A nurse is caring for a client who reports experiencing alteration in sense of smell following surgery for a total laryngectomy. The nurse should address the client's concern through which of the following response?

"Your body will slowly develop an ability to smell through your stoma."

"Breathing through a stoma has altered your sense of smell."

"Your sense of smell will gradually return after several months."

"As your appetite returns, your sense of smell will also return."

Answer and Explanation

The Correct Answer is B

A. "Your body will slowly develop an ability to smell through your stoma." The olfactory system relies on air passing through the nasal passages to detect scents. After a total laryngectomy, the airway is rerouted through a stoma, bypassing the nose entirely. The body does not develop an alternative way to smell through the stoma, making this statement inaccurate.
B. "Breathing through a stoma has altered your sense of smell." A total laryngectomy permanently separates the respiratory and digestive tracts, preventing air from passing through the nose, which is necessary for olfaction. As a result, clients often experience anosmia (loss of smell). This response accurately explains the reason behind the alteration in the client’s sense of smell.
C. "Your sense of smell will gradually return after several months." Unlike temporary post-surgical changes, the loss of smell after a total laryngectomy is typically permanent unless the client learns to use techniques such as the "polite yawning" method (nasal airflow-inducing maneuver) to regain some olfactory function. It does not naturally return over time.
D. "As your appetite returns, your sense of smell will also return." Appetite and sense of smell are closely linked, but appetite improvement does not restore olfaction after a laryngectomy. Since air no longer flows through the nasal passages, the ability to detect smells is significantly impaired or lost.

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Correct Answer is ["B","C","D"]

Explanation

A. Hypotension: While hypotension can occur in clients with acute respiratory failure (ARF), it is not a primary manifestation of the condition. Hypotension may arise due to other factors, such as sepsis or significant fluid loss, but is not universally present in ARF. Therefore, it is less likely to be a key finding in this context.
B. Severe dyspnea: This is a hallmark manifestation of ARF. Clients typically experience significant difficulty in breathing due to inadequate oxygenation or ventilation, leading to an urgent need for medical intervention. Monitoring for severe dyspnea is critical as it directly indicates the severity of respiratory distress.
C. Headache: Headaches can be a manifestation of acute respiratory failure, particularly due to hypoxia or hypercapnia (elevated carbon dioxide levels) affecting cerebral circulation. This symptom may arise as the body struggles to compensate for decreased oxygen levels, making it important to monitor in clients with ARF.
D. Decreased level of consciousness: This is a significant concern in ARF and can indicate worsening hypoxia or hypercapnia. Alterations in consciousness may range from confusion to unresponsiveness and require immediate evaluation and intervention, making it a critical manifestation to monitor.
E. Nausea: Although some clients may experience nausea as a secondary symptom due to anxiety or as a response to hypoxia, it is not a primary or definitive manifestation of acute respiratory failure. Therefore, while it may occur in some cases, it is not one of the key findings to consistently monitor in clients with ARF.

Correct Answer is ["15"]

Explanation

Formula:

Volume to administer (mL) = (Desired dose (mEq) / Available concentration (mEq/mL))

Desired dose = (40 mEq / 2 doses)

=20mEq

Available concentration = 6.7 mEq / 5 mL

Calculate the concentration per mL:

6.7 mEq / 5 mL = 1.34 mEq/mL

Volume to administer = 20 mEq / 1.34 mEq/mL

= 14.925... mL

Round to the nearest whole number:

Volume to administer = 15 mL

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A nurse is caring for a client who reports experiencing alteration in sense of smell following surgery for a total laryngectomy. The nurse should address the client's concern through which of the following response?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has an acute respiratory failure (ARF). The nurse should monitor the client for which of the following manifestations of this condition? (Select all that apply.)

Correct Answer is ["B","C","D"]

Explanation

A nurse is preparing to administer potassium chloride elixir 40 mEq divided into 2 equal doses every 12 hr. Available is 6.7 mEq/5 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["15"]

Explanation

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