Brunner And Suddarth Textbook Of Medical Surgical Nursing,11th Edition By Suzanne C. Smeltzer test bank

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Brunner And Suddarth Textbook Of Medical Surgical Nursing,11th Edition By Suzanne C. Smeltzer test bank


Brunner And Suddarths Textbook Of Medical Surgical Nursing,11th Edition By Suzanne C. Smeltzer -Test Bank
Sample  Question  
1. A nurse has scheduled a hypertension clinic. This service would be an example of which type of health care?
  A) Tertiary prevention C) Primary prevention
  B) Secondary prevention D) Disease prevention


2. The nursing instructor preparing to take her students into the community to provide nursing care discusses the patients that they are likely to care for in the home. Which of the following are the most frequent users of home care services?
  A) Postpartum patients C) Terminally ill patients
  B) Postoperative patients D) Elderly patients


3. Patients lifestyles in the home may vary greatly from the nurses own beliefs. To work successfully with the patient, the nurse must:
  A) Ask for another assignment if there is a conflict of interest.
  B) Ask the patient to come to the agency to receive treatment.
  C) Convey respect for the patients beliefs.
  D) Adapt the patients home to a hospital-like environment.


4. When providing care in a home, how will the nurse best implement infection control?
  A) Cleanse the hands before and after giving direct patient care
  B) Remove the patients wound dressings from the home
  C) Dispose of patients syringes in the patients garbage
  D) Disinfect all work areas in the patients home


5. The patient is ready to be discharged from the hospital. When should discharge planning begin?
  A) The day prior to discharge C) The day the patient is admitted
  B) The day of estimated discharge D) Once the nurse determines care needs


6. During the home care nurses initial visit to a patients home, it is important to provide the patient and family with which of the following information?
  A) Other available community resources to meet their needs
  B) Information on other patients in the area with similar health care needs
  C) The nurses home address and phone number
  D) Dates and times of all scheduled home care visits


7. After the home health nurse has read a referral from the hospital for a patient who needs a home visit, she should:
  A) Identify community services to initiate for the patient.
  B) Obtain a physicians order for the visit.
  C) Call the patient to obtain permission to visit.
  D) Schedule a home health aide to visit the patient.


8. The nurse should inform the health care agency of the daily routines and phone numbers of the patients that are scheduled. The purpose of this is to:
  A) Allow the agency to keep track of payment due to the nurse
  B) Protect the nurse making a home care visit
  C) Allow the nurse to be easy accessibility for changes in assignments
  D) Allow the patient to cancel appointments with minimal inconvenience


9. Documentation related to home care has specific guidelines and regulations that the nurse must consider and follow. What is most important for the nurse to document to ensure reimbursement for services while taking care of a patient who has Medicaid?
  A) The supplies the nurse will need
  B) Directions to the patients home
  C) Quality of nursing care needed
  D) The patients homebound status and the need for skilled professional nursing care


10. The patient who is being discharged following a total knee replacement will need to walk with crutches for 6 weeks. What assessment does the home care nurse need to make prior to the patient being discharged home?
  A) Assistance of significant others C) Costs of the visits
  B) Previous health status D) Home environment


11. A nurse who has achieved advanced education in primary care for a pediatric population and who is employed in a health clinic is functioning in the role of a:
  A) Nurse practitioner C) Clinical nurse specialist
  B) Case co-coordinator D) Clinic supervisor


12. A nurse working in a large meat packaging plant sees patients for work-related issues. The nurse would be functioning in which of the following roles?
  A) Occupational health nurse C) Nurse clinician
  B) Staff nurse D) Nurse educator


13. A school nurse is concerned about a 4th-grade student with cystic fibrosis because she is aware that children with health problems are at risk for:
  A) Sports injuries
  B) Attention disorders
  C) Experiencing school-related stress due to a desire to overachieve
  D) Underachieving or failing in school


14. Which type of patient seeks health care late in the course of illness and deteriorates more quickly than other patients?
  A)  The homeless    B)  Immigrants    C)  The elderly    D)  Adolescents


