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 A
Explanation
Choice A rationale
Limiting sodium intake to no more than 2,000 milligrams per day is a recommended strategy to prevent hypertension. Excessive sodium intake can increase blood pressure by causing the body to retain fluid, which increases the volume of blood and subsequently, blood pressure.
Choice B rationale
While regular exercise is beneficial for overall health, the statement “I should exercise for 30 minutes three times per week” may not be sufficient for hypertension prevention. The American Heart Association recommends at least 150 minutes per week of moderate-intensity aerobic activity or 75 minutes per week of vigorous aerobic activity, or a combination of both, preferably spread throughout the week.
Choice C rationale
Eating fish once per week is not a specific recommendation for preventing hypertension. While fish can be a good source of lean protein and omega-3 fatty acids, it does not directly relate to blood pressure control.
Choice D rationale
The statement “With a BMI of 30, I should maintain my current weight” is incorrect. A BMI of 30 falls into the category of obesity, which is a risk factor for hypertension. Weight loss is recommended for hypertension prevention and control in overweight and obese individuals.
Correct Answer is A
Explanation
Choice A rationale
For a client with COPD who reports shortness of breath and little appetite, limiting fluid intake during meals can help to prevent early satiety and promote better food intake. Fluids can make the client feel full quickly, which can limit their intake of necessary nutrients.
Choice B rationale
Consuming three regular meals daily may not be the best approach for a client with COPD who has little appetite. Smaller, more frequent meals may be easier for the client to tolerate.
Choice C rationale
Eating lighter, low-calorie foods first is not the best advice for a client with COPD who has little appetite. The client may need high-calorie, nutrient-dense foods to meet their nutritional needs.
Choice D rationale
Eliminating dairy products is not generally recommended for clients with COPD unless they have a specific intolerance. Dairy products can be a good source of protein and other nutrients.
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