Which of the following should the nurse recognize as a sign of possible infection in a postoperative client? (Select all that apply.)
Dry crust on the incision line
Adventitious breath sounds
Increased urine output
Decreased level of consciousness
Oral temperature of 38.3° C (101° F)
Correct Answer : B,D,E
A. Dry crust on the incision line may indicate normal healing, not necessarily infection.
B. Adventitious breath sounds can be indicative of pneumonia, a potential infection.
C. Increased urine output is not a sign of infection but may suggest other issues.
D. Decreased level of consciousness suggests a systemic issue, which could include infection affecting the central nervous system.
E. Oral temperature of 38.3° C (101° F) indicates fever which is a common sign of infection.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"A"}}
Explanation
Understanding: A, D, E, F
No understanding: B, C
A. This indicates understanding. Distractions during meals are discouraged to focus on chewing and swallowing.
B. This indicates no understanding. This is not a recommended technique for managing dysphagia. It's important to maintain a neutral head position during swallowing.
C. This indicate no understanding. Nuts are a common choking hazard and are often restricted for individuals with dysphagia to prevent aspiration.
D. This is a correct understanding. It's important to separate drinking liquids and eating to prevent choking and aspiration.
E. This is a correct understanding. Depending on the severity of dysphagia, a soft or pureed diet may be recommended.
F. Cream soups are generally allowed on a dysphagia diet, as they are usually smooth and do not pose a high risk of aspiration.
Correct Answer is A
Explanation
A. Asking the client to describe one physical effect after teaching is seeking feedback to ensure understanding.
B. The environment refers to the physical surroundings and context of communication, not the client's response.
C. The message is the information conveyed during teaching.
D. The channel is the method or medium through which communication occurs, such as verbal or written communication.
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