Nursing and Mrs. Newman

Mrs. Newman has been experiencing hoarseness and a change in her voice, but she did not seek medical advice until she began to accept adversity swallowing. Afterwards actuality apparent by her healthcare provider, she is appointed for outpatient anaplasty for a absolute laryngoscope to access a adeptness and booty a biopsy. Mrs. Newman arrives at the outpatient surgical administering at 6:30 am and is escorted to her room. The acceptance assistant begins her assessment; 1. Which catechism is best important for the assistant to ask Mrs. Newman? A) Accept you had annihilation to eat or booze aback midnight? B) Are you demography any medications? C) Accept you smoked any cigarettes in the aftermost 24 hours? D) Aback was the aftermost time you drank any alcohol? The acceptance assistant completes the acceptance appraisal and starts an IV. Mrs. Newman is taken to the operating allowance for the biopsy. Sifter the procedure, Mrs. Newman is accepted into the PACU. 2. Which activity will the PACU assistant implant first? A) Check the healthcare provider’s prescriptions B) Monitors Mrs. Newman’s beating OX C) Contain Mrs. Newman’s basic signs D) Assess Mrs. Newman’s gag reflex Afterwards 2 canicule Mrs. Newman calls the oncologist and cautiously agrees to a absolute laryngectomy. Mrs. Newman comes to the oncology appointment to accommodated with the oncology assistant specializations to altercate the preoperative and postoperative care. Mrs. Newman tells them that she is actual abashed about accepting this surgery. She says that she has no questions about the medical aspects of the procedure, but states she is anxious about how her activity will change. She tells the assistant she realizes she allegation to accept the anaplasty but is clashing and doesn’t apperceive is she will be able to go through with it afterwards all. . Which nursing activity is best accessible to mars Newman? A) Refer mars Newman to a analyst to altercate her fears about accepting this anaplasty B) Give Mrs. Newman abstract provided by the American blight association C) Ask Mrs. Newman if she would like to allocution to addition who has had this anaplasty D) Tell Mrs. Newman atom is OK to be abashed and authority her easily Mrs. Newman is anxious about singing in the country and western club and asks the ONS “how continued do you anticipate it will be afore I can sing with my bandage again” 4. How should the ONS RESPOND? A) Request that the oncologist appointment with Mrs. Newman and explain the activity to her afresh B) Explain that her articulate cords will be removed, and that she will not be able to sing C) Reassure her that she will be able to sing with the band, but her articulation may be altered D) Ask Mrs. Newman if she understands what a absolute laryngectomy is The ONS has accustomed exact and accounting advice to Mrs Newman answered any questions and is commutual the concrete appraisal 5. Which catechism is important for the assistant to ask Mrs. Newman? A) Aback did you aboriginal apprehension any hoarseness in your voice? B) How continued did you say accept you been singing w/the band? C) How abundant booze do u booze a week? D) What foods are difficult for you to wallow? Mrs. Newman letters that she drinks occasionally, mainly on the weekends with friends. The assistant is added anxious that Ms Newman smokes one backpack of cigarettes a day. She discusses this affair with mars Newman, who says “Don’t anguish about my smoking. I will never smoke addition cigarette again” 6. How should the assistant acknowledge to advice Mrs. Newman in her attack to stop smoking? A) I apperceive it will be adamantine and I am actual appreciative of u B) You will kit be able to smoke afterwards urn anaplasty C) anyone abroad in urn domiciliary smoke D) What accomplish is u activity to booty to stop smoking? Mrs. Newman discusses the anaplasty with her ancestors and a woman from a laryngectomy abutment group. Mrs. Newman decides to go advanced and he a absolute larygectomy. 7. A barometer to which affiliate of the indiciplinary aggregation will be best important for mars Newman above-mentioned to surgery: A) Case manger B) Social artisan C) Concrete therapist D) Accent therapist The accent therapist discusses with mars Newman addition tech delving for abating her accent afterwards surgery. Selection of the best techniques varies from actuality to actuality depending on their age and claimed preferences. Esophageal accent is accepted amid laryngectomies because it costs beneath and can accommodate a added accustomed aural articulation than some of the alternative options. 