A nurse is caring for a client two months following a total laryngectomy. The nurse should recognize that which of the following statements made by the client indicates the need for further teaching?

"My sense of smell is taking a long time to return."

"Breathing through my stoma has diminished my sense of smell."

"I can't smell what I eat, but hope to enjoy eating in the future."

"I am happy to have a mild sense of taste despite no sense of smell."

Answer and Explanation

The Correct Answer is A

A. "My sense of smell is taking a long time to return.": This statement indicates a misunderstanding because, after a total laryngectomy, the sense of smell is significantly impaired or lost due to the inability to breathe through the nose. The client needs further teaching to understand that this change is likely permanent.

B. "Breathing through my stoma has diminished my sense of smell.": This statement is accurate as the stoma bypasses the nasal passages, reducing the sense of smell.

C. "I can't smell what I eat, but hope to enjoy eating in the future.": This shows an understanding that the sense of smell is impaired but expresses a positive outlook on enjoying food in other ways.

D. "I am happy to have a mild sense of taste despite no sense of smell.": This statement indicates an understanding of the sensory changes post-laryngectomy and reflects realistic expectations.

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Correct Answer is A

Explanation

A. GI intolerance and neutropenia: Antiretroviral therapy can cause gastrointestinal intolerance, including nausea, vomiting, diarrhea, and abdominal pain. Neutropenia, a decrease in neutrophil count, can also occur as a side effect of some antiretroviral medications.

B. T-cell count of 500 and diarrhea: While diarrhea can be a side effect of antiretroviral therapy, a T-cell count of 500 is not necessarily an adverse effect and may indicate effective treatment.

C. Anorexia and constipation: Anorexia and constipation are not commonly associated with antiretroviral therapy. However, gastrointestinal side effects such as diarrhea are more common.

D. Bone demineralization and thrush: Bone demineralization (osteoporosis) can occur as a long- term complication of HIV infection and antiretroviral therapy, but it is not a direct adverse effect of antiretroviral medications. Thrush (oral candidiasis) can occur in HIV-infected individuals, but it is not specifically related to antiretroviral therapy.

A. Client calm not agitated. Grimaces with movement. B. Oral mucous membranes dry. C. Axillary temp 102 F (38.9 C), client shivering. D. Productive cough. E. Coarse rhonchi bilaterally. Crackles in bases. F. Respirations irregular with periods of apnea G. Client resting in recliner. RR 12, regular

Correct Answer is {"A":{"answers":"B"},"B":{"answers":"B"},"C":{"answers":"C"},"D":{"answers":"B"},"E":{"answers":"C"},"F":{"answers":"A"},"G":{"answers":"A"}}

Explanation

Client calm not agitated. Grimaces with movement.
No change: While the client is calm and not agitated, grimacing with movement indicates continued discomfort or pain, which remains unchanged.
Oral mucous membranes dry.

No change: Dry oral mucous membranes persist, suggesting ongoing dehydration or inadequate oral hydration.
Axillary temp 102 F (38.9 C), client shivering.

Declined: The axillary temperature has increased from 100.8 F (38.22 C) to 102 F (38.9 C), indicating a worsening of the client's fever. Shivering suggests the body's attempt to generate heat in response to the fever.
Productive cough.

No change: The client continues to have a productive cough, indicating ongoing respiratory congestion or infection.
Coarse rhonchi bilaterally. Crackles in bases.

Declined: The presence of coarse rhonchi bilaterally and crackles in the bases suggests worsening respiratory status, possibly indicating progression of underlying lung disease or development of complications such as pneumonia.
Respirations irregular with periods of apnea.

Improved: The client's respirations, previously irregular with periods of apnea, are now regular, indicating an improvement in respiratory function.
Client resting in recliner. RR 12, regular.

Improved: The client's respiratory rate has decreased from 18 to 12 breaths per minute, and respirations are now regular, suggesting improved respiratory status and possibly reduced distress.

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A nurse is caring for a client two months following a total laryngectomy. The nurse should recognize that which of the following statements made by the client indicates the need for further teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client diagnosed with HIV and receiving antiretroviral therapy. The nurse should assess for which potential adverse effects of long-term antiretroviral therapy?

Correct Answer is A

Explanation

A nurse caring for a client who is at home on hospice care. Exhibits At the end of the visit, the nurse reevaluates the client. Indicate if the assessment findings are improved, show no change, or show that the client has declined.

Correct Answer is {"A":{"answers":"B"},"B":{"answers":"B"},"C":{"answers":"C"},"D":{"answers":"B"},"E":{"answers":"C"},"F":{"answers":"A"},"G":{"answers":"A"}}

Explanation

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