A nurse is caring for a client following an esophagogastroduodenoscopy (EGD) procedure.
Which of the following assessments is the nurse's priority?
Level of consciousness
Gag reflex
Nausea
Pain
The Correct Answer is B
Choice A reason:
While assessing the client's level of consciousness is important, it is not the priority after an EGD procedure. Ensuring the client's airway and protective reflexes is more crucial.
Choice B reason:
This is the correct answer. After an EGD, the client may have residual effects from sedation. Assessing the gag reflex helps ensure that the client's airway is protected.
Choice C reason:
Nausea is a common side effect after an EGD, but it is not the priority assessment. Ensuring the client's airway and safety come first.
Choice D reason:
Assessing pain is important for the client's comfort, but it is not the priority assessment after an EGD. Ensuring the client's airway and protective reflexes is more crucial.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason:
McBurney's point is a point on the right side of the abdomen that is one-third of the distance from the anterior superior iliac spine to the umbilicus
Choice B reason:
McBurney's point is a point on the right side of the abdomen that is one-third of the distance from the anterior superior iliac spine to the umbilicus
Choice C reason:
McBurney's point is a point on the right side of the abdomen that is one-third of the distance from the anterior superior iliac spine to the umbilicus
Choice D reason:
McBurney's point is a point on the right side of the abdomen that is one-third of the distance from the anterior superior iliac spine to the umbilicus
Correct Answer is B
Explanation
Choice A reason:
Monitoring creatinine levels is important, but it may not be the top priority in this situation.
Choice B reason:
This statement is correct. Given the severe diarrhea associated with Clostridium difficile infection, monitoring potassium levels is crucial to identify and address potential electrolyte imbalances, which can lead to serious complications.
Choice C reason:
Monitoring white blood cell levels is important in the context of infection, but potassium levels are more directly relevant to managing severe diarrhea associated with Clostridium difficile.
Choice D reason:
Hemoglobin levels are important for assessing anemia, but in this context, monitoring potassium levels takes precedence due to the potential for electrolyte imbalances from severe diarrhea.
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