A client experiences impaired swallowing after a stroke and has worked with speech-language pathology on eating. What nursing assessment best indicates that the expected outcome for this problem has been met?

Gains 2 lbs (1 kg) after 1 week.

Chooses preferred items from the menu.

Clearly understands and articulates.

Eats 75 to 100% of all meals and snacks.

Answer and Explanation

The Correct Answer is J

Choice A Reason:

Gaining weight can be an indicator of improved nutrition, but it does not directly address the client’s ability to swallow safely and effectively. Weight gain could be due to other factors such as fluid retention or changes in metabolism. Therefore, while it is a positive outcome, it is not the best indicator of improved swallowing function.

Choice B Reason:

Choosing preferred items from the menu indicates that the client is engaged in their meal planning and has an appetite. However, it does not directly measure the client’s ability to swallow safely. The client might still have difficulty swallowing even if they are choosing their preferred foods.

Choice C Reason:

Clear understanding and articulation are important for communication and can indicate cognitive improvement. However, this choice does not directly relate to the client’s swallowing ability. The primary concern in this scenario is the client’s ability to swallow safely, not their communication skills.

Choice D Reason:

Eating 75 to 100% of all meals and snacks is the best indicator that the client has improved their swallowing ability. This choice directly measures the client’s ability to consume food and liquids safely and effectively. It shows that the client can manage their meals without significant difficulty, which is the primary goal of the intervention.

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Correct Answer is A

Explanation

Choice A Reason:

Occasional palpitations are a common symptom of supraventricular tachycardia (SVT) with a non-sustained ventricular response. Palpitations are sensations of a rapid, fluttering, or pounding heartbeat, which occur due to the irregular and fast heart rate characteristic of SVT. These palpitations can be intermittent and may vary in intensity, often causing discomfort and anxiety in patients.

Choice B Reason:

Weakness can be associated with SVT, but it is not as specific or common as palpitations. Weakness may occur due to the reduced cardiac output and decreased perfusion to the muscles during episodes of rapid heart rate. However, it is not the primary symptom that nurses would anticipate in patients with SVT.

Choice C Reason:

Shortness of breath is another symptom that can occur with SVT, especially during prolonged episodes. The rapid heart rate can lead to decreased efficiency in blood circulation, causing the patient to feel breathless. While shortness of breath is a significant symptom, palpitations are more directly associated with the diagnosis of SVT.

A. Decreased thyroxine (T4) level. B. Decreased triiodothyronine (T3) level. C. Decreased thyroid-stimulating immunoglobulins (TSI) percentage. D. Decreased thyroid-stimulating hormone (TSH) level.

Correct Answer is D

Explanation

Choice A Reason:

A decreased thyroxine (T4) level is not expected in a client with Graves’ disease. Graves’ disease is an autoimmune disorder that leads to hyperthyroidism, where the thyroid gland produces excessive amounts of thyroid hormones, including T4. Therefore, the T4 level is typically elevated, not decreased.

Choice B Reason:

Similarly, a decreased triiodothyronine (T3) level is not expected in Graves’ disease. Like T4, T3 levels are usually elevated due to the overactive thyroid gland. T3 is the active form of thyroid hormone and is often increased in hyperthyroid conditions.

Choice C Reason:

Decreased thyroid-stimulating immunoglobulins (TSI) percentage is incorrect. In Graves’ disease, TSI levels are elevated because these antibodies stimulate the thyroid gland to produce more thyroid hormones. TSI mimics the action of TSH, leading to increased production of T3 and T4.

Choice D Reason:

Decreased thyroid-stimulating hormone (TSH) level is the correct answer. In Graves’ disease, the excessive thyroid hormones (T3 and T4) exert negative feedback on the pituitary gland, leading to suppressed TSH production. Therefore, TSH levels are typically low in patients with Graves’ disease.

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A client experiences impaired swallowing after a stroke and has worked with speech-language pathology on eating. What nursing assessment best indicates that the expected outcome for this problem has been met?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which symptom will the nurse anticipate in a patient diagnosed with supraventricular tachycardia (SVT) with a non-sustained ventricular response?

Correct Answer is A

Explanation

A nurse is assessing a client who has Graves’ disease. The nurse should expect which of the following laboratory results?

Correct Answer is D

Explanation

The nurse is caring for a client who had a hemorrhagic stroke. Which assessment finding is the earliest sign of increasing intracranial pressure (ICP) for this client?

The nurse is planning health teaching for a client starting on donepezil for Alzheimer’s disease (AD). For which side effect will the nurse teach the family to monitor?

A client has been admitted with new-onset status epilepticus. Which seizure precautions would the nurse implement? (Select all that apply.)

A postoperative client following a thyroidectomy suddenly develops difficulty breathing, stridor, and an increase in swelling of the anterior neck area. What should the nurse do first?

The nurse is caring for a client recovering from an esophagogastroduodenoscopy (EGD). Which of the following client symptoms would require further nursing assessment?

The provider writes an order for a client to have a chest tube removed. Which of the following are appropriate reasons to discontinue a chest tube? Select all that apply.

You are caring for a client in the ED with B/P 254/139 mm Hg. Which of the following actions would you take first?

The nurse is taking care of a 60-year-old client with constant bubbling in the water seal chamber. The nurse knows that constant bubbling in the water seal of a chest drainage system indicates which problem?