1. Nurses play an important role in providing health education to patients. Who is ultimately responsible for maintaining and promoting health?
  A)  Classroom teachers    B)  Parents    C)  Physicians    D)  Patients


2. The nurse has learned from the patients daughter that the patient is not following the instructions she received upon discharge last month. Which of the following would be a factor in a patient not adhering to her therapeutic regimen?
  A) Ethnic background of health care provider
  B) Costs of prescribed regimen
  C) Wellness state
  D) Personality of the physician


3. Non-adherence to a therapeutic regimen is a significant problem for elderly people. What is the best strategy for the nurse to implement to assist the elderly in adhering to a therapeutic regimen?
  A) Demonstrate a dressing change and allow the patient to practice.
  B) Provide a pamphlet on a dressing change.
  C) Verbally instruct the patient how to change a dressing.
  D) Have a family member change the dressing.


4. A nurse is preparing to teach a patient how to administer an insulin injection. One of the major variables that influence a patients readiness to learn is:
  A)  Life span    B)  Gender    C)  Occupation    D)  Culture


5. Which of the following behaviors shows a newly diagnosed diabetic patients willingness to learn?
  A) The patient requests a visit from the diabetic educator.
  B) The patient declines a slice of pie at lunch.
  C) The patient has a family member meet with the dietician to discuss meals.
  D) The patient allows the nurse to take daily blood sugar.


6. The nurse can enhance a 75-year-old patients ability to learn how to administer medication by:
  A) Providing links to websites that contain information related to the medication
  B) Excluding family members from the session
  C) Using color-coded materials
  D) Making the information relevant to the patients condition


7. Teaching is an integral intervention implied by all nursing diagnoses. In which of the following nursing diagnoses would education of the patient be the highest priority?
  A) Risk for impaired mobility related to joint pain
  B) Incontinence related to surgical repair of bladder
  C) Altered range of movement related to contractures
  D) Risk for ineffective management of therapeutic regimen


8. The nurse practitioner is discussing health promotion with a group of final-year nursing students. Which of the following would be considered health promotion?
  A) Blood pressure clinic C) Immunization clinic
  B) Family planning clinic D) Workplace health and safety seminar


9. A nurse has taught an asthmatic patient how to administer his daily inhaler. The nurse should evaluate the teaching-learning process by:
  A) Using teaching aides
  B) Identifying teaching strategies
  C) Directly observing the patient using his inhaler
  D) Documenting the teaching session in the patients record


10. A group of nurse practitioner students have been assigned to complete a health-promotion teaching project. Which of the following will the nursing instructor accept as an example of a health-promotion teaching project?
  A) Demonstrating an injection technique to a patient for anticoagulant therapy
  B) Explaining the side effects of a medication to an adult patient
  C) Discussing the importance of preventing sexually transmitted disease to a group of 12th-grade students
  D) Instructing an adolescent patient about safe food preparation


11. While health promotion should continue across the lifespan, it is important for the nurse to understand when to initiate it. At what point in the lifespan should health promotion begin?
  A)  Adolescence    B)  School age    C)  Preschool    D)  Before birth


12. Health promotion remains a contemporary topic of discussion in publications and by the media. Based upon current knowledge, which of the following is the most significant factor in health and longevity?
  A) Good nutrition C) Use of vitamins
  B) Stress reduction D) Screening for health risks


13. Excessive stress levels have been associated with infectious diseases. Which of the following supports the rationale for this statement?
  A) Stress impairs sleep patterns. C) Stress increases weight.
  B) Stress decreases the immune response. D) Stress decreases concentration.


14. Which of the following sites could be best used by the community health nurse for holding a series of health-promotion education sessions for a group of middle-age adults?
  A)  Physicians office    B)  The workplace    C)  The hospital    D)  The nurses clinic


15. As health care professionals, nurses have a responsibility to promote activities that foster well-being. How has the nurse come to play this vital role?
  A) Nurses are seen as nurturing.
  B) Nurses have post-secondary education.
  C) Nurses have a desire to help others.
  D) Nurses have long-established credibility with consumers.


