A nurse is providing care for a client who is to undergo a total laryngectomy. Which of the following interventions is the nurse's priority?

Explain the techniques of esophageal speech.

Schedule a support session for the client.

Determine the client's reading ability.

Review the use of an artificial larynx with the client.

None

Answer and Explanation

The Correct Answer is C

A. Explain the techniques of esophageal speech. Esophageal speech is one method of communication but is learned later through speech therapy. Not the immediate priority.

B. Schedule a support session for the client. While providing emotional support is important, it is not the immediate priority. The client needs to understand how to communicate effectively after the laryngectomy.

C. Determine the client's reading ability. After surgery, the client will not be able to speak initially. Knowing if the client can read and write allows the nurse to provide a communication method (such as writing or using a communication board) to meet immediate needs, especially related to airway, pain, and care.

D. Review the use of an artificial larynx with the client. An electrolarynx is an option but is introduced later in recovery. It is not the immediate concern before surgery.

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Correct Answer is D

Explanation

The nurse should ask a second nurse to record her signature when wasting any unused portion of the controlled substance. This is a standard procedure for the safe handling and documentation of controlled substances.

a. The nurse should report any discrepancy in the count total of the controlled substance before administration, not after.

b. The wasted portion of the controlled substance should be disposed of according to facility policy, which may not involve placing it in a sharps container.

c. The count total of the controlled substance should be verified before removing the amount needed, not after.

A. Take a 30-min nap daily. B. Eat a light carbohydrate snack before bedtime. C. Exercise 1 hr before bedtime. D. Drink a cup of hot cocoa before bedtime.

Correct Answer is B

Explanation

The correct answer is that the nurse should recommend the client to eat a light carbohydrate snack before bedtime. Eating a light carbohydrate snack before bedtime can help promote sleep by increasing the level of tryptophan in the brain, which can help induce sleep.

Options a, c and d are not appropriate interventions for insomnia. Taking a 30-min nap daily can disrupt nighttime sleep and worsen insomnia. Exercising 1 hr before bedtime can increase alertness and make it harder to fall asleep. Drinking a cup of hot cocoa before bedtime can also disrupt sleep due to its caﬀeine content.

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A nurse is providing care for a client who is to undergo a total laryngectomy. Which of the following interventions is the nurse's priority?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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