8. Which account describes esophageal speech? A) Generator captivated to the close creates accordance those anatomy words aback the applicant speaks B) Swallowed air acclimated to actualize about and words in a controlled acquittal C) Vibration and complete are acclimated to anatomy words by occluding a valve over the stoma D) A handheld accessory delivers accent via a artificial tube that is amid into the aperture Afterwards discussing her options with a accent therapist mars Newman demonstrates her adeptness to use esophageal accent she comments” I acclimated to apprehend my son and his accompany arbor like this. Won’t he be surprised? Two canicule later, mars Newman is accepted to the hospital accompanied by her bedmate and her two developed children. She is in the preoperative captivation area. 9. Which interventions will the assistant implement? A) ask mars Newman if she has any apropos about the accessible anaplasty B) Notify the surgeon that mars Newman has been accepted to the hospital C) Reassure mars Newman that her ancestors can break with her until anaplasty D) Retrained if mars Newman has any problems audition or autograph Mrs. Newman shares with the assistant that she is abashed that no one will advice her if she needs advice and that she will not be able to allocution anymore. 10. Which activity should the assistant implement? A) Assure Mrs. Newman that addition will be with her at all times B) Accommodate a alarm that she can arena as addition agency of advice C) Show her how to assignment the nurses alarm ablaze and accept her accomplish a acknowledgment affirmation D) Tell her that whiles her fears are justified; she should not try to worry. Afterward a seven –hour anaplasty mars Newman was aboriginal placed in the PACU, afore actuality transferred to the accelerated affliction unit. 11. Which nursing activity should the ICU assistant implement? A) Discourage coughing for the aboriginal 24 hrs B) Notify the healthcare provider during rounds C) Actuate aback mars Newman accustomed her aftermost antibacterial D) Assist mars Newman to irrigate w/warm acrid baptize The assistant is commutual the about-face appraisal and addendum that Mrs. Newman has white and aphotic amber patchy areas on her argot and articulate mucosa. 12. Which activity should the assistant implement? A) Document this award and booty no activity B) Notify the bloom affliction provider during circuit C) Actuate aback Mrs. Newman accustomed her aftermost antibacterial D) Assist Mrs. Newman to irrigate with balmy water, acrid baptize Because of the blight mars Newman is at accident for abeyant complications, such as close would fistula and carotid affected blast 13. When anticipating these accessible complications, the assistant should abode which accessories at absence addition bedside? A) Several bales of antiseptic 4x4 cast B) Two non antiseptic hemostats C) A syringe abounding w/calcium benumb D) The accelerated affliction assemblage blast barrow While assessing mars Newman, the assistant notices that Mrs. Newman’s claret burden is 92/60 and her beating is 112. Mrs. Newman letters activity actual tired. 14 What activity should the assistant apparatus first? A) Check mars Newman’s absorbent basic signs B) Assimilation mars Newman tracheotomy C) Administrate oxygen via nasal cannula D) Slip a gloved duke beneath the client’s neck The assistant additionally calls the nurses’ base and requests a CBC carbon 15 which class aftereffect constant w/blood accident through hemorrhaging A) A hematocrit 40 % B) Erythrocyte sedimentation bulk 8 mm/hr C) Red claret corpuscle calculation 5. 2 million/mm^3 D) Hemoglobin 11. 3g/dl. Mrs. Newman’s gag reflex has alternate and she is advancing to eat her aboriginal meal. 16 which activity should the assistant apparatus A) Abode algid packs about the audience close above-mentioned to bistro B) Remind her to abode the aliment on the advanced of the argot and angle her arch astern to absorb C) Ensure the applicant has a array of attenuate liquids to booze D) Accommodate Mrs. Newman with bendable foods aback bistro for the aboriginal time afterwards anaplasty 17. What activity should the assistant booty apropos Mrs. Newman’s concern? A) Explain to the applicant that this is accustomed afterward this blazon of anaplasty B) He the applicant aroma a array of aromas to ensure that the applicant cannot aroma C) Reassure he applicant that these senses will acknowledgment afterwards post-operative edema subsides D) Notify the healthcare provider about these allegation aback authoritative circuit Mrs. Newman has a tracheotomy that has an close canola. The assistant is assuming accepted tracheotomy affliction 18 Which activity should the assistant apparatus first? A) ablution the border of the alien cannula with accustomed acrid B) Pour hydrogen achromatize and accustomed acrid into abstracted containers C) Cleanse the close cannula application a baby aqueduct besom D) Abolish the tracheotomy bathrobe with apple-pie disposable gloves What should the assistant do afore inserting the close canola? A) Tap or agitate close cannula to abolish balance moisture B) Dry the alfresco of the close cannula with non antiseptic cast C) Abolish the alien cannula, reinsert the close cannula, again abode aback into stoma D) Apple-pie it w/hydrogen achromatize An actionable advantageous cadre UAP is acceptable the surgical attic assistant w/morning affliction for mars Newman 20. Which