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 A

Explanation

A. "I feel frustrated when you interrupt me. It's important for us to take turns speaking during client discussions." This response demonstrates assertive behavior because it expresses the nurse's feelings directly and respectfully while addressing the specific behavior that is problematic. By focusing on "I feel" statements, the nurse communicates personal feelings without blaming or attacking the colleague. This approach encourages a constructive dialogue and promotes a more collaborative working relationship.
B. "If you keep interrupting me, I'll report you to our supervisor for disciplinary action." This response is not assertive; it is more aggressive and threatening. It shifts the focus from the behavior to a punitive action and can escalate conflict rather than fostering a constructive conversation. It may create defensiveness in the colleague and is unlikely to resolve the underlying issue.
C. "You always interrupt me when I'm talking. Can't you see how disrespectful that is?" This response is accusatory and confrontational, which is not assertive behavior. While it addresses the behavior, it does so in a way that may cause the colleague to become defensive or hostile. Effective assertiveness involves expressing feelings and needs without assigning blame or using harsh language.
D. "I can't work with someone who constantly takes over conversations. You need to find another partner." This statement is dismissive and aggressive, effectively shutting down communication rather than encouraging teamwork. It does not allow for resolution or discussion of the behavior, making it counterproductive in promoting effective collaboration. Assertive communication should focus on addressing issues while maintaining a willingness to work together.

A. The importance of adhering closely to the prescribed medication regimen. B. The client must remain in respiratory isolation until medication treatment ends. C. The fact that the disease is self-limiting, but can take up to two years to resolve. D. The importance of participating in physical therapy to re-establish functional abilities.

Correct Answer is A

Explanation

A. The importance of adhering closely to the prescribed medication regimen. Tuberculosis requires strict adherence to a long-term antibiotic regimen, typically lasting 6 to 9 months, to prevent drug resistance, treatment failure, and disease relapse. Noncompliance can lead to multidrug-resistant TB (MDR-TB), which is more difficult to treat. Directly observed therapy (DOT) is often recommended to ensure adherence.
B. The client must remain in respiratory isolation until medication treatment ends. While respiratory isolation is essential for active TB, it is not required until the full course of treatment is completed. Isolation is typically maintained until the client has received at least two weeks of effective therapy, symptoms improve, and three consecutive sputum smears are negative for acid-fast bacilli (AFB).
C. The fact that the disease is self-limiting, but can take up to two years to resolve. TB is not self-limiting; without proper treatment, it can persist indefinitely, worsen, and become fatal. Standard treatment with first-line drugs such as isoniazid, rifampin, ethambutol, and pyrazinamide effectively eradicates the infection within 6 to 9 months in most cases.
D. The importance of participating in physical therapy to re-establish functional abilities. While TB can cause fatigue and weakness, physical therapy is not a primary focus of treatment. The priority is to eradicate the infection through strict medication adherence, as untreated TB can progress to severe pulmonary damage, systemic involvement, and complications.

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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?

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Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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