参考答案：D

解析：Although all of these options are appropriate postoperative goals, maintaining a patent airway takes priority, especially on the first postoperative day. A laryngectomy tube is most likely to be in place, and suctioning is commonly needed to clear secretions. Edema and hematoma formation at the surgical site also can increase the risk of a blocked airway. Communicating by use of esophageal speech and attaining optimal level of nutrition are important hut wouldn’t take priority on the first postoperative day. Improving body image is a long-term goal.