16. The nurse is teaching a patient about the importance of disease prevention. Why is disease prevention necessary in health promotion?
  A) Prevention is emphasized in the link between personal behavior and health.
  B) The majority of deaths of Americans under age 60 are not related to preventable causes.
  C) Health maintenance organizations now emphasize prevention as the main criterion of health care.
  D) The external environment affects the outcome of most disease processes.


17. What is the most important principle for the nurse to utilize when teaching a patient how to perform tracheostomy care?
  A) Providing the most up-to-date information available
  B) Alleviating the patients guilt associated with not knowing appropriate self-care
  C) Determining the patients readiness to learn new information
  D) Building on previous information


18. Which of the following teaching methods is most effective for the nurse preparing to teach a patient to self-catheterize at home upon discharge?
  A) A list of instructions written at a 6th-grade level
  B) A short videotape providing useful information and demonstrations
  C) An audiotaped version of discharge instructions
  D) A discussion and demonstration between the nurse and the patient
1. An 80-year-old patient tells the nurse assessing him that he continues to enjoy swimming, bowling, and gardening. The nurse determines that this patient is exhibiting a theory of aging termed:
  A)  Trust    B)  Autonomy    C)  Activity    D)  Integrity


2. A gerontologic nurse practitioner frequently cares for patients with heart disease and is aware that it is the leading cause of death in the aged. This is due in part to which of the following?
  A) Heart muscle and arteries lose their elasticity.
  B) Systolic blood pressure decreases.
  C) Resting heart rate decreases with age.
  D) The aged are less likely to adopt a healthy lifestyle.


3. An occupational health nurse overhears an employee talking to his manager about a 65-year-old coworker. The nurse is concerned about ageism when she hears the employee state:
  A) He is a very active individual and enjoys playing tennis.
  B) He should retire and make way for some new blood.
  C) He should spend more time with his family.
  D) He is a bad apple.


4. A nurse is planning to teach an 80-year-old patient who has exhibited short-term memory loss how to change his dressing. She should:
  A) Set long-term goals with the patient. C) Keep visual cues to a minimum.
  B) Provide some music to aid learning. D) Keep teaching periods short.


5. A 65-year-old patient has been diagnosed with essential hypertension. Which of the following blood pressure readings demonstrate essential hypertension?
  A)  140/92    B)  145/88    C)  90/62    D)  120/68


6. A 75-year-old patient with very dry skin is hospitalized for a fractured radius. The nurse should instruct the patient to:
  A) Bathe one to 2 times a week. C) Avoid prolonged use of sunscreens.
  B) Use makeup to cover the wrinkles. D) Drink more milk.


7. A nurse is planning a presentation on the normal signs of aging to a group of senior citizens. Which of the following should be included in the teaching plan?
  A) Enhanced sense of smell
  B) Decrease in muscle mass
  C) Disappearance of sexual desire for both men and women
  D) Increased sebaceous and sweat glands for both men and women


8. A nurse is caring for a female patient who has been diagnosed with kyphosis. In which of the following activities might the patient find it difficult to participate?
  A) Light yoga class with hyperextension of the spine
  B) Therapeutic touch
  C) Sitting in a chair and knitting
  D) Reading a newspaper


9. An elderly patient is having difficulty with bowel movements. What intervention could the nurse suggest?
  A) Stress reduction C) Adequate privacy
  B) Increasing caloric intake D) Increasing intake of water


10. An 84-year-old patient who has returned from the PACU is oriented to name only and has been diagnosed with delirium. The nurse should explain the following to the patients family:
  A) There is nothing to worry about.
  B) Delirium involves a progressive decline in memory loss.
  C) Delirium may only last a short time.
  D) Delirium is generally more prevalent in women.


11. A nurse makes a home visit to a 90-year-old patient who has cardiovascular disease. The patient states, Can you see the little green bugs that have been singing to me? The patient is also confused and agitated. The nurse should:
  A) Have the patients home care increased.
  B) Have a family member check in on the patient in the evening.
  C) Have the patient see his or her physician.
  D) Refer the patient to an adult day program.