assignment should the assistant agent to the UAP? A) Abandoned the Foley and almanac the achievement B) Apple-pie Mrs. Newman’s bath C) Change the intravenous bag on the pump D) Accomplish the accepted tracheotomy care The allegation assistant notices that the primary assistant caring for mars Newman is acid 4x4 cast to use as a tracheotomy bathrobe 21. What activity should the allegation assistant implant? A) Praise the primary assistant for application a bulk extenuative address B) Instruct the primary assistant not to cut cast for the tracheotomy bathrobe C) Booty no activity aback Mrs. Newman is the primary nurse’s albatross D) Actuate why commercially able dressings aren’t actuality acclimated The night assistant is advancing to administrate the 12:00 midnight dosage of gentamicin, an intravenous amino glycoside antibacterial that was started aback Mrs. Newman was in the PACU. The assistant notices the abandoned IV antibacterial bag that was administered during the day about-face is labeled ampicilllin. The assistant checks the medication administering almanac and realizes applicant does not accept a decree for ampicillin. 22. Which activity should the night assistant implement? A) Notify the pharmacist about the medication absurdity B) Complete a medication absurdity address c) Alarm the day assistant to actuate what occurred D) Asses Mrs. Newman’s white claret corpuscle calculation WBC The abutting time the assistant enters Mrs. Newman allowance Mrs. Newman writes on the advice inboard is there article wrong? I heard addition in the anteroom say article about me accepting the amiss medication? 23. How should the assistant respond? A) Please don’t anguish about anything. I am apologetic you overheard that chat B) No Mrs. Newman you did not accept the amiss medication C) C) You are anxious that you ability accept accustomed the amiss medication D) you were declared to accept gentamcin but you accustomed ampicillin 24. Which activity should the assistant accommodate to Mrs. Newman? A) Insert a assimilation tube into the stoma while applying suction, the abolish while agee the tube B) Booty a abysmal breath, choke the tracheotomy with urn feel ahem and abolish your feel C) Insert a baby bulk of antiseptic accustomed acrid into the stoma and ahem in a accustomed address D) Booty a abysmal borsch in through the nose, ahem and belch the secretions through the tracheostomy The assistant is discussing activities of circadian active with Mrs. Newman. Which apprenticeship should the assistant include? A) Caution Mrs. Newman to booty alone tub baths B) Animate Mrs. Newman to use aerosol deodorants C) Advise Mrs. Newman not to abrasion any types of perfumes D) Explain the allegation to abrasion a artificial bib aback assuming 26. Which activity has accomplished antecedence to discharge? A) animate the applicant to abrasion adorable coverings over stoma B) Ensure that Mrs. Newman carries a appropriate identification agenda C) Stress the accent of abiding to as accustomed a affairs as accessible D) Altercate the accent of accessory abutment accumulation affairs Mrs. Newman is actuality absolved home today afterwards bristles canicule in the hospital. Mr. Newman stops the assistant in the alley and says that he is absolutely abashed about demography his wife home 27 what is the best acknowledgment by the nurse? A) Accept you discussed your fears w/ur wife B) It sounds like you can’t booty affliction of her C) I apperceive this charge be actual alarming but u and ur wife are able D) Let’s sit bottomward and altercate what u are abashed about Mr. Newman cautiously shares with the assistant that he is abashed to blow his wife How should the assistant respond? A) Would u like to allocution to your wife’s doctor, I can alarm him for u? B) You can blow ur wife all u want, u will not aching her C) You are abashed about affecting ur wife but she needs ur abutment appropriate now D) Tell me added about what you beggarly by affecting ur wife A home healthcare assistant has been assigned to affliction for Mrs. Newman and is authoritative the antecedent visit. Afterwards commutual the acceptance appraisal the home healthcare assistant develops a nursing affliction plan for Mrs. Newman 29 of the nursing analysis included in Mrs. Newman’s careplan, which one has the accomplished priority? A) Deficient of ability B) Anticipatory grieving C) Ineffective airway approval D) Impaired exact advice Again home healthcare assistant is discussing the plan of affliction with Mrs. Newman and her husband, she instructs them to accumulate the apartment humidified at all times. Mr. Newman asks why this is important. 30. Which account should the assistant provide? A) It will abatement the amt of adopted actual that enters the stoma B) Humidified air decreases the allegation for articulate fluids C) Humidified air will accumulate close membranes and secretions clammy D) The lower airway amenable for humidification was removed during surgery

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