Choice D is correct. The client's vomiting following a tonsillectomy requires immediate follow-up because vomiting and coughing may trigger hemorrhage. This client requires immediate follow-up so the nurse may treat the vomiting with prescribed anti-emetics and assess the client for potential hemorrhage.

Choices A, B, and C are incorrect. A client with COPD experiencing a productive cough and experiencing pursed-lipped breathing is an expected finding. Further, coughing indicates a patent airway. This client does not require immediate follow-up. A client recovering from laparoscopic procedures will likely have abdominal cramping and shoulder pain because of gastric insufflation (the process of instilling air or carbon dioxide into the abdominal cavity to visualize the abdominal organs); this is often relieved by having the client ambulate. An exacerbation of ulcerative colitis often causes a client to have multiple blood stools that accompanied by abdominal cramping. This is an expected finding.

✓ Following a tonsillectomy, the nurse should discourage coughing as this may stress the operative site and lead to hemorrhage

✓ Nausea and vomiting following a tonsillectomy should be promptly treated to prevent stress to the operative that may lead to hemorrhage