A nurse is caring for a client who has just returned from the Post-Anesthesia Care Unit (PACU) with an intravenous (IV) fluid infusion and a nasogastric (NG) tube in place following abdominal surgery. Which of the following data is the priority for the nurse to assess?

The coping ability of the client

The client's bowel sounds

The patency of the NG tube

The surgical dressing

None

Answer and Explanation

The Correct Answer is C

Choice A reason:
Assessing the coping ability of the client is important, but it is not the immediate priority following abdominal surgery. The nurse must first ensure that the client's physiological needs are met and that there are no immediate postoperative complications.

Choice B reason:
While monitoring bowel sounds can provide valuable information about the return of gastrointestinal function, it is not the most immediate concern postoperatively. The nurse should prioritize assessments that ensure the client's safety and immediate physiological stability.

Choice C reason:
Ensuring the patency of the NG tube is the priority assessment. A patent NG tube is crucial for decompressing the stomach, preventing nausea and vomiting, and reducing the risk of aspiration, which can be life-threatening. It is also essential for the removal of gastric secretions and to prevent abdominal distention, which can compromise the surgical site and lead to complications such as wound dehiscence.

Choice D reason:
Assessing the surgical dressing is important to check for signs of bleeding or infection. However, the patency of the NG tube takes precedence as it is directly related to the client's airway and breathing, which are always the top priorities in postoperative care.

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Correct Answer is D

Explanation

Choice A reason:
Monitoring temperature is important postoperatively as it can indicate infection or inflammation. However, it is not the immediate priority following a thyroidectomy. The primary concern post-thyroidectomy is ensuring the airway is not compromised due to swelling or bleeding.

Choice B reason:
Monitoring urination is part of postoperative care to ensure kidney function and that the body is adequately eliminating fluids. While important, it is not the priority in the immediate postoperative period following a thyroidectomy.

Choice C reason:
Pain control is essential for patient comfort and recovery. However, while managing pain is a significant aspect of postoperative care, it is not the most critical priority following a thyroidectomy. The nurse must first ensure that the airway is clear.

Choice D reason:
Airway patency is the priority for monitoring a client post-thyroidectomy. Due to the proximity of the surgery to the trachea, there is a risk of swelling, hematoma, or other complications that could lead to airway obstruction. Ensuring the client has a patent airway is crucial to prevent respiratory distress or compromise.

A. A 25-year-old female who has metabolic syndrome B. A 73-year-old male who has an iodine deficiency C. A 35-year-old male who has Graves' disease D. A 45-year-old female who has a family history of autoimmune disorders

Correct Answer is C

Explanation

Choice A reason:
While metabolic syndrome is associated with several health issues, it is not a direct risk factor for hyperthyroidism. Metabolic syndrome typically includes conditions like insulin resistance, hypertension, and dyslipidemia, which are more closely related to diabetes and cardiovascular diseases rather than thyroid function.

Choice B reason:
An iodine deficiency is commonly associated with hypothyroidism, not hyperthyroidism. Iodine is essential for the production of thyroid hormones, and a lack of it can lead to decreased hormone production and an underactive thyroid.

Choice C reason:
Graves' disease is the most common cause of hyperthyroidism. It is an autoimmune disorder where the immune system mistakenly attacks the thyroid gland, causing it to produce too much thyroid hormone. A 35-year-old male with Graves' disease would indeed be at high risk for hyperthyroidism.

Choice D reason:
While a family history of autoimmune disorders can increase the risk of developing autoimmune-related hyperthyroidism, it is not as direct a risk factor as having Graves' disease itself. Autoimmune disorders can have a genetic component, but having a family history does not guarantee the development of hyperthyroidism.

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A nurse is caring for a client who has just returned from the Post-Anesthesia Care Unit (PACU) with an intravenous (IV) fluid infusion and a nasogastric (NG) tube in place following abdominal surgery. Which of the following data is the priority for the nurse to assess?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is monitoring a client who is postoperative following a thyroidectomy. Which of the following data should the nurse identify as the priority to monitor?

Correct Answer is D

Explanation

A nurse is reviewing the medical records of clients on a hospital floor. Which client would the nurse expect is most at risk for hyperthyroidism?

Correct Answer is C

Explanation

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