The practical nurse (PN) is performing a focused assessment on a client with hyperthyroidism. To confirm the presence of exophthalmos, which action should the PN include in the assessment?

Choice A reason: A sore throat is a common and expected concern after an endoscopy. During the procedure, an endoscope is passed through the mouth and down the throat to examine the upper gastrointestinal tract, which can cause irritation and discomfort in the throat. This is typically temporary and can be managed with soothing remedies such as warm saltwater gargles or throat lozenges. The practical nurse should reassure the client that a sore throat is a normal side effect and provide appropriate comfort measures.
Choice B reason: Clay-colored stools are not typically associated with an endoscopy. This finding is more indicative of a problem with bile flow, possibly related to liver or gallbladder conditions. The presence of clay-colored stools suggests that bile is not reaching the intestines, which can occur in conditions such as biliary obstruction. While it is an important symptom to report, it is not directly related to the endoscopic procedure.
Choice C reason: Pain in the mid-abdominal area is not a common post-endoscopy concern. While some mild discomfort or bloating can occur due to the air introduced into the stomach during the procedure, severe or persistent mid-abdominal pain is not expected and should be evaluated further. This symptom could indicate a complication such as perforation, which is rare but serious.
Choice D reason: White, chalky emesis is not a typical concern after an endoscopy. This type of emesis may be related to the ingestion of barium, a contrast material used in certain radiologic studies, but it is not associated with an endoscopic examination. If a client experiences white, chalky emesis, further investigation is needed to determine the cause, but it is not a normal post-endoscopy symptom.

Choice A reason: Yellow urine can be a sign of dehydration or other conditions, but it is not typically associated with cholelithiasis. While it is important to monitor urine color, it does not indicate a direct complication of gallstones.
Choice B reason: Restlessness can be caused by various factors, including discomfort or anxiety. However, it is not a specific indicator of a complication related to cholelithiasis. The practical nurse should assess the cause of restlessness, but it does not warrant immediate reporting to the charge nurse in the context of gallstones.
Choice C reason: Persistent nausea can be a symptom of cholelithiasis, especially if the gallstones are causing a blockage in the bile ducts. While nausea should be monitored and managed, it is not the most critical finding that requires immediate reporting to the charge nurse.
Choice D reason: Clay-colored stools are a significant finding that indicates a possible bile duct obstruction. When bile flow is blocked, it can result in pale or clay-colored stools. This is a critical sign that requires immediate attention and reporting to the charge nurse, as it suggests a serious complication that needs prompt intervention.