12. A patient with early stage Alzheimers disease has been prescribed tacrine hydrochloride. The nurse should explain to the patient and family about which of the following potential side effects of this drug?
  A)  Liver toxicity    B)  Dental caries    C)  Depression    D)  Sexual impotence


13. A nurse is caring for an 86-year-old frail female patient. During the assessment, the patient indicates that she has fallen 3 times in the month but has not injured herself to date. The nurse is aware there is a high potential for:
  A) A hip fracture
  B) A fracture of the mandible
  C) An increased likelihood of confusion
  D) Noncompliance with preventive teaching


14. The nurse makes a home visit to a 76-year-old male widower who is taking multiple medications. The patient states that he has been taking some herbal remedies. The nurse should include the following in the patients teaching:
  A) Herbal remedies are holistic.
  B) Herbal remedies are often cheaper than prescribed medicine.
  C) It is important to avoid herbal remedies.
  D) He should inform his physician and pharmacist about the herbal remedies.


15. The nurse is caring for an elderly patient who exhibits signs of dementia. The most common cause of dementia in an elderly patient is:
  A)  Delirium    B)  Depression    C)  Excessive drug use    D)  Alzheimers disease


16. The nurse is caring for a patient with late-stage Alzheimers disease whose wife says that her husband has become very dependent and she feels guilty if she takes any time for herself because the patient cries out for her. The nurse should develop which of the following outcomes to assist the patients wife?
  A) The caregiver learns to explain to the patient why she needs time for herself.
  B) The caregiver distinguishes obligations she must fulfill from those that can be controlled or limited.
  C) The caregiver leaves the patient at home alone for short periods of time to encourage independence.
  D) The caregiver avoids asking other family members to help for fear of imposing on them.


17. When developing a care plan for an older adult, the nurse should consider which challenges faced by patients in this age group?
  A) Selecting a vocation, becoming financially independent, and managing a home
  B) Developing leisure activities, preparing for retirement, and resolving empty-nest crisis
  C) Managing a home, developing leisure activities, and preparing for retirement
  D) Adjusting to retirement, deaths of family members, and decreased physical strength


18. The nurse administering IM injections to an older patient should remember that an older patient has:
  A) Less subcutaneous tissue and muscle mass than a younger patient
  B) More subcutaneous tissue and less muscle mass than a younger patient
  C) Less subcutaneous tissue and more muscle mass than a younger patient
  D) More subcutaneous tissue and muscle mass than a younger patient


19. The nurse assessing an elderly patient should consider that one normal aging change is:
  A)  Cloudy vision    B)  Incontinence    C)  Diminished reflexes    D)  Tremors


20. The nurse is assessing a 47-year-old patient who has come to the physicians office for his annual physical. One of the first physical signs of aging is:
  A) Having more frequent aches and pains
  B) Failing eyesight, especially close vision
  C) Increasing loss of muscle tone
  D) Accepting limitations while developing assets


21. The nurse caring for an 85-year-old patient should be aware that this factor directly influences this patients mental health:
  A) The patients attitude toward life circumstances
  B) The patients age, education level, social status, and economic level
  C) The number of children and grandchildren in the family and the patients relationship with them
  D) Grief issues related to loss, role changes, and physical stamina


22. To encourage adequate nutritional intake for a patient with Alzheimers disease, the nurse should:
  A) Stay with the patient and encourage him to eat.
  B) Help the patient fill out his menu.
  C) Give the patient privacy during meals.
  D) Fill out the menu for the patient.


23. A 78-year-old Alzheimers patient is being treated for malnutrition and dehydration. The nurse places him closer to the nurses station because of his tendency to:
  A)  Forget to eat    B)  Yell out often    C)  Exhibit acquiescent behavior    D)  Wander


24. Which intervention would be most useful in an 89-year-old patient suffering from Alzheimers-type dementia?
  A) Provide a safe environment. C) Avoid the use of touch.
  B) Provide a stimulating environment. D) Use restraints whenever necessary.


