A nurse is gathering information from a patient who has undergone a bronchoscopy. Which of the following observations should the nurse report to the healthcare provider?
Sore throat
Presence of gag reflex
Blood pressure 110/88 mm Hg
Facial edema
The Correct Answer is D
A. Sore throat: A sore throat is a common side effect following a bronchoscopy due to irritation of the airway. It is typically expected and does not indicate a serious complication.
B. Presence of gag reflex: The return of the gag reflex after a bronchoscopy is a normal finding. It indicates that the protective airway reflexes are intact, which is a positive sign.
C. Blood pressure 110/88 mm Hg: Although the diastolic pressure is a bit high, this blood pressure reading is generally acceptable post-procedure and is not typically concerning in the context of a bronchoscopy.
D. Facial edema: Facial edema is not a normal finding following a bronchoscopy. It may indicate an allergic reaction, adverse response to medications used during the procedure, or a complication such as airway edema. This finding should be reported immediately to the healthcare provider as it could signal a potentially serious condition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A decreased level of consciousness in a client who had a head injury 2 days ago is a critical sign that requires immediate attention. This could indicate a serious complication such as brain swelling or bleeding. The other clients’ needs, while important, are not as immediately life- threatening and can be addressed after the client with the head injury is stabilized.
Correct Answer is {"dropdown-group-1":"D","dropdown-group-2":"B"}
Explanation
The client is at highest risk for developing hypovolemic shock as evidenced by the client’s capillary refill time and urine output.
These indicators suggest poor perfusion and decreased blood volume, which are key signs of hypovolemic shock.
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