NCLEX-RN Exam Dumps | A client is having a vertical partial laryngectomy, and the nurse is planning his postoperative care.

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Question 17/686

A client is having a vertical partial laryngectomy, and the nurse is planning his postoperative care. A priority postoperative nursing diagnosis for a client having a vertical partial laryngectomy would be:

A. Activity intolerance

B. Ineffective airway clearance

C. High risk for infection

D. Altered oral mucous membrane

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He has suddenl...; Question 394: A 56-year-old client is admitted to the psychiatric unit in ...; Question 395: Children often experience visual impairments. Refractive err...; Question 396: A client's renal calculi are identified as consisting of cal...; Question 397: The nurse is admitting an infant with bacterial meningitis a...; Question 398: The nurse teaches a male client ways to reduce the risks ass...; Question 399: A 27-year-old healthy primigravida is brought to the labor a...; Question 400: A 2-year-old child will undergo a cardiac catheterization to...; Question 401: A client with severe PIH receiving MgSO4 is placed in a quie...; Question 402: A 17-year-old pregnant client who is gravida 1, para 0, is a...; Question 403: A female client has married recently. A month ago she visite...; Question 404: The nurse documents a client's surgical incision as having r...; Question 405: A 28-year-old client performs a long, involved ritual in get...; Question 406: A 55-year-old man is admitted to the hospital with complaint...; Question 407: A 10-year-old boy has been diagnosed with Legg-Calve Perthes...; Question 408: With a geriatric client, the nurse should also assess whethe...; Question 409: After 3 weeks of treatment, a severely depressed client sudd...; Question 410: Discharge teaching was effective if the parents of a child w...; Question 411: A 20-year-old female client delivers a stillborn infant. Fol...; Question 412: At her first prenatal visit, a 21-year-old woman who is grav...; Question 413: The nurse is preparing a 6-year-old child for an IV insertio...; Question 414: A 30-year-old client has a history of several recent traumat...; Question 415: Which of the following activities would be most appropriate ...; Question 416: Which stage of labor lasts from delivery of the baby to deli...; Question 417: A newborn infant is exhibiting signs of respiratory distress...; Question 418: A female client is exhibiting signs of respiratory distress....; Question 419: A chronic alcoholic client's condition deteriorates, and he ...; Question 420: A client in active labor asks the nurse for coaching with he...; Question 421: A client states to his nurse that "I was told by the doctor ...; Question 422: A dose of theophylline may need to be altered if a client wi...; Question 423: Which of the following findings would be abnormal in a postp...; Question 424: A client with IDDM is given IV insulin for a blood glucose l...; Question 425: A female client was recently diagnosed with gastric cancer. ...; Question 426: After 3 weeks of treatment, a severely depressed client sudd...; Question 427: A 45-year-old male client experiences a sense of depression ...; Question 428: A client had a ruptured abdominal aortic aneurysm that was r...; Question 429: A primigravida with a blood type A negative is at 28 weeks' ...; Question 430: A 26-year-old client is diagnosed with an astrocytoma, a ben...; Question 431: A physician's order reads: 0.25 normal saline at 50 mL/hr un...; Question 432: A parent told the public health nurse that her 6-year-old so...; Question 433: The mother of a client is apprehensive about taking home her...; Question 434: The physician orders medication for a client's unpleasant si...; Question 435: A client's membranes have just ruptured spontaneously. Which...; Question 436: Which of the following would indicate the need for further t...; Question 437: A 3-year-old child was hospitalized for acute laryngotracheo...; Question 438: A client is receiving peritoneal dialysis. He has been taugh...; Question 439: A 3-year-old child was hospitalized for acute laryngotracheo...; Question 440: Assessment of a client reveals a 30% loss of preillness weig...; Question 441: Which of the following should be included in discharge teach...; Question 442: The primary focus of nursing interventions for the child exp...; Question 443: A depressed client is seen at the mental health center for f...; Question 444: A client suffering from schizophrenia has been taking chlorp...; Question 445: A 4-week-old infant is admitted to the emergency room in res...; Question 446: A 66-year-old female client has smoked 