The nurse is providing care for a patient who had surgical repair of a paraesophageal (rolling) hernia. The nurse observes that the patient is having difficulty swallowing during the first postoperative meal.What action should the nurse take?

Assure the patient the problem is temporary.

Cut the food into small pieces.

Report the observation to the healthcare provider (HCP).

Offer the patient liquids instead.

Answer and Explanation

The Correct Answer is C

Choice A rationale
Assuring the patient that the problem is temporary may not be accurate. Postoperative dysphagia could indicate a complication from the surgery, such as the stomach fundus being wrapped too tight around the esophagus, causing food obstruction. It’s important to not dismiss the patient’s concerns without proper assessment.
Choice B rationale
Cutting the food into small pieces might help the patient swallow easier, but it does not address the underlying issue. The patient’s difficulty in swallowing could be a sign of a serious problem that needs medical attention.
Choice C rationale
Reporting the observation to the healthcare provider (HCP) is the correct action. After the repair of a paraesophageal hernia, dysphagia should be reported to the HCP. The corrective fundoplication surgery may have the stomach fundus wrapped too tight around the esophagus, causing food obstruction.
Choice D rationale

Offering the patient liquids instead might alleviate the symptom temporarily, but it does not solve the potential problem. The healthcare provider needs to be informed about the dysphagia to assess and treat the possible complication.

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Correct Answer is A

Explanation

Choice A rationale
Moderate sedation is commonly used for colonoscopies. It provides adequate comfort and relaxation for the patient during the procedure, while allowing them to breathe on their own.
Choice B rationale

Local anesthesia is not typically used for colonoscopies. It numbs a specific area of the body and would not provide sufficient comfort or relaxation for a colonoscopy.
Choice C rationale
Regional anesthesia, such as spinal or epidural anesthesia, is not typically used for colonoscopies. It blocks pain in a larger area of the body than local anesthesia, but is more commonly used for surgeries rather than diagnostic procedures like colonoscopies.
Choice D rationale
General anesthesia is rarely used for colonoscopies. It causes complete unconsciousness and is typically reserved for more invasive or lengthy surgical procedures.

A. No stool noted in the collection bag B. Bluish-Purplish colored stoma C. Edematous stoma D. Slight bleeding of the stoma site

Correct Answer is B

Explanation

Choice A rationale
No stool noted in the collection bag is not an immediate concern as it can take several days for the bowel to start functioning after surgery.
Choice B rationale

A bluish-purplish colored stoma could indicate inadequate blood supply to the stoma, which is a medical emergency and should be reported to the provider immediately.
Choice C rationale
An edematous stoma is a common finding in the immediate postoperative period.
Choice D rationale
Slight bleeding of the stoma site can be a normal finding after colostomy placement.

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The nurse is providing care for a patient who had surgical repair of a paraesophageal (rolling) hernia. The nurse observes that the patient is having difficulty swallowing during the first postoperative meal.What action should the nurse take?

Nursing Test Bank

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