25. A home health care nurse is working with the family of a patient who has Alzheimers disease. The patients spouse is too exhausted to continue providing care on her own. The adult children live too far away to provide relief on a weekly basis. Which nursing intervention would be most helpful?
  A) Calling a family meeting to tell the absent children that they must participate in helping the patient
  B) Suggesting that the spouse seek psychological counseling to help her cope with exhaustion
  C) Investigating community resources for adult day care and other services
  D) Insisting that the patient be placed in a long-term-care facility for the good of his spouse and children


26. A nurse practitioner (NP) who specializes in serving the elderly population is learning Spanish to help increase her ability to communicate with the clients in her practice. The NP is aware that:
  A) The elderly Hispanic population is about to peak and then steadily decline.
  B) The NP should probably learn the French language instead, because the elderly French-speaking population will be greater than the Hispanic population in the next 10 years.
  C) The elderly Hispanic population is the fastest growing elderly population in the United States.
  D) The elderly population is steadily moving toward the southern states and learning Spanish will help the NP teach patients in the future.


27. An 81-year-old man is being seen at the primary care clinic for hypertension. He has been having problems with lightheadedness when he gets up in the middle of the night to use the bathroom and sometimes when he gets up quickly to answer the phone. The nurse instructs the patient to:
  A) Decrease his fluid intake over the course of the day to decrease urination at night.
  B) Unplug the phone when he is sleeping to decrease the need to get up quickly to answer the phone.
  C) Move slowly from a lying to a sitting position and then slowly from sitting to standing.
  D) Increase his coffee intake during the day to help increase his blood pressure.


28. A 74-year-old healthy and happy retired attorney who complains that she is getting very forgetful but is still able to beat her 49-year-old son doing crossword puzzles asks if this is normal. The nurse tells her:
  A) The loss of memory and intelligence is progressive and sometime in the future your son will most likely begin to win more games.
  B) Crossword puzzles are a great way to spend time with your son; he must care about you.
  C) That seems normal; we seem to lose short-term memory as we age but our problem-solving skills remain unchanged.
  D) We often lose short-term memory when we have a stroke; do you think you have had a stroke?


29. A 72-year old man has come to immediate care because he has been feeling confused for a couple of days; today, however, he feels like he might pass out and is short of breath. When the nurse questions him about chest pain, he states he just has heartburn. The nurses greatest concern is that he:
  A) Is very agitated and now has an upset stomach
  B) Has come to the clinic because he is depressed and wants to talk with someone
  C) May be under too much stress and is having an anxiety attack
  D) May be having a heart attack and does not realize it


30. A nurse is caring for a 70-year-old woman in the emergency room who is complaining of shortness of breath and has a history of congestive heart failure along with hypertension. She was seen by a new cardiologist this week and was started on four new medications. She thinks one is a new water pill, and she is unsure about the others. The drugs are very expensive and she is waiting for them to arrive by mail order, so she quit taking all her other medications two days ago. The nurses best set of interventions would be to:
  A) Obtain a list of her current medications, check for interactions, and consult the emergency room physician
  B) Obtain a brief history and vitals, then allow the emergency room physician to sort out the details because he will be ordering the medications
  C) Obtain a set of vitals, do a focused assessment, compile a list of her medications along with when she took them last, and consult with the emergency room physician
  D) Obtain a set of vitals, do a complete assessment, compile a list of her medications and exactly when she took them last, then consult with the emergency room physician


31. A 76-year-old widow has recently moved from her home to a nursing home; her daughter has come to the primary care nurse who has taken care of her mother for years concerned that her mother seems to have lost her memory. She would like an appointment for her mother to be seen. The nurse is aware that:
  A) The daughter is overreacting because she may feel guilty for putting her mother in the nursing home.
  B) Cognitive changes are uncommon in the elderly people over a short period, and this may be serious.
  C) Based on the daughters report, the mother may be in an abusive situation at the nursing home.
  D) Cognitive changes are common when elderly people have significant changes in their environment.


