A preoperative nurse is caring for a client who is being prepped for emergency surgery related to a small bowel obstruction. The client is anxious and doesn’t understand what the surgeon means by “adhesions” causing the blockage. Which of the following statements is the best response from the nurse?

The most important thing is that now you are here, and it is going to get taken care of.

This means that scar tissue formed from the healing of a past abdominal surgery is now constricting the opening in your intestine.

I will be happy to go and get you some reading materials about this procedure to explain it further.

It’s okay. It happens all the time and I’ve seen a lot of clients with this issue.

Answer and Explanation

The Correct Answer is B

Choice A Reason: The most important thing is that now you are here, and it is going to get taken care of

While this statement is reassuring, it does not provide the client with the specific information they are seeking about adhesions. Clients often feel more at ease when they understand the cause of their condition. Providing clear and accurate information helps reduce anxiety and empowers the client to be more involved in their care.

Choice B Reason: This means that scar tissue formed from the healing of a past abdominal surgery is now constricting the opening in your intestine

This statement is the best response because it directly addresses the client’s question about adhesions. Adhesions are bands of scar tissue that can form after abdominal surgery, causing organs or tissues to stick together. These adhesions can constrict the intestines, leading to a blockage. Providing this explanation helps the client understand the cause of their condition and the reason for the surgery.

Choice C Reason: I will be happy to go and get you some reading materials about this procedure to explain it further

Offering reading materials can be helpful, but it does not immediately address the client’s anxiety or their specific question about adhesions. While additional information can be beneficial, the nurse should first provide a clear and direct explanation to help the client understand their condition.

Choice D Reason: It’s okay. It happens all the time and I’ve seen a lot of clients with this issue

This statement may come across as dismissive and does not provide the client with the information they need. While it is important to reassure the client, it is equally important to provide specific information about their condition. Understanding the cause of their symptoms can help reduce anxiety and improve the client’s overall experience.

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Correct Answer is D

Explanation

Choice A Reason: Parent who has cardiovascular disease

Having a parent with cardiovascular disease is considered a non-modifiable risk factor. This means it is related to genetic predisposition and cannot be changed or controlled by the individual. While family history is important in assessing stroke risk, it is not something that can be modified through lifestyle changes or medical interventions.

Choice B Reason: Client’s age

Age is another non-modifiable risk factor for stroke. The risk of stroke increases with age, but it is not something that can be altered. While age is an important consideration in stroke risk assessment, it is not a factor that can be modified to reduce the risk.

Choice C Reason: History of sickle cell disease

Sickle cell disease is a genetic disorder that affects the shape and function of red blood cells. It is a non-modifiable risk factor for stroke because it is inherited and cannot be changed. While managing sickle cell disease can help reduce complications, the condition itself remains a fixed risk factor.

Choice D Reason: Hypertension

Hypertension, or high blood pressure, is a significant modifiable risk factor for stroke. It can be managed and controlled through lifestyle changes such as diet, exercise, and medication. Lowering blood pressure can significantly reduce the risk of stroke, making it a key focus in stroke prevention efforts.

A. Nutritional therapy B. Speech therapy C. Occupational therapy D. Respiratory therapy

Correct Answer is B

Explanation

Choice A Reason:

Nutritional therapy focuses on dietary needs and ensuring patients receive adequate nutrition. While this is important for overall health, it does not directly address the swallowing difficulties experienced by patients with Parkinson’s disease.

Choice B Reason:

This is the correct answer. Speech therapy is essential for patients with Parkinson’s disease who have difficulty swallowing. Speech-language pathologists (SLPs) are trained to assess and treat swallowing disorders (dysphagia). They can provide exercises and strategies to improve swallowing function and reduce the risk of aspiration.

Choice C Reason:

Occupational therapy helps patients with daily living activities and improving motor skills. While occupational therapists can assist with feeding techniques, they do not specialize in treating swallowing disorders.

Choice D Reason:

Respiratory therapy focuses on breathing and lung function. It is not directly related to swallowing difficulties, although respiratory therapists may be involved if there are complications such as aspiration pneumonia.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the electronic medical record of a middle-aged client who was admitted following a stroke. Which of the following findings should the nurse identify as a modifiable risk factor for stroke?

Correct Answer is D

Explanation

A nurse is providing care to a client who has Parkinson’s disease and is having difficulty swallowing. Which of the following departments should the nurse plan to contact for a consultation?

Correct Answer is B

Explanation

A nurse is assessing a client who has had diarrhea for several days. Which of the following findings should the nurse expect?

A nurse is administering a tap water enema to a client who is constipated. During the administration of the enema, the client states he is having abdominal cramps. Which of the following actions should the nurse take to relieve the client’s discomfort?

A nurse is caring for a client who is newly diagnosed with Parkinson’s disease. The client states, “I have no idea why I got this.” Which of the following is the most important question the nurse should ask this client while performing the assessment?

A nurse is caring for a hospitalized client at risk for complications of immobility. Which of the following interventions should the nurse include to prevent complications?

A nurse is working with a nursing student to care for several clients who have musculoskeletal injuries. The nurse should identify which of the following functions of the musculoskeletal system? (Select All that Apply)

A nurse is reviewing laboratory values for a client. Which of the following findings indicates the presence of an infection?

A nurse is caring for a client who states their parent died from complications of a GI bleed. Which of the following statements from the nurse will help the client decrease their risk of developing a peptic ulcer?

A nurse is teaching a client who has constipation. Which of the following statements should the nurse include?