NCLEX-RN

Category - Reduction of Risk

Blaine, a client diagnosed with laryngeal carcinoma, will undergo partial laryngectomy and anterior neck dissection in two days. During one of the nurse’s rounds, Blaine asked the nurse about the surgery’s effect on his voice. The client works as a professional singer. What response should the nurse give to the client?
  1. “Your voice may be quite hoarse or weak.”
  2. “The quality of your voice will not change.”
  3. “You will lose your voice, but there are alternative ways you can communicate.”
  4. “The voice changes will depend on the rate of healing of your surgical wound.”
Explanation
Answer: A - The nurse should inform the client to expect voice hoarseness or weakness after the surgery. A partial laryngectomy will only remove a part of the voice box, and completely losing the voice is not one of the expected side effects. Complete laryngectomy causes inability to speak in the normal way. After the surgery, other forms of communication can be used such as esophageal speech or electrolarynx. No matter how hard it may be for the client, the nurse should provide factual information regarding cosmetic and functional limitations after the surgery.
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