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NEW QUESTION 52
A client is going to have a pneumonectomy in the morning. She had a previous negative surgical experience, is talking rapidly, and has an increased pulse and respiratory rate. Nursing interventions for this client should include:

A. Reminding her that this surgery is not as extensive as her past surgery wasB. Telling her that she should not be so nervous and assuring her that everything will be OKC. Providing distractors such as reading or watching televisionD. Providing opportunities to ask questions and talk about concerns

Answer: D

Explanation:
Explanation/Reference:
Explanation:
(A) This intervention will help to clarify any misunderstandings about the surgery and give the client an opportunity to verbalize concerns about the surgery. (B) Distractors will not alleviate the preoperative anxiety that the client is experiencing. This response actually denies the client's anxiety. (C) This intervention is false assurance and denies that anxiety is a normal response to the threat of surgery. (D) Psychological responses are not directly related to the extent of the surgery, because they are influenced by the client's past experiences.

 

NEW QUESTION 53
A baby who was diagnosed with pyloric stenosis has continued to have projectile vomiting. With prolonged vomiting, the infant is prone to:

A. Respiratory alkalosisB. Metabolic acidosisC. Respiratory acidosisD. Metabolic alkalosis

Answer: D

Explanation:
(A) Respiratory acidosis is the result of problematic ventilation. Plasma pH decreases, while plasma PCO2 and plasma HCO3 increase. (B) Respiratory alkalosis results from increased respiratory rate and depth. Plasma pH increases, while plasma PCO2 and plasma HCO3 decrease. (C) Metabolic acidosis occurs when there is strong acid gain in the body. Plasma pH, PCO2, and HCO3 decrease. (D) Increased risk for metabolic alkalosis is due to a loss of hydrogen ions; depletion of potassium, sodium, and chloride when vomiting occurs. Plasma pH and plasma PCO2 increase; plasma HCO3 may decrease and then increase to compensate.

 

NEW QUESTION 54
A child receiving chemotherapeutic drugs experiences a loss of appetite directly related to the therapy. Which of the following strategies should be most effective in encouraging the child to eat?

A. Offer the child a diet with a wider variety of foods and with more seasoning than her usual diet.B. Schedule procedures immediately after eating so that the child will not be tired or in pain at mealtime.C. Provide a well-balanced diet at usual times, and restrict dessert if the child fails to eat well.D. Offer the child smaller meals more frequently than usual, and include as many of her favorite foods as possible.

Answer: D

Explanation:
(A) Because the child's appetite is capricious at best, regular servings may be overwhelming. Praise the child for what is eaten. (B) The child will soon learn that procedures follow meals and may play with food rather than eat it to avoid or delay the procedure. (C) Young children usually do not like highly seasoned foods and may need the security of usual foods. Such a change may actually increase anorexia. (D) Small servings appear more achievable to the child, and the inclusion of favorite foods can add a sense of security.

 

NEW QUESTION 55
A 9-year-old child was in the garage with his father, who was repairing a lawnmower. Some gasoline ignited and caused an explosion. His father was killed, and the child has split-thickness and full-thickness burns over 40% of his upper body, face, neck, and arms. All of the following nursing diagnoses are included on his care plan. Which of these nursing diagnoses should have top priority during the first 24-48 hours postburn?

A. Pain related to tissue damage from burnsB. Potential for impaired gas exchange related to edema of respiratory tractC. Fluid volume deficit related to increased capillary permeabilityD. Potential for infection related to contamination of wounds

Answer: B

Explanation:
(A, B, C) These answers are all correct; however, maintenance of airway is the top priority.
(D) Persons burned about the face and neck during an explosion are also likely to suffer burns of the respiratory tract, which can lead to edema and respiratory arrest.

 

NEW QUESTION 56
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