A nurse is reinforcing teaching about pernicious anemia with a client following a total gastrectomy.
Which of the following dietary supplements should the nurse include in the teaching as the treatment for pernicious anemia?

Choice A rationale
Development of gastric ulcers is not a common complication of an esophagogastroduodenoscopy (EGD) procedure. Gastric ulcers are typically caused by factors such as Helicobacter pylori infection or long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), not by the EGD procedure itself.
Choice B rationale
Perforation of the esophagus, stomach, or duodenum is a potential complication of an EGD procedure. During an EGD, a flexible tube with a camera is inserted through the mouth and down into the gastrointestinal tract. If the tube accidentally punctures or tears the lining of the esophagus, stomach, or duodenum, it can cause a perforation. This is a serious complication that requires immediate medical attention.
Choice C rationale
While allergic reactions to the sedation medication used during an EGD procedure can occur, they are not a direct complication of the EGD procedure itself. Allergic reactions would be related to the specific medication used for sedation and not the procedure.
Choice D rationale
Infection at the site of the procedure is not a common complication of an EGD. The procedure is performed using aseptic technique to minimize the risk of infection.

Choice A rationale
Pursed-lip breathing can help improve oxygenation and reduce shortness of breath in clients with COPD. However, it is not the priority action when a client reports difficulty breathing.
Choice B rationale
Increasing the oxygen flow rate without a physician’s order can lead to oxygen toxicity or suppress the respiratory drive in clients with COPD. Therefore, this is not the priority action.
Choice C rationale
Coughing and expectorating secretions can help clear the airways, but it is not the priority action when a client reports difficulty breathing.

Choice D rationale
Evaluating the client’s respiratory status is the priority action. The nurse should assess the client’s breath sounds, respiratory rate, use of accessory muscles, and oxygen saturation to determine the severity of the client’s difficulty breathing and guide further interventions.