A client returns to the unit after having a bronchoscopy. The client states "my throat is so dry. Can I have a glass of water?". How will the nurse respond?

"I will give you some ice chips instead of a drink of water".

"I have to assess your gag reflex before giving you any food or water".

"I will call the primary health care provider and request an order for food and water".

"Let's try having a small sip of water to see if you can swallow".

Answer and Explanation

The Correct Answer is B

A.   Offering ice chips, might seem like a safe alternative, but it still poses a risk if the gag reflex is not intact.
B.   Assessing the gag reflex is crucial before offering food or fluids to ensure the client can protect their airway and swallow safely. This response prioritizes safety and is appropriate to ensure the client does not aspirate.
C.   Calling the healthcare provider to request orders for food and water may be necessary if there are specific protocols or if the client's condition requires further assessment or interventions before oral intake can be resumed. However, this response does not address the immediate need for comfort and hydration.
D.   This response involves assessing the client's ability to swallow directly. While it addresses the client's request for water, it may not be the safest initial approach without first assessing the client's readiness and ability to swallow safely.

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Correct Answer is B

Explanation

A. Metabolic alkalosis is characterized by a high pH (>7.45) and an elevated bicarbonate (HCO3-). The ABG results show a pH of 7.32 (which is acidic), PaCO2 of 48 mm Hg (slightly elevated), and HCO3- of 23 mEq/L (within normal range). These findings do not indicate metabolic alkalosis.
B. Respiratory acidosis is characterized by a low pH (<7.35) and an elevated PaCO2 (>45 mm Hg). The ABG results show a pH of 7.32 (acidic) and a PaCO2 of 48 mm Hg (slightly elevated). These findings are consistent with respiratory acidosis, where the elevated PaCO2 indicates inadequate ventilation leading to retention of carbon dioxide and subsequent acidosis.

C. Metabolic acidosis is characterized by a low pH (<7.35) and a decreased bicarbonate (HCO3-). The ABG results show a pH of 7.32 (acidic) and HCO3- of 23 mEq/L (normal). These findings are not indicative of metabolic acidosis.
D. Respiratory alkalosis is characterized by a high pH (>7.45) and a decreased PaCO2 (<35 mm Hg). The ABG results show a pH of 7.32 (acidic) and a PaCO2 of 48 mm Hg (elevated). These findings do not indicate respiratory alkalosis.

A. "I will be drinking a lot of fluid after the test is over." B. "I will be anesthetized so that I lie perfectly still during the procedure." C. "I will make sure I let them know I do not have a shellfish ally." D. "will follow the food and drink restrictions as directed before the test is scheduled."

Correct Answer is B

Explanation

A. This statement suggests that the client may not understand the purpose or procedure of the CT scan. CT scans typically do not require the client to drink excessive fluids afterward. However, hydration might be encouraged if contrast dye was used to help eliminate it from the body. Education is needed to clarify post-procedure instructions.
B. This statement indicates a misconception about the procedure. CT scans do not usually require anesthesia unless it's a complex situation, such as a young child or someone with severe claustrophobia. It's essential to educate the client about what to expect during the CT scan to reduce anxiety and ensure cooperation during the procedure.
C. This statement shows awareness of potential allergies to contrast dye, which often contains iodine. It indicates that the client understands the importance of disclosing allergies to the healthcare team before the procedure. While this is generally a positive sign of awareness, further education may still be needed to ensure complete understanding of allergy management.
D. This statement demonstrates understanding of pre-procedure instructions, which often include fasting or specific dietary restrictions. It suggests that the client understands the importance of these restrictions to ensure accurate test results and safety during the CT scan.

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A client returns to the unit after having a bronchoscopy. The client states "my throat is so dry. Can I have a glass of water?". How will the nurse respond?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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