Practice Question
A nurse is caring for a client who is postoperative following an endoscopy with moderate (conscious) sedation. Which of the following assessment findings is the nurse's priority?
Answer Choices:
Correct Answer:
Gag reflex
Rationale:
🔷 After moderate sedation and endoscopy, assessing the gag reflex is essential before allowing oral intake.
🔷 Absence of this reflex increases the risk of aspiration, which can lead to pneumonia or airway obstruction.
🔷 Pain and temperature are secondary concerns; protecting the airway is the priority.
🔷 Sedatives can temporarily suppress protective reflexes, requiring careful recovery monitoring.
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This question is from RN Adult Medsurg~2023 which contains 44 questions.
More Questions from This Exam
A nurse in the emergency department is managing the care of a client who has an electrical shock injury. Which of the following actions should the nurse take first?
Answer Choices:
A. Change dressings over the entrance and exit wounds.
B. Obtain an ECG.
C. Administer an opioid pain medication.
D. Titrate IV fluids to maintain urine output at 75 mL/hr.
A nurse is assessing a client who is postoperative following a transurethral resection of the prostate and is receiving continuous bladder irrigation. The client reports bladder spasms, and the nurse notes a scant amount of fluid in the urinary drainage bag. Which of the following actions should the nurse take?
Answer Choices:
A. Apply a cold compress to the suprapubic area.
B. Secure the urinary catheter to the upper left quadrant of the client's abdomen.
C. Use 0.9% sodium chloride to perform an intermittent bladder irrigation.
D. Encourage the client to urinate every 2 hr.
A nurse is assessing a client who has a urinary catheter. The nurse notes the client's IV tubing is kinked and the urinary catheter bag is lying next to the client in bed. The nurse should identify that the client is at risk for which of the following conditions?
Answer Choices:
A. Skin breakdown
B. Infection
C. Neurogenic bladder
D. Phlebitis
A nurse is providing instructions to a client who has primary syphilis. Which of the following instructions should the nurse include in the discharge plan?
Answer Choices:
A. "You will need to take an antiviral medication for 6 months."
B. "You will need cryotherapy for 1 to 2 weeks;
C. "You will need three follow-up blood tests within a 24-month period."
D. "You will need to be monitored for 15 minutes after receiving each medication dose."
A nurse is teaching the family of a client who has Alzheimer's disease about caring for the client at home. Which of the following instructions should the nurse include?
Answer Choices:
A. Cover electrical outlets in the client's home with tape.
B. Keep the client's bedroom dark at night.
C. Hang a monthly calendar in the client's bedroom.
D. Place a large-face clock in the client's bedroom.
Question Details
- Category: RN Nursing Exam(s)
- Subcategory: ATI Exam(s)
- Domain: RN ATI MedSurg
- Answer Choices: 4