Nursing Acceleration Challenge Exam (NACE) PN-RN Practice Test

After surgery, what is the priority action for a nurse when a patient shows signs of aspiration risk?

1. Check vital signs for distress.

2. Encourage slow breathing techniques.

3. Position the patient appropriately.

4. Administer prescribed sedatives.

The correct answer is: Position the patient appropriately.

When a patient shows signs of aspiration risk after surgery, the primary concern is to ensure their airway remains clear and they are positioned to prevent further complications. Positioning the patient appropriately is vital because it helps facilitate proper airway management and reduce the likelihood of any secretions or food entering the airway. For instance, placing the patient in an upright or semi-upright position can help gravity assist in keeping the airway open and reduce aspiration risk. This position also aids in monitoring for any respiratory distress signs more effectively. While checking vital signs is important for monitoring the patient’s overall condition, it does not directly address the immediate risk of aspiration. Similarly, encouraging slow breathing may help with anxiety or breath control but does not mitigate the risk of aspiration. Administering sedatives can further compromise the patient's responsiveness and airway protection, potentially increasing the risk of aspiration rather than reducing it. Therefore, the priority action is to position the patient appropriately to ensure their safety and promote effective airway management.