Which response is best when a patient refuses a stool softener after pituitary surgery?

"You need the stool softener because it will be hard to defecate while you remain in bed."

"Any manipulation of the pituitary gland can cause difficulty in defecation, so stool softeners are important after your surgery."

"It is important you do not strain during bowel movements because this could result in increased pressure on your surgical site."

"You can choose not to take the stool softener if you feel you do not need it."

Answer and Explanation

The Correct Answer is C

A. "You need the stool softener because it will be hard to defecate while you remain in bed.": This is not the most appropriate response. While immobility can make bowel movements more difficult, the primary concern following pituitary surgery is the avoidance of straining due to the potential for increased intracranial pressure (ICP). The emphasis should be on avoiding pressure on the surgical site rather than general difficulties from immobility.
B. "Any manipulation of the pituitary gland can cause difficulty in defecation, so stool softeners are important after your surgery.": This is misleading. While pituitary surgery may influence certain bodily functions, the most critical concern is preventing straining to avoid raising ICP. The focus should be on explaining the rationale for avoiding pressure on the surgical site.
C. "It is important you do not strain during bowel movements because this could result in increased pressure on your surgical site.": This is the correct response. Straining during bowel movements can increase ICP, which could potentially compromise healing or lead to complications after pituitary surgery. This explanation directly addresses the patient's safety and emphasizes the need for stool softeners to prevent straining.
D. "You can choose not to take the stool softener if you feel you do not need it.": This response is inappropriate because it does not emphasize the importance of preventing straining, which is a critical consideration after pituitary surgery. The nurse should provide education on the necessity of the stool softener to avoid complications rather than leaving the decision solely to the patient.

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Correct Answer is C

Explanation

A. Hypertension is not typically associated with pneumonia, especially in older adults. Pneumonia can lead to hypotension or sepsis, but not usually hypertension.
B. Unequal pupils are not a typical finding associated with pneumonia. This could suggest a neurological issue or a possible eye problem, not a respiratory infection.
C. Confusion is a common sign of pneumonia in older adults, especially in the elderly, who may present with altered mental status due to hypoxia, infection, or dehydration. Delirium or confusion is a common manifestation of pneumonia in this population.
D. Tympany on chest percussion suggests air in the abdominal cavity, not in the lungs, and is not typically associated with pneumonia. Pneumonia is more likely to present with dullness upon percussion due to consolidation in the lungs.

A. Wheezes B. Stridor C. Crackles D. Rhonchi

Correct Answer is A

Explanation

A. Wheezes are continuous, high-pitched musical sounds produced by the narrowing of airways, commonly heard in conditions like asthma. They occur mainly during exhalation and are indicative of airflow obstruction.
B. Stridor is a high-pitched, harsh sound that occurs during inspiration, often associated with an upper airway obstruction, such as laryngospasm or a foreign body.
C. Crackles are fine, crackling sounds heard during inspiration, typically due to fluid accumulation in the lungs (e.g., in pneumonia or heart failure).
D. Rhonchi are low-pitched, snoring sounds caused by the obstruction or narrowing of larger airways, often heard in conditions like chronic bronchitis, but they are not high-pitched like wheezes.

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Which response is best when a patient refuses a stool softener after pituitary surgery?

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Explanation

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Correct Answer is A

Explanation

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