A client who had a cerebrovascular accident is assessed by a speech therapist after choking and having difficulty swallowing. Which of the following would be appropriate for the nurse to recommend?
Steak
Iced tea
Grapes
Mashed potatoes
The Correct Answer is D
Choice A reason: Steak, a solid, requires chewing and swallowing coordination, risking aspiration in dysphagia post-CVA due to impaired pharyngeal muscle control.
Choice B reason: Iced tea, a thin liquid, flows quickly, increasing aspiration risk in CVA patients with weakened swallow reflexes, unable to manage thin consistencies safely.
Choice C reason: Grapes, small and round, pose choking and aspiration hazards in dysphagia, as they require intact bolus control, often compromised post-stroke.
Choice D reason: Mashed potatoes, soft and thick, are easier to swallow, reducing aspiration risk in dysphagia post-CVA, aligning with thickened consistency recommendations.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: ESRD impairs fluid excretion, causing hypervolemia, leading to edema, crackles from pulmonary fluid, and hypertension from increased vascular volume, matching these symptoms.
Choice B reason: Hypovolemia, low fluid volume, causes hypotension and dry tissues, not swelling, crackles, or high blood pressure, which indicate excess fluid, not deficit.
Choice C reason: Hyperkalemia elevates potassium, causing arrhythmias or muscle issues, not directly linked to crackles, edema, or hypertension, which are fluid-related in ESRD.
Choice D reason: Hyponatremia, low sodium, may cause neurological symptoms, but crackles, edema, and hypertension point to fluid overload, not sodium imbalance primarily.
Correct Answer is ["B"]
Explanation
Choice A reason: Calcium carbonate supplements increase serum calcium by providing exogenous calcium, worsening hyperparathyroidism’s already elevated levels from excessive PTH-driven bone resorption and gut absorption.
Choice B reason: A low calcium diet reduces intake, limiting absorption, while high fiber binds calcium in the gut, enhancing fecal excretion, countering PTH’s hypercalcemic effect in hyperparathyroidism.
Choice C reason: Parathyroidectomy removes overactive glands, directly stopping excessive PTH production, which drives calcium release from bones and reabsorption in kidneys, effectively normalizing calcium levels.
Choice D reason: Furosemide, a loop diuretic, increases renal calcium excretion by inhibiting reabsorption in the loop of Henle, reducing serum calcium elevated by PTH in hyperparathyroidism.
Choice E reason: Fluid restriction raises calcium concentration by reducing dilution, worsening hypercalcemia in hyperparathyroidism, where PTH already increases calcium reabsorption, making this counterproductive.
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