The nurse is caring for a client who is scheduled to have Mohs Micrographic surgery for a basal cell carcinoma. Which statement by the client Indicates a need for further teaching?

"The layers removed are individually examined to determine if additional tissue needs to be removed."

"The surgeon will remove a layer of skin and perform a needle biopsy of the lymph node to assess for tumor spread."

"The tumor is removed in horizontal layers to minimalize removal of healthy tissue."

"This type of procedure removes less healthy tissue and often produces a favorable cosmetic outcome."

Answer and Explanation

The Correct Answer is B

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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Correct Answer is B

Explanation

A. Bowel sounds, abdominal girth, and NG tube output provide important information about gastrointestinal function and the potential for complications like ileus or obstruction. However, they do not provide direct information regarding fluid volume status.
B. Vital signs (including blood pressure and heart rate), cardiac rhythm, and peripheral pulses are the first indicators to assess for decreased fluid volume. Hypovolemia often manifests as tachycardia, hypotension, and weak peripheral pulses, which are critical early signs of fluid depletion.
C. Blood Urea Nitrogen (BUN), creatinine, and daily weight are useful in assessing kidney function and long-term fluid status, but they may not be as immediate indicators of acute fluid volume changes in the immediate postoperative period.
D. Respiratory rate, depth, and pulse oximetry are important for assessing respiratory function and oxygenation. While fluid volume imbalances can impact respiratoryfunction, these parameters are not the most direct indicators of fluid volume status.

A. Be alert for non-verbal clues for pain or discomfort B. Answer for the client during rounds with the physician C. Assessment of the ability to cough and swallow D. Provide enough time for the client to respond

Correct Answer is C

Explanation

A. While being alert for non-verbal clues for pain or discomfort is important, it does not directly address the risk for ineffective airway clearance.
B. Answering for the client during rounds with the physician may compromise the client's ability to communicate their needs and concerns, which is not appropriate.
C. Assessment of the ability to cough and swallow is crucial for clients who have undergone oral surgery, as it directly relates to their airway clearance and safety in managing secretions.
D. Providing enough time for the client to respond is important for overall communication and comfort but does not specifically address the risk for ineffective airway clearance, which requires more targeted interventions.

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The nurse is caring for a client who is scheduled to have Mohs Micrographic surgery for a basal cell carcinoma. Which statement by the client Indicates a need for further teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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