A nurse is preparing a young adult client who has a hearing impairment for surgery. Which of the following actions should the nurse take?
Allow the client to take her morning vitamins.
Allow the client to keep her tongue stud in.
Allow the client to keep her hearing aids in.
Allow the client to consume clear liquids up to the time of surgery.
The Correct Answer is C
a. Allow the client to take her morning vitamins: This is generally acceptable unless there are specific preoperative instructions regarding medication.
b. Allow the client to keep her tongue stud in: Metallic objects, including tongue studs, are
usually removed before surgery to prevent interference with equipment and to ensure patient safety.
c. Allow the client to keep her hearing aids in: It is important for the client with a hearing
impairment to keep hearing aids in place to facilitate communication and maintain awareness of the environment.
d. Allow the client to consume clear liquids up to the time of surgery: Clear liquids are typically restricted before surgery to prevent aspiration. This action may not align with standard
preoperative fasting guidelines.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
a. "The pain radiates down to my lower back." This statement is not typical of peptic ulcer
disease. Radiation of pain to the lower back may suggest other abdominal or musculoskeletal issues.
b. "I feel so much better after eating." Relief of pain after eating is more indicative of gastric ulcer rather than peptic ulcer disease. Peptic ulcers are often associated with pain that worsens after eating.
c. "My pain is relieved by having a bowel movement." Relief of pain with bowel movements is
not a characteristic finding of peptic ulcer disease. This may suggest other gastrointestinal issues.
d. "The pain is worse after I eat a meal high in fat." This statement is consistent with peptic ulcer disease. High-fat meals stimulate gastric acid secretion, potentially exacerbating the pain
associated with peptic ulcers.
Correct Answer is D
Explanation
a. Position the client flat in bed: This position may increase pressure on the abdomen and exacerbate ascites. The head of the bed should be elevated to enhance respiratory function.
b. Weigh the client weekly: Weighing the client daily is more appropriate to monitor fluid retention and assess the effectiveness of interventions.
c. Medicate the client with acetaminophen for discomfort: While acetaminophen can be used for pain relief, its use should be monitored closely due to the potential for liver toxicity in clients with cirrhosis.
d. Measure the client’s abdominal girth every 8 hours: Monitoring abdominal girth is crucial for assessing the degree of ascites and evaluating the effectiveness of interventions.
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