2 packs of cigarettes...; Question 447: Forty-eight hours after a thyroidectomy, a female client com...; Question 448: A child becomes neutropenic and is placed on protective isol...; Question 449: A female client with major depression stated that "life is h...; Question 450: The nurse is caring for a client who has diabetes insipidus....; Question 451: Following her surgery, a 5-year-old child will return to the...; Question 452: Nursing assessment of early evidence of septic shock in chil...; Question 453: A client has developed congestive heart failure secondary to...; Question 454: A client is being discharged with albuterol (Proventil) and ...; Question 455: A 26-year-old client is admitted to the labor, delivery, rec...; Question 456: A client is a victim of domestic violence. She is now receiv...; Question 457: A 2-year-old child with a scalp laceration and subdural hema...; Question 458: A 24-year-old woman who is gravida 1 reports, "I can't take ...; Question 459: The most commonly known vectors of Lyme disease are:...; Question 460: A 20-year-old male client is being treated for protein defic...; Question 461: A 15-year-old client was diagnosed as having cystic fibrosis...; Question 462: A client is hyperactive and not sleeping. She will not remai...; Question 463: A client with cirrhosis of the liver becomes comatose and is...; Question 464: Parents of young children often need anticipatory guidance f...; Question 465: Which of the following nursing care goals has the highest pr...; Question 466: Assessment of a client reveals a 30% loss of preillness weig...; Question 467: A client was admitted with rib fractures and a pneumothorax,...; Question 468: The doctor has ordered a restricted fluid intake for a 2- ye...; Question 469: Which of the following serum laboratory values would the nur...; Question 470: A schizophrenic client has made sexual overtures toward her ...; Question 471: Which of the following would indicate the need for further t...; Question 472: A client is diagnosed with Mycobacterium tuberculosis. He is...; Question 473: A client had a right below-the-knee amputation 4 days ago. H...; Question 474: What is the appropriate nursing action for a child with incr...; Question 475: Nursing assessment of early evidence of septic shock in chil...; Question 476: Which one of the following is considered a reliable indicato...; Question 477: The postpartum nurse should include which of the following i...; Question 478: The primary reason that an increase in heart rate (100 bpm) ...; Question 479: A client on the infectious disease unit is discussing transm...; Question 480: Hematotympanum and otorrhea are associated with which of the...; Question 481: The nurse is caring for a 6-week-old girl with meningitis. T...; Question 482: Three hours postoperatively, a 27-year-old client complains ...; Question 483: A client was admitted to the hospital after falling in her h...; Question 484: A 38-year-old pregnant woman visits her nurse practitioner f...; Question 485: A client returned to the unit following a pneumonectomy. As ...; Question 486: The nurse enters the playroom and finds an 8-year-old child ...; Question 487: A client is diagnosed with organic brain disorder. The nursi...; Question 488: A 28-year-old woman was admitted to the hospital for a thyro...; Question 489: When a client with pancreatitis is discharged, the nurse nee...; Question 490: Prior to his discharge from the hospital, a cardiac client i...; Question 491: A seventh grader lost consciousness after being hit in the h...; Question 492: An elective saline abortion has been performed on a 3- week ...; Question 493: A client with a head injury asks why he cannot have somethin...; Question 494: A client has been instructed in how to take her nitroglyceri...; Question 495: A 43-year-old client is admitted to the hospital with a diag...; Question 496: A female client decides on hemodialysis. She has an internal...; Question 497: The nurse begins morning assessment on a male client and not...; Question 498: The nurse discovers that a 78-year-old client who received h...; Question 499: Goal setting for a client with Meniere's disease should incl...; Question 500: A first-trimester primigravida is diagnosed with anemia. The...; Question 501: A female client has been diagnosed with chronic renal failur...; Question 502: A new mother experiences strong uterine contractions while b...; Question 503: A baby is circumcised. Immediate postoperative care should i...; Question 504: A client's membranes have just ruptured spontaneously. Which...; Question 505: A 56-year-old psychiatric inpatient has had recurring episod...; Question 506: When a client with pancreatitis is discharged, the nurse