A client who is fully awake after a gastroscopy asks the nurse for something to drink.
After confirming that liquids are allowed, which assessment action should the nurse consider a priority before offering oral intake?
Provide thickened fluids with a straw.
Listen to bilateral lung and bowel sounds.
Check the client's Hypoglossal nerve and Vestibulocochlear cranial nerve function.
Check the client's Glossopharyngeal nerve and Vagus cranial nerve function.
The Correct Answer is D
Choice A rationale: Providing thickened fluids with a straw is more related to swallowing difficulties and is not the priority in this context.
Choice B rationale: While assessing lung and bowel sounds is important, it's not directly related to offering oral intake after a gastroscopy.
Choice C rationale: Assessing the Hypoglossal nerve and Vestibulocochlear cranial nerve function isn't directly related to offering oral intake post-gastroscopy.
Choice D rationale: Checking the client's Glossopharyngeal nerve and Vagus cranial nerve function is crucial as these nerves play roles in swallowing, taste, and the gag reflex, which are important before allowing oral intake post-gastroscopy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale: Redness briefly after removing the appliance might be common due to increased blood flow but does not necessarily indicate an issue.
Choice B rationale: A deep red-purple stoma color can suggest impaired blood supply to the stoma and requires immediate attention.
Choice C rationale: The consistency of output from the colostomy may vary based on the site and type of colostomy and might not necessarily be concerning.
Choice D rationale: The length of the stoma can vary and usually depends on the type of colostomy, and 1/2 inch above the abdomen is within an acceptable range.
Correct Answer is B
Explanation
Choice A rationale: Used primarily for gout and familial Mediterranean fever, not for Paget's disease.
Choice B rationale: Alendronate is a bisphosphonate commonly used to manage Paget's disease by slowing down bone breakdown and reducing the risk of complications.
Choice C rationale: Prednisone is a corticosteroid used for various inflammatory conditions but not typically prescribed for Paget's disease.
Choice D rationale: Used to lower uric acid levels and prevent gout attacks, not a primary medication for Paget's disease.
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