A nurse is caring for a patient who reports experiencing an alteration in sense of smell following surgery for a total laryngectomy.

The nurse should address the patient’s concern through which of the following responses?

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

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

“Your sense of smell will gradually return after several months.”.

“Breathing through a stoma has altered your sense of smell.”.

Answer and Explanation

The Correct Answer is D

Choice A rationale
While it’s true that appetite and sense of smell are closely linked, the return of appetite does not necessarily mean the return of the sense of smell, especially after a total laryngectomy.
Choice B rationale
The body does not develop an ability to smell through the stoma. The sense of smell is primarily mediated by the olfactory nerve (Cranial Nerve I), which is located in the upper part of the nasal cavity.
Choice C rationale
The sense of smell does not typically return after several months following a total laryngectomy. This is because the surgery involves removal of the larynx and separation of the airway from the mouth, nose and throat.
Choice D rationale
Breathing through a stoma after a total laryngectomy does alter the sense of smell. This is because the nose and mouth are bypassed during breathing, and these are the primary routes for smell.

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Correct Answer is A

Explanation

Choice A rationale
The initial assessment finding in a client diagnosed with a pulmonary embolism (PE) is typically dyspnea and anxiety. This is because a PE can block blood flow in the lungs, leading to difficulty breathing (dyspnea). The sudden onset of this symptom can cause significant anxiety in the patient.
Choice B rationale
An altered level of consciousness is not typically an initial finding in PE. While severe cases can lead to decreased oxygen levels in the blood, causing confusion or loss of consciousness, these are not usually initial symptoms.
Choice C rationale
Wheezing in lung bases is not a typical initial finding in PE. Wheezing is more commonly associated with conditions that cause narrowing of the airways, such as asthma or COPD12.
Choice D rationale
While an increased pulse and respiratory rate can occur in PE due to the body’s attempt to compensate for decreased oxygen in the blood, they are not the most specific initial findings. Dyspnea and anxiety are more characteristic initial symptoms of PE12.

A. Application of anti-embolism stockings. B. Use of the incentive spirometer. C. Assessment of the chest tube and pleur-evac. D. Repositioning the patient in bed.

Correct Answer is C

Explanation

Choice A rationale
While the application of anti-embolism stockings can be beneficial in preventing deep vein thrombosis in postoperative patients, it is not the most prioritized nursing intervention in the immediate postoperative period for a patient who has undergone a left pneumonectomy. The immediate postoperative period after a pneumonectomy is critical for monitoring and managing potential complications such as respiratory distress, hemorrhage, and bronchopleural fistula.
Choice B rationale
The use of the incentive spirometer is an important nursing intervention for postoperative patients to promote lung expansion and prevent atelectasis. However, in the immediate postoperative period following a pneumonectomy, the priority is to monitor for complications and ensure the stability of the patient.
Choice C rationale
Assessment of the chest tube and pleur-evac is the most prioritized nursing intervention in the immediate postoperative period for a patient who has undergone a left pneumonectomy. After a pneumonectomy, a chest tube is placed to drain air, blood, and fluid from the pleural space to allow the remaining lung to re-expand. It is crucial to monitor the chest tube system for proper functioning and to assess for complications such as excessive bleeding, infection, or pneumothorax.
Choice D rationale
Repositioning the patient in bed is a standard nursing intervention in postoperative care to enhance comfort, promote lung expansion, and prevent complications such as pressure ulcers and deep vein thrombosis. However, it is not the most prioritized intervention in the immediate postoperative period following a pneumonectomy, where monitoring for respiratory complications and ensuring the stability of the patient are paramount.

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

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A nurse is caring for a patient who reports experiencing an alteration in sense of smell following surgery for a total laryngectomy.

The nurse should address the patient’s concern through which of the following responses?