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. Assessing pupils is important, but it provides only partial information about the overall neurologic status and does not give a comprehensive picture of improvement or deterioration.
B. Vital signs can indicate some changes in condition but are not specific to neurologic status and do not provide detailed insight into cognitive or motor function.
C. Performing serial Glasgow Coma Scales allows for a standardized and objective assessment of a patient's level of consciousness, motor responses, and verbal responses over time, making it the most effective method to evaluate neurologic status.
D. The Mini Mental Status Exam provides useful information about cognitive function but may not capture acute changes in neurologic status as effectively as the Glasgow Coma Scale.

A. "It is imperative that you make dietary changes and increase your intake of fiber." B. "You should discuss family history of cancer and early screening options with your primary care provider." C. "You can get a Carcinoembryonic antigen (CEA) blood test annually to predict your chances of developing cancer." D. "There is no need to worry about this until you are over 60 years old."

Correct Answer is B

Explanation

A. Increasing fiber intake is generally beneficial for digestive health but alone may not address the client's specific concern regarding colon cancer risk, making this advice too narrow.
B. Discussing family history and early screening options with a primary care provider is crucial, as it can lead to earlier detection and intervention, especially given the family history of colon cancer.
C. The CEA blood test is not routinely used for cancer screening; it is primarily used to monitor treatment response or recurrence, not for predicting the development of cancer.
D. Waiting until the age of 60 to be concerned about colon cancer is not advisable, especially with a family history; proactive discussions about screening should begin earlier based on risk factors.

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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

Naxlex Comprehensive Predictor Exams

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