32. During a home health visit, the nurse notices that her new elderly patients home is in disarray and she states that her son takes care of her but only comes once a week. She also reports, He has a hard job and gets mad easily. The nurses plan of care would need to include:
  A) Monitoring to see if the patients situation improves over the next month.
  B) Meeting with a social worker and the son to evaluate the situation further for elder abuse.
  C) Moving the patient to a nursing home to protect her and have her son arrested.
  D) Reporting the suspected abuse to federal law enforcement.


33. A nurse in the emergency room (ER) tells the ER manager that she has been too busy with traumas to talk to people about advance directives. The ER manager informs the nurse that:
  A) It is not a law to provide patient education about advance directives, but it is a professional expectation of this unit.
  B) All hospitals require advance directives to be completed prior to the patient being admitted.
  C) It is a federal law to provide patient education about advance directives at the time of hospital admission.
  D) Although advance directives are voluntary and are not legal in most states, it is a unit policy to complete the form.


34. An elderly patient while being seen in immediate care for a possible respiratory infection asks the nurse if Medicare is going to cover the cost of the visit. The nurse educates the patient to the fact that:
  A) Medicare pays for only about half of all personal health costs, requiring the patient to pay the balance, so you may have to pay part of the bill.
  B) Medicare pays for 100% of the cost for acute care services, so the cost of your visit is covered.
  C) Medicare will only pay the cost for acute care services if you are very poor.
  D) Medicare will not pay for the cost for acute care services, so you will be billed for the services provided today.


35. An elderly man who has come to a health promotion clinic offering education related to understanding and filling out advance directives tells the nurse that he does not want to complete an advance directive because he does not want anyone controlling his finances. The nurse teaches the man that:
  A) Advance directives are not legal documents, so he has nothing to worry about.
  B) Advance directives are limited only to health care instructions and directives.
  C) His finances cannot be managed without an advance directive.
  D) Advance directives are implemented when you become incapacitated, then you use a living will to allow the state to manage your money.


1. During cold season, what information should the nurse provide to the patient to best prevent transmission of organisms?
  A) Take prescribed antibiotics. C) Dress warmly.
  B) Use warm salt-water gargles. D) Wash the hands frequently.


2. A patient visits the clinic and is diagnosed with acute sinusitis. To promote sinus drainage, the nurse instructs the patient to:
  A) Apply a cold pack to the affected area.
  B) Apply a mustard poultice to the forehead.
  C) Perform postural drainage.
  D) Increase fluid intake.


3. The nurse is instructing a patient on the administration of nasal spray. What information is most important to include in this teaching plan?
  A) Finish the bottle of nasal spray to clear the infection effectively.
  B) Nasal spray can be shared between family members only.
  C) Administer the nasal spray in a prone position.
  D) Overuse of nasal spray may cause rebound congestion.


4. The patient has been prescribed an antibiotic for tonsillitis and has been instructed to take the antibiotic for 10 days. The patient informs the nurse that she is feeling better and is stopping the medication because she has taken it for 4 days. What information should the nurse provide to this patient?
  A) Keep the remaining tablets for an infection at a later time.
  B) Discontinue the medications if the fever is gone.
  C) Dispose of the remainder of the medication in a biohazard receptacle.
  D) Antibiotics must be completed to eliminate the organism.


5. Which of the following patients is at greater risk for developing chronic pharyngitis?
  A) Habitual use of alcohol and tobacco C) Diet of spicy foods
  B) Caffeine use D) Type A personality


6. Following tonsillectomy surgery, the nurse will assess the patient for:
  A) Difficulty ambulating C) Decrease in temperature
  B) Frequent swallowing D) Bradycardia


7. Which of the following would be the best diet choice for a patient 3 days after a tonsillectomy?
  A)  Tacos    B)  Pork chops    C)  Chili    D)  Macaroni and cheese


8. A 45-year-old obese man who arrives in a clinic with complaints of daytime sleepiness, headache, and sore throat in the morning is exhibiting manifestations of which of the following?
  A)  Angina    B)  Diabetes    C)  Obstructive sleep apnea    D)  Depression


9. A patient visits the clinic and is diagnosed with acute laryngitis. The nurse should instruct the patient to:
  A) Place warm cloths on the throat. C) Limit speech.
  B) Inhale warm steam. D) Decrease fluid intake.