nee...; Question 507: A child is admitted with severe headache, fever, vomiting, p...; Question 508: A 28-year-old client comes to the clinic for her first prena...; Question 509: A 26-year-old male client is brought by his wife to the emer...; Question 510: A client undergoes a transurethral resection, prostate (TURP...; Question 511: Which of the following should the nurse anticipate receiving...; Question 512: The nurse is interviewing a client with a diagnosis of possi...; Question 513: During a client's first postpartum day, the nurse assessed t...; Question 514: The therapeutic blood-level range for lithium is:...; Question 515: Nursing care of the infant prior to surgical closure of a me...; Question 516: While changing the dressing on a client's central line, the ...; Question 517: The nurse is caring for a laboring client. Assessment data i...; Question 518: Hematotympanum and otorrhea are associated with which of the...; Question 519: A client has been admitted to the nursing unit with the diag...; Question 520: A 3-year-old child is admitted with a diagnosis of possible ...; Question 521: A nurse is taking a maternal history for a client at her fir...; Question 522: A client presents to the emergency room with cyanosis, cough...; Question 523: An infant weighing 15 lb has just been treated for severe di...; Question 524: A primipara is assessed on arrival to the postpartum unit. T...; Question 525: A client with emphysema is placed on diuretics. In order to ...; Question 526: During the active phase of rheumatic fever, the nurse teache...; Question 527: A 24-hours' postpartum client complains of discomfort at the...; Question 528: The nurse is caring for a 6-week-old girl with meningitis. T...; Question 529: A 30-year-old client has just been treated in the ER for bru...; Question 530: A 23-year-old college student seeks medical attention at the...; Question 531: In evaluating the effectiveness of magnesium sulfate (MgSO4)...; Question 532: The nurse is developing a plan of care for a client with an ...; Question 533: The nurse notes hyperventilation in a client with a thermal ...; Question 534: A 55-year-old client is admitted with a diagnosis of renal c...; Question 535: Nursing care for the parents of a child with a congenital he...; Question 536: A client reports to the nurse that the voices are practicall...; Question 537: A client is experiencing muscle weakness and lethargy. His s...; Question 538: In discussing the plan of care for a child with chronic neph...; Question 539: When evaluating a client with symptoms of shock, it is impor...; Question 540: Which of the following physician's orders would the nurse qu...; Question 541: A client is admitted to the hospital for an induction of lab...; Question 542: A client undergoes a transurethral resection, prostate (TURP...; Question 543: An 80-year-old male client with a history of arteriosclerosi...; Question 544: A 4-year-old child with a history of sickle cell anemia is a...; Question 545: A client on the infectious disease unit is discussing transm...; Question 546: A 60-year-old male client was hospitalized 3 days ago with t...; Question 547: A client returns for her 6-month prenatal checkup and has ga...; Question 548: The nurse recognizes that a client with the diagnosis of cho...; Question 549: A client who has sustained a basilar skull fracture exhibits...; Question 550: Pregnant women with diabetes often have problems related to ...; Question 551: A client has been in labor 10 hours and is becoming very tir...; Question 552: To prevent thrombophlebitis in a client on complete bed rest...; Question 553: A 70-year-old client is almost finished receiving her second...; Question 554: A type I diabetic client is diagnosed with cellulitis in his...; Question 555: The mother of a child taking phenytoin will need to plan app...; Question 556: Which of the following findings would be abnormal in a postp...; Question 557: To prevent transmission of bacterial meningitis, the nurse w...; Question 558: Dietary planning is an essential part of the diabetic client...; Question 559: A 50-year-old depressed client has recently lost his job. He...; Question 560: A 6-year-old girl is visiting the outpatient clinic because ...; Question 561: A female client has been treated since childhood for mitral ...; Question 562: A 30-year-old female client is receiving antineoplastic chem...; Question 563: When planning care for a 9-year-old client, the nurse uses w...; Question 564: A female client at 10 weeks' gestation complains to her phys...; Question 565: A 6-year-old child returned to the surgical floor 20 hours a...; Question 566: A 60-year-old woman exhibits forgetfulness, emotional labili...; Question 567: A 