A nurse is providing teaching to a client who has otitis media and is 1 hr postoperative following a myringotomy. Which of the following statements should the nurse include in the teaching?

"You should not drink through a straw for 2 weeks.

"You should expect excessive ear drainage for about 48 hours

"You can wash your hair 3 days after the procedure."

"You should blow your nose with your mouth closed."

Answer and Explanation

The Correct Answer is A

Rationale:

A. "You should not drink through a straw for 2 weeks.": Drinking through a straw can create pressure in the middle ear, which may dislodge the tympanic membrane graft or interfere with healing after a myringotomy. Avoiding straws is an important precaution to protect the surgical site and promote proper recovery.

B. "You should expect excessive ear drainage for about 48 hours": Some drainage may occur, but excessive drainage is not expected and could indicate infection or complications. Clients should be instructed to report any abnormal or persistent drainage to the provider rather than expecting it as normal.

C. "You can wash your hair 3 days after the procedure.": Hair washing is typically delayed until the provider confirms it is safe, usually after avoiding water in the ear for a few days. Premature washing could allow water to enter the middle ear, increasing the risk of infection.

D. "You should blow your nose with your mouth closed": Blowing the nose increases pressure in the middle ear and can compromise the healing of the tympanic membrane. Clients should be taught to avoid nose-blowing entirely or do so gently with the mouth open if necessary.

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Correct Answer is C

Explanation

Rationale:

A. Calcium: While calcium is important for many bodily functions, it is not a primary indicator for monitoring hepatic encephalopathy. Calcium imbalances do not directly correlate with the severity or management of this condition.

B. Potassium: Potassium levels are important for overall electrolyte balance, but they are not specific to hepatic encephalopathy. Monitoring potassium is part of routine care but does not indicate the progression or severity of encephalopathy.

C. Ammonia: Elevated ammonia levels are a key contributor to hepatic encephalopathy. The liver normally converts ammonia to urea, and when liver function is impaired, ammonia accumulates, affecting neurological function. Monitoring ammonia helps assess severity and guide treatment interventions.

D. Glucose: While glucose monitoring is important in general care, it is not specific to hepatic encephalopathy. Hyper- or hypoglycemia may occur with liver disease but does not directly reflect the presence or progression of encephalopathy.

A. Hypotension B. Dyspnea C. Dry cough D. Tachycardia

Correct Answer is B

Explanation

Rationale:

A. Hypotension: While hypotension can indicate shock or fluid imbalance, it may develop secondary to other complications. It is concerning but not necessarily the earliest indicator of an acute pulmonary embolism.

B. Dyspnea: Sudden or worsening shortness of breath is the most immediate sign of a possible pulmonary embolism, which is life-threatening. Prompt recognition and reporting are critical to initiate interventions such as oxygen therapy, anticoagulation, or advanced imaging.

C. Dry cough: A dry cough may accompany a pulmonary embolism but is nonspecific and less urgent. It does not indicate immediate compromise compared with respiratory distress or hypoxia.

D. Tachycardia: Elevated heart rate can be an early sign of stress or hypoxia but is less specific than dyspnea. Tachycardia warrants monitoring, but shortness of breath takes priority for immediate action.

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A nurse is providing teaching to a client who has otitis media and is 1 hr postoperative following a myringotomy. Which of the following statements should the nurse include in the teaching?

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