10. A patient is admitted with epistaxis. Pressure has been applied to the patients midline septum for 10 minutes. The attempt to stop the bleeding is unsuccessful. What treatments may be used to control the bleeding?
  A)  Nasal plugs    B)  Suction    C)  Nasal spray    D)  Silver nitrate applicators


11. A patient has been treated in the emergency room for epistaxis. What information should the nurse include in patient discharge teaching to prevent epistaxis?
  A) Keep nasal passages clear. C) Avoid picking the nose.
  B) Use a dehumidifier. D) Use a tissue when blowing the nose.


12. The nurse is preparing a care plan for a patient scheduled for a laryngectomy. Which of the following nursing diagnoses should receive the highest priority for this surgery?
  A) Anxiety related to diagnosis of cancer
  B) Altered nutrition related to swallowing difficulties
  C) Ineffective airway clearance related to surgical alterations in the airway
  D) Impaired verbal communication related to removal of the larynx


13. The patient with a laryngectomy needs an evaluation of his ability to perform self-care of the stoma prior to discharge. Which patient action would demonstrate safe and appropriate stoma care?
  A) The patient has the nurse clean his or her tracheostomy tube.
  B) The patient carefully removes crusting from around the stoma.
  C) The patient tells the nurse that he has enrolled in swimming lessons.
  D) The patient vigorously cleans the crusts from into his stoma.


14. The home care nurse is assessing the home environment of a patient with a laryngectomy. The nurse informs the patient that he will need to arrange for installation of which system in the home?
  A) A humidification system C) A water purification system
  B) An air conditioning system D) A radiant heating system


15. The nurse is caring for a patient in the outpatient clinic and there is suspicion that the patient may have cancer due to recent weight losses for unidentifiable reasons. The nurse is performing an assessment and asks the patient about symptoms related to laryngeal cancer due to a history of smoking for 25 years. Which of the following is a symptom associated with laryngeal cancer?
  A)  Hoarseness    B)  Dyspnea    C)  Dysphagia    D)  Alopecia


16. The nurse caring for a patient following a supraglottic laryngectomy reminds the patient that a common symptom that occurs after a supraglottic laryngectomy is:
  A)  Inability to speak    B)  Vertigo    C)  Increased saliva production    D)  Dysphagia


17. A nurse is caring for a patient scheduled for a total laryngectomy. The patient is aware that his true vocal cords will be removed. He asks the nurse how he will communicate. What is the nurses best response?
  A) You will be taught sign language.
  B) You will work with a speech therapist to learn an effective type of speech.
  C) Removal of the true vocal cords will not affect your speech.
  D) You will communicate with a small computer.


18. The nurse is caring for a postoperative patient following a laryngectomy. The patient has been a heavy smoker for 25 years. The nurse observes that the patient is coughing copious thin white sputum. The nurse should:
  A) Suction the patient.
  B) Contact the patients physician immediately.
  C) Apply oxygen non-recreate mask at 10 L.
  D) Assess the patient for bleeding.


19. The nurse determines that the patient with a total laryngectomy has understood the discharge instructions when the patient says:
  A) I can go swimming if I stay in shallow water.
  B) I should keep my living area well humidified.
  C) I can continue to use powder when I finish my shower.
  D) I should cover my stoma with a wool scarf in the winter.


20. A patient is in the first postoperative day after a total laryngectomy and radical neck dissection. Which of the following is a priority goal?
  A) Communicate by use of esophageal speech.
  B) Improve body image and self-esteem.
  C) Attain optimal levels of nutrition.
  D) Maintain a patent airway.


21. The patient presents to the outpatient office with numerous upper

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