29-year-old client delivered her fifth child by the Lamaze...; Question 568: An infant with a congenital heart defect is being discharged...; Question 569: The nurse would be sure to instruct a client on the signs an...; Question 570: The physician prescribes phenytoin (Dilantin) for a client w...; Question 571: At 30 weeks' gestation, a client is admitted to the unit in ...; Question 572: A physician's order reads: Administer furosemide oral soluti...; Question 573: A male client is experiencing auditory hallucinations. His n...; Question 574: A 40-year-old client is admitted to the hospital for tests t...; Question 575: After a 10-year-old child with insulin-dependent diabetes me...; Question 576: A client is having a pneumonectomy done today, and the nurse...; Question 577: A complication for which the nurse should be alert following...; Question 578: A 25-year-old client is admitted for a tonsillectomy. She te...; Question 579: A 16-year-old client with anorexia nervosa is on an inpatien...; Question 580: A client is experiencing visual problems at school. She has ...; Question 581: Home-care instructions for the child following a cardiac cat...; Question 582: A 22-year-old single woman was admitted to the psychiatric h...; Question 583: A client is pregnant for the fourth time and has had three n...; Question 584: What specific hormone must be present in serum or urine labo...; Question 585: After an infant is delivered by cesarean delivery and placed...; Question 586: A 2-year-old toddler is hospitalized with epiglottitis. In a...; Question 587: A female client has just died. Her family is requesting that...; Question 588: A male client is experiencing extreme distress. He begins to...; Question 589: A 48-year-old client presents with a long history of severed...; Question 590: Nursing care for the parents of a child with a congenital he...; Question 591: Which of the following changes in blood pressure readings sh...; Question 592: An 8-year-old boy has been diagnosed with hemophilia. Which ...; Question 593: A 3-year-old child is in the burn unit following a home acci...; Question 594: Which nursing implication is appropriate for a client underg...; Question 595: A 4-week-old infant is admitted to the emergency room in res...; Question 596: The nurse discovers that a 78-year-old client who received h...; Question 597: What is the appropriate nursing action for a child with incr...; Question 598: A client has chronic obstructive pulmonary disease. She is s...; Question 599: A male client has been hospitalized with congestive heart fa...; Question 600: A six-month-old infant has been admitted to the emergency ro...; Question 601: A client has chronic obstructive pulmonary disease. She is s...; Question 602: A 17-year-old client has a T-4 spinal cord injury. At presen...; Question 603: A 16-year-old diabetic girl has been selected as a cheerlead...; Question 604: A client is to be discharged from the hospital and is to con...; Question 605: When providing dietary teaching to an individual who has dia...; Question 606: The physician orders fluoxetine (Prozac) for a depressed cli...; Question 607: During an examination, the nurse notes that an infant has di...; Question 608: A depressed client is seen at the mental health center for f...; Question 609: When assessing a female child for Turner's syndrome, the nur...; Question 610: A 35-weeks-pregnant client is undergoing a nonstress test (N...; Question 611: When the nurse is evaluating lab data for a client 18-24 hou...; Question 612: A 27-year-old healthy primigravida is brought to the labor a...; Question 613: A 55-year-old man has recently been diagnosed with hypertens...; Question 614: The nurse is teaching a mother care of her child's spica cas...; Question 615: A female client has been treated since childhood for mitral ...; Question 616: A 25-year-old outpatient presents with a diagnosis of compul...; Question 617: The nurse notes hyperventilation in a client with a thermal ...; Question 618: A complication for which the nurse should be alert following...; Question 619: A 3-month-old infant has had a unilateral cleft lip repair. ...; Question 620: One of the medications that is prescribed for a male client ...; Question 621: Following a gastric resection, a 70-year-old client is admit...; Question 622: A client's renal calculi are identified as consisting of cal...; Question 623: A 19-year-old client fell off a ladder approximately 3 ft to...; Question 624: Which of the following findings would necessitate discontinu...; Question 625: An 11-year-old boy has received a partial-thickness burn to ...; Question 626: An 18-year-old client enters the emergency room complaining ...; Question 627: A client on the