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Mrs. Newman has been experiencing hoarseness and a change in her voice, but she did not seek medical help until she began to have difficulty swallowing. After being seen by her healthcare provider, she is scheduled for outpatient surgery for a direct laryngoscope to obtain a culture and take a biopsy. Mrs. Newman arrives at the outpatient surgical department at 6:30 am and is escorted to her room. The admitting nurse begins her assessment; 1. Which question is most important for the nurse to ask Mrs. Newman? A) Have you had anything to eat or drink since midnight? B) Are you taking any medications?

C) Have you smoked any cigarettes in the last 24 hours?
D) When was the last time you drank any alcohol?
The admission nurse completes the admission assessment and starts an IV. Mrs. Newman is taken to the operating room for the biopsy. Sifter the procedure, Mrs. Newman is admitted into the PACU. 2. Which intervention will the PACU nurse implant first?

A) Check the healthcare provider’s prescriptions
B) Monitors Mrs. Newman’s pulse OX
C) Contain Mrs. Newman’s vital signs
D) Assess Mrs. Newman’s gag reflex
After 2 days Mrs. Newman calls the oncologist and reluctantly agrees to a total laryngectomy. Mrs. Newman comes to the oncology office to meet with the oncology nurse specializations to discuss the preoperative and postoperative care. Mrs. Newman tells them that she is very scared about having this surgery. She says that she has no questions about the medical aspects of the procedure, but states she is concerned about how her life will change. She tells the nurse she realizes she need to have the surgery but is ambivalent and doesn’t know is she will be able to go through with it after all. 3. Which nursing intervention is most helpful to mars Newman? A) Refer mars Newman to a psychologist to discuss her fears about having this surgery B) Give Mrs. Newman literature provided by the American cancer society C) Ask Mrs. Newman if she would like to talk to someone who has had this surgery D) Tell Mrs. Newman iota is OK to be scared and hold her hands Mrs. Newman is concerned about singing in the country and western club and asks the ONS “how long do you think it will be before I can sing with my band again” 4. How should the ONS RESPOND?

A) Request that the oncologist visit with Mrs. Newman and explain the procedure to her again B) Explain that her vocal cords will be removed, and that she will not be able to sing C) Reassure her that she will be able to sing with the band, but her voice may be different D) Ask Mrs. Newman if she understands what a total laryngectomy is The ONS has given verbal and written information to Mrs Newman answered any questions and is completing the physical assessment 5. Which question is important for the nurse to ask Mrs. Newman? A) When did you first notice any hoarseness in your voice? B) How long did you say have you been singing w/the band? C) How much alcohol do u drink a week?

D) What foods are difficult for you to wallow?
Mrs. Newman reports that she drinks occasionally, mainly on the weekends with friends. The nurse is more concerned that Ms Newman smokes one pack of cigarettes a day. She discusses this issue with mars Newman, who says “Don’t worry about my smoking. I will never smoke another cigarette again” 6. How should the nurse respond to help Mrs. Newman in her attempt to stop smoking? A) I know it will be hard and I am very proud of u

B) You will kit be able to smoke after urn surgery
C) anyone else in urn household smoke
D) What steps is u going to take to stop smoking?
Mrs. Newman discusses the surgery with her family and a woman from a laryngectomy support group. Mrs. Newman decides to go ahead and he a total larygectomy. 7. A referral to which member of the indiciplinary team will be most important for mars Newman prior to surgery: A) Case manger

B) Social worker
C) Physical therapist
D)...
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