The nurse is caring for a client post-operatively following an open (incisional) cholecystectomy. Which would be the priority nursing intervention for this client?

Administer a narcotic analgesic every two hours.

Encourage a low-fat diet the first post-op day.

Encourage the use of the incentive spirometer.

Ambulate the client in the hall the first post-op evening.

Answer and Explanation

The Correct Answer is C

A. While administering a narcotic analgesic may be necessary for pain management, it does not address the immediate post-operative needs related to respiratory function and mobility.
B. Encouraging a low-fat diet is important after a cholecystectomy, but this can be addressed after ensuring the client's respiratory function and mobilization are stable.
C. Encouraging the use of the incentive spirometer is the priority intervention as it promotes lung expansion, reduces the risk of atelectasis, and improves oxygenation, which is crucial in the post-operative period.
D. While ambulating the client is important for recovery and preventing complications such as deep vein thrombosis, it should follow ensuring that the patient is able to effectively use the incentive spirometer to maintain respiratory function first.

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Correct Answer is C

Explanation

A. Large tumors with distant metastasis may not respond well to radiation therapy, as the effectiveness diminishes when cancer spreads beyond the primary site.
B. While radiation can be effective for superficial cancers, it is most impactful when the cancer is localized.
C. Radiation therapy is most effective for localized cancers, where the treatment can target the tumor directly without affecting surrounding healthy tissues extensively.
D. Cancer spread to multiple sites in one organ complicates treatment and may reduce the efficacy of radiation therapy, as multiple targets may require different approaches.

A. "The layers removed are individually examined to determine if additional tissue needs to be removed." B. "The surgeon will remove a layer of skin and perform a needle biopsy of the lymph node to assess for tumor spread." C. "The tumor is removed in horizontal layers to minimalize removal of healthy tissue." D. "This type of procedure removes less healthy tissue and often produces a favorable cosmetic outcome."

Correct Answer is B

Explanation

A. This statement is accurate as Mohs surgery involves examining each layer of skin for cancer cells before proceeding with further removal.
B. The client indicates a misunderstanding; Mohs surgery does not typically involve a needle biopsy of the lymph node at the time of the procedure, as it focuses on the local removal of skin cancer.
C. This statement is correct as the goal of Mohs surgery is to remove the cancer while preserving as much healthy tissue as possible.
D. This statement is also true as Mohs surgery is designed to minimize healthy tissue removal, often resulting in better cosmetic outcomes

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The nurse is caring for a client post-operatively following an open (incisional) cholecystectomy. Which would be the priority nursing intervention for this client?

Nursing Test Bank

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