infectious disease unit is discussing transm...; Question 628: A 23-year-old female client is brought to the emergency room...; Question 629: A client has received preoperative teaching for the vertical...; Question 630: A client is being discharged on warfarin (Coumadin), an oral...; Question 631: Which of the following risk factors associated with breast c...; Question 632: Which of the following would differentiate acute from chroni...; Question 633: The therapeutic blood-level range for lithium is:...; Question 634: A primigravida is at term. The nurse can recognize the secon...; Question 635: The nurse assesses a postoperative mastectomy client and not...; Question 636: What specific hormone must be present in serum or urine labo...; Question 637: A client has had amniocentesis. One of the tests performed o...; Question 638: After a 10-year-old child with insulin-dependent diabetes me...; Question 639: A client is a depressed, 48-year-old salesman. A serious con...; Question 640: A male client is scheduled for a liver biopsy. In preparing ...; Question 641: A 30-year-old male client is admitted to the psychiatric uni...; Question 642: A newborn girl's father expresses concern that the newborn d...; Question 643: Clinical manifestations seen in left-sided rather than in ri...; Question 644: A client with bipolar disorder taking lithium tells the nurs...; Question 645: A client is a depressed, 48-year-old salesman. A serious con...; Question 646: During an examination, the nurse notes that an infant has di...; Question 647: Prenatal clients are routinely monitored for early signs of ...; Question 648: After a 10-year-old child with insulin-dependent diabetes me...; Question 649: A client has been diagnosed as being preeclamptic. The physi...; Question 650: A 2-year-old child with a scalp laceration and subdural hema...; Question 651: When planning care for the passive-aggressive client, the nu...; Question 652: A 17-year-old pregnant client who is gravida 1, para 0, is a...; Question 653: During the active phase of rheumatic fever, the nurse teache...; Question 654: A client has begun to exhibit signs of alcohol withdrawal. H...; Question 655: A 48-year-old female client is going to have a cholecystecto...; Question 656: The physician has ordered that ampicillin 250 mg IV be given...; Question 657: A male client was involved in a motor vehicle accident earli...; Question 658: A 26-year-old female client presents at 10 weeks' gestation....; Question 659: A female client presents to the obstetric-gynecology clinic ...; Question 660: The parents of a 9-year-old child with acute lymphocytic leu...; Question 661: A school-age child with asthma is ready for discharge from t...; Question 662: A 60-year-old woman exhibits forgetfulness, emotional labili...; Question 663: A male client has heart failure. He has been instructed to g...; Question 664: To prevent fungal infections of the mouth and throat, the nu...; Question 665: A child with celiac disease is being discharged from the hos...; Question 666: A 23-year-old female client is brought to the emergency room...; Question 667: Which of the following physician's orders would the nurse qu...; Question 668: A pregnant client is at the clinic for a third trimester pre...; Question 669: In performing the initial nursing assessment on a client at ...; Question 670: A 47-year-old client comes to the emergency department compl...; Question 671: The nurse has been caring for a 16-year-old female who recen...; Question 672: A child sustains a supracondylar fracture of the femur. When...; Question 673: A client is pregnant with her second child. Her last menstru...; Question 674: A 24-year-old graduate student recognizes that he has a phob...; Question 675: A male client has a history of diverticulosis. He has questi...; Question 676: A male client receives 10 U of regular human insulin SC at 9...; Question 677: During the admitting mental health assessment, a client demo...; Question 678: A 24-hours' postpartum client complains of discomfort at the...; Question 679: A 14-year-old client has a history of lying, stealing, and d...; Question 680: A hyperactive client is experiencing flight of ideas. The mo...; Question 681: A 79-year-old client with Alzheimer's disease is exhibiting ...; Question 682: When a client is receiving vasoactive therapy IV, such as do...; Question 683: A client at 6 months' gestation complains of tiredness and d...; Question 684: Which of the following would differentiate acute from chroni...; Question 685: In caring at home for a child who just ingested a caustic al...; Question 686: In an interview for suspected child abuse, the child's mothe...

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