Ensure the client has a human body of thin liquids to drink D) Provide Mrs.Newman with soft foods when eating for the first time after surgery 17. What action should the nurse take regarding Mrs. Newmans concern? A) Explain to the client that this is normal following this type of surgery B) He the client smell a variant of aromas to ensure that the client cannot smell C) Reassure he client that these senses will return after post-operative dropsy subsides D) Notify the health care provider about these findings when making rounds Mrs.Newm an has a tracheotomy that has an informal canola. The nurse is performing routine tracheotomy care 18 Which action should the nurse implement first? A) wash the lip of the outer cannula with normal saline B) Pour heat content peroxide and normal saline into separate containers C) mitigate the inner cannula using a small call brush D) Remove the tracheotomy dressing with neat disposable gloves What should the nurse do before inserting the inner canola? A) Tap or shake inner cannula to bear off excess moistureB) Dry the outside of the inner cannula with non uninspired gauze C) Remove the outer cannula, reinsert the inner cannula, hence place back into stoma D) Clean it w/hydrogen peroxide An unlicensed assistive force play UAP is assisting the surgical floor nurse w/ dayspring care for mars Newman 20. Which task should the nurse deputise to the UAP? A) Empty the Foley and record the output B) Clean Mrs. Newmans bathroom C) Change the intravenous bag on the pump D) Perform th e routine tracheotomy careThe safekeeping nurse notices that the immemorial nurse caring for mars Newman is cutting 44 gauze to use as a tracheotomy dressing 21. What action should the charge nurse implant? A) Praise the primary nurse for using a cost sparing technique B) Instruct the primary nurse not to cut gauze for the tracheotomy dressing C) sire no action since Mrs. Newman is the primary nurses responsibility D) Determine why commercially nimble dressings arent being used The night nurse is preparing to administer the 1200 midnight dose of gentamicin, an intravenous amino glycoside antibiotic that was started when Mrs.Newman was in the PACU. The nurse notices the empty IV antibiotic bag that was administered during the day shift is designate ampicilllin. The nurse checks the medication administration record and realizes client does not have a prescription for ampicillin. 22. Which action should the night nurse implement? A) Notify the apothecary about the medication er ror B) Complete a medication error report c) Call the day nurse to determine what occurred D) Asses Mrs. Newmans white blood cell count WBC The next time the nurse enters Mrs. Newman room Mrs.Newman writes on the communication inboard is there something harm? I heard someone in the hall say something about me receiving the wrong medication? 23. How should the nurse respond? A) Please have on thint worry about anything. I am sorry you overheard that conversation B) No Mrs. Newman you did not receive the wrong medication C) C) You are concerned that you talent have received the wrong medication D) you were mantic to receive gentamcin but you received ampicillin 24. Which intervention should the nurse provide to Mrs. Newman?A) Insert a sucking tube into the stoma while applying suction, the remove while twisting the tube B) recognize a buddy-buddy breath, occlude the tracheotomy with urn finger cough and remove your finger C) Insert a small aggregate of sterile normal saline in to the stoma and cough in a normal manner D) Take a deep broth in through the nose, cough and expel the secretions through the tracheostomy The nurse is discussing activities of daily living with Mrs. Newman. Which instruction should the nurse overwhelm? A) Caution Mrs. Newman to take only tub baths B) get ahead Mrs.Newman to use aerosol deodorants C) Advise Mrs. Newman not to wear any types of perfumes D) Explain the need to wear a plastic bib when showing 26. Which intervention has highest precession to discharge? A) encourage the client to wear benignant coverings over stoma B) Ensure that Mrs. Newman carries a special identification card C) Stress the importance of returning(a) to as normal a lifestyle as possible D) Discuss the importance of attending support group meetings Mrs. Newman is being discharged root today after five days in the hospital.Mr. Newman moolah the nurse in the hallway and says that he is rightfully scared about taking his married woman home 27 wha t is the best response by the nurse? A) Have you discussed your fears w/ur wife B) It sounds like you cant take care of her C) I know this must be very scary but u and ur wife are strong D) permits sit down and discuss what u are worried about Mr. Newman hesitantly shares with the nurse that he is afraid to touch his wife How should the nurse respond? A) Would u like to talk to your wifes doctor, I can call him for u?B) You can touch ur wife all u want, u will not hurt her C) You are worried about pinch ur wife but she needs ur support right now D) Tell me more about what you mean by touching ur wife A home healthcare nurse has been assigned to care for Mrs. Newman and is making the initial visit. After completing the admission assessment the home healthcare nurse develops a nursing care plan for Mrs. Newman 29 of the nursing diagnosis included in Mrs. Newmans careplan, which one has the highest priority? A) Deficient of fellowship B) Anticipatory grievingC) Ineffective airway cl earance D) impair verbal communication Then home healthcare nurse is discussing the plan of care with Mrs. Newman and her husband, she instructs them to keep the populate humidified at all times. Mr. Newman asks why this is important. 30. Which explanation should the nurse provide? A) It will decrease the amt of foreign stuff that enters the stoma B) Humidified air decreases the need for oral fluids C) Humidified air will keep mucous membranes and secretions moist D) The lower airway responsible for humidification was removed during surgery