A nurse is assisting with the plan of care for a client who had an upper endoscopy 1 hr ago. The nurse should place the priority on monitoring which of the following?
Sore throat
Abdominal bloating
Gag reflex
Belching
The Correct Answer is C
Choice A rationale
While a sore throat can be a side effect of an upper endoscopy, it is not the priority for monitoring after the procedure.
Choice B rationale
Abdominal bloating can occur after an upper endoscopy, but it is not the priority for monitoring.
Choice C rationale
Monitoring the return of the gag reflex is a priority after an upper endoscopy. The gag reflex may be impaired due to the use of local anesthetics during the procedure. An impaired gag reflex increases the risk of aspiration.
Choice D rationale
Belching can occur after an upper endoscopy, but it is not the priority for monitoring
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Sleeping on a large wedge-style pillow can actually help reduce heartburn symptoms by elevating the head and preventing stomach acid from flowing back into the esophagus.
Choice B rationale
Consuming low-fat meats is generally recommended for patients with GERD as fatty foods can trigger heartburn symptoms.
Choice C rationale
Eating dinner early in the evening can help prevent heartburn as it allows the stomach to empty before lying down, reducing the risk of acid reflux.
Choice D rationale
Regularly drinking orange juice can contribute to heartburn in patients with GERD. Orange juice is acidic and can lower the pH of the stomach, triggering symptoms of heartburn.
Correct Answer is B
Explanation
Choice A rationale
Ecchymosis of the extremities is not a typical finding in a patient with an obstruction and inflammation of the common bile duct due to cholelithiasis.
Choice B rationale
Fatty stools, or steatorrhea, is a common symptom in patients with cholelithiasis. This is because the obstruction in the common bile duct can prevent the flow of bile, which is necessary for the digestion and absorption of fats.
Choice C rationale
Straw-colored urine is not typically associated with cholelithiasis. Dark urine can be a symptom of this condition, as the obstruction can cause bilirubin to leak into the blood and urine.
Choice D rationale
Tenderness in the left upper abdomen is not a typical symptom of cholelithiasis. Pain associated with this condition is usually located in the right upper quadrant or the middle upper part of the abdomen.
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