A nurse is caring for a client who is 5 days postoperative after abdominal surgery. The client reports a sudden pulling sensation and pain in his surgical incision. Upon examination, the nurse finds an evisceration. Which of the following interventions is appropriate?
Use sterile gloves to place gentle pressure on the exposed organs.
Have the client lie supine with legs straight.
Gently suction secretions from the wound bed using a 12-gauge sterile catheter.
Cover the area with saline-soaked sterile dressings.
The Correct Answer is D
Choice A reason: Applying gentle pressure on the exposed organs is not recommended as it can cause further damage.
Choice B reason: Having the client lie supine with legs straight is part of the correct positioning, but it does not address the need to protect the exposed organs.
Choice C reason: Suctioning secretions from the wound bed is not the immediate priority and can be harmful to the exposed tissues.
Choice D reason: Covering the area with saline-soaked sterile dressings is the correct intervention to keep the organs moist and reduce the risk of organ damage until surgical repair can be performed.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Hypertension is not typically a direct complication of inhaled anesthetics.
Choice B reason: Urinary retention can occur postoperatively but is not specifically associated with inhaled anesthetics.
Choice C reason: Laryngospasm is a potential complication of inhaled anesthetics, which can occur due to irritation of the airway during anesthesia.
Choice D reason: Anxiety is not a complication of inhaled anesthetics; it is more likely to be associated with preoperative stress.
Correct Answer is A
Explanation
Choice A reason: Displacement is a defense mechanism where a person redirects a negative emotion from its original source to a less threatening recipient, which is what Mr. Thomas is doing.
Choice B reason: Projection involves attributing one's own unacceptable feelings or thoughts to others, which is not what Mr. Thomas is doing.
Choice C reason: Regression is a return to earlier stages of development when faced with stress, which does not describe Mr. Thomas's behavior.
Choice D reason: Reaction formation involves behaving in a way that is opposite to what one truly feels, which is not indicated in this scenario.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.