A nurse is caring for a postoperative client experiencing shallow respirations and refusing to cough or get out of bed to the chair.
The nurse should educate the client about the increased risk of which complication?
Skin breakdown.
Pneumonia.
Thrombosis.
Atelectasis.
The Correct Answer is D
Choice A rationale
While skin breakdown can occur due to prolonged bed rest, it is not directly related to shallow respirations and refusal to cough or get out of bed.
Choice B rationale
Pneumonia is a possible complication due to immobility and shallow breathing. However, it is not the most immediate risk for a postoperative client who is refusing to cough or get out of bed.
Choice C rationale
Thrombosis is a risk associated with immobility, but it is not directly related to shallow respirations.
Choice D rationale
Atelectasis, or the collapse of alveoli in the lungs, is a common complication after surgery due to shallow breathing and lack of movement. This condition leads to reduced or absent gas exchange, which can further complicate the client’s recovery.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Reports routinely listing the identification number of any equipment involved is not a problem. This is a standard practice in incident reporting as it helps in identifying and tracking the equipment involved in the incident.
Choice B rationale
Reports routinely omitting the names of witnesses to the occurrence is a problem that should be reported to the risk manager. Witnesses can provide crucial information about the incident, and their statements can help in understanding the sequence of events and identifying the root cause of the incident.
Choice C rationale
Reports being completed within 24 hours after the incident is not a problem. Timely reporting of incidents is crucial for accurate recall of events and immediate initiation of corrective actions.
Choice D rationale
Reports routinely including the client’s hospital number is not a problem. This is a standard practice in incident reporting as it helps in identifying and tracking the patient involved in the incident.
Correct Answer is C
Explanation
Choice A rationale
A never event refers to a particularly shocking medical error (such as wrong-site surgery) that should never occur. A surgical site infection, while unfortunate, does not fall into this category.
Choice B rationale
A near miss refers to an event that could have had adverse consequences but did not, either by chance or timely intervention. In this case, the client did experience an adverse consequence (the infection), so this term does not apply.
Choice C rationale
An adverse event is an injury caused by medical management rather than the underlying disease. In this case, the surgical site infection that developed after the knee replacement surgery can be considered an adverse event.
Choice D rationale
A sentinel event is a specific type of unexpected occurrence involving death or serious physical or psychological injury. While serious, a surgical site infection requiring prolonged antibiotic therapy and wound care does not typically fall into this category.
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