A nurse in a surgical clinic is providing teaching to a client who is scheduled for a modified radical mastectomy. Which of the following statements by the client indicates an understanding of the teaching?
"I will complete my arm exercises four times a day."
“I will have my drains removed 1 hour prior to going home."
“I can begin to drive 24 hours after surgery."
"I can shower within 48 hours of my surgery.”
The Correct Answer is A
A. "I will complete my arm exercises four times a day.": Performing arm and shoulder exercises after a modified radical mastectomy helps maintain range of motion, prevent stiffness, and reduce the risk of lymphedema. Regular exercises multiple times a day reflect proper understanding of postoperative rehabilitation.
B. “I will have my drains removed 1 hour prior to going home.": Drain removal is based on the volume of drainage and physician assessment, not a set time before discharge. Premature removal can increase the risk of fluid accumulation and infection.
C. “I can begin to drive 24 hours after surgery.": Driving is usually not recommended until the client has regained adequate strength, range of motion, and is off strong pain medications, typically several days postoperatively. Doing so within 24 hours can be unsafe.
D. "I can shower within 48 hours of my surgery.": Showering is usually delayed until drains are in place and the incision is sufficiently healed, often following specific surgeon instructions. Showering too early can disrupt wound healing and increase infection risk.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Inspect the skin under the boot every 8 hr: Frequent skin assessment is critical for clients in Buck's traction because the traction boot or straps can cause pressure injuries, skin breakdown, or irritation. Checking the skin every 8 hours allows early detection of redness, sores, or areas of compromised circulation and prevents complications associated with prolonged immobility and pressure.
B. Assess the client's peripheral circulation every 12 hr: Peripheral circulation should be assessed more frequently than every 12 hours, typically every 1–2 hours initially, to detect early signs of neurovascular compromise such as cyanosis, pallor, coolness, or numbness. Waiting 12 hours could delay identification of circulation issues that may lead to tissue damage or compartment syndrome.
C. Ensure the weights are resting on the floor: Traction weights must hang freely to maintain proper alignment and effective traction. Allowing the weights to rest on the floor disrupts the pulling force, reducing traction effectiveness, increasing pain, and potentially worsening fracture displacement.
D. Remove the traction to allow the client to use the bathroom: Buck's traction should not be removed for routine activities such as toileting because interrupting traction can cause misalignment, increased pain, and delayed healing. Alternative methods, such as a bedside commode or urinal, should be used while maintaining traction integrity.
Correct Answer is A
Explanation
A. The client started working in a parking garage 3 months ago: Working in a parking garage can increase exposure to carbon monoxide and other exhaust fumes, which can be harmful to both the pregnant client and the fetus. Prolonged inhalation of these toxins may reduce oxygen delivery and contribute to complications, making this finding a priority for further evaluation.
B. The client is doing 30 min of moderate exercise daily: Moderate exercise is recommended during pregnancy as it improves circulation, reduces stress, and supports healthy weight gain. This behavior is considered safe and beneficial unless otherwise contraindicated by the provider.
C. The client is drinking 2.5 L of water per day: Adequate hydration is essential during pregnancy to support amniotic fluid levels, circulation, and kidney function. A daily intake of 2.5 liters is appropriate and aligns with recommended guidelines for pregnant clients.
D. The client last visited the dentist 4 months ago: Routine dental care is important during pregnancy due to increased risk of gingivitis, but a dental visit 4 months ago does not indicate an unsafe behavior. Continuing regular appointments every 6 months is generally sufficient unless specific concerns arise.
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