A client with a neurological disorder has difficulty swallowing. The nurse should take special care with the client’s diet because of a potential risk of imbalanced nutrition. Which measure may be taken by the nurse to ensure that the client’s diet allows for easy swallowing?

Offer liquids frequently, in large quantities

Allow optimum physical activity before meals to expedite digestion

Help the client sit upright when eating and feed slowly

Instruct the client to lie on the bed when eating

Answer and Explanation

The Correct Answer is C

Reasoning:

Choice A reason: Offering large quantities of liquids frequently increases aspiration risk in clients with dysphagia from neurological disorders. Large volumes can overwhelm swallowing mechanisms, leading to choking or pneumonia. Controlled, small sips with proper positioning are safer to ensure nutrition without compromising airway safety.

Choice B reason: Allowing physical activity before meals may improve appetite but does not address swallowing difficulties. Activity does not facilitate safe swallowing in neurological disorders, where muscle coordination is impaired. Proper positioning and pacing during feeding are more effective to prevent aspiration and ensure nutritional intake.

Choice C reason: Helping the client sit upright and feeding slowly minimizes aspiration risk in neurological dysphagia. Upright positioning aligns the airway to prevent food or liquid entry, and slow feeding allows better coordination of swallowing muscles, reducing choking and ensuring adequate nutrition, critical for safe intake.

Choice D reason: Instructing the client to lie down while eating is dangerous in dysphagia, as it increases aspiration risk. Lying down allows food or liquids to enter the airway, potentially causing pneumonia. Upright positioning is essential to facilitate safe swallowing and prevent complications in neurological disorders.

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Correct Answer is B

Explanation

Reasoning:

Choice A reason: Hair loss may not significantly decline with successful Cushing’s syndrome treatment. Excess cortisol causes hirsutism or hair thinning due to androgen excess or protein catabolism. Treatment reduces cortisol, but hair changes may persist due to slow hair growth cycles or irreversible follicular damage.

Choice B reason: Successful treatment of Cushing’s syndrome lowers serum glucose levels. Excess cortisol induces insulin resistance and gluconeogenesis, causing hyperglycemia. Reducing cortisol through treatment (e.g., surgery or medication) restores insulin sensitivity and reduces glucose production, normalizing blood sugar levels, a key indicator of effective management.

Choice C reason: Bone demineralization may not decline quickly with treatment. Chronic cortisol excess inhibits osteoblast activity and calcium absorption, causing osteoporosis. While treatment halts further bone loss, reversal is slow due to the time required for bone remodeling, making this less immediate than glucose normalization.

Choice D reason: Menstrual flow may not immediately increase with treatment. Cortisol excess disrupts gonadotropin release, causing amenorrhea. Restoring normal cortisol levels may improve menstrual cycles, but hormonal recovery is gradual, and changes in flow are less immediate or reliable than glucose level declines as a treatment outcome.

A. Consume adequate amounts of fluid B. Come to the clinic for IV fluid therapy daily C. Limit the fluid intake at night D. Weigh themselves daily

Correct Answer is A

Explanation

Reasoning:

Choice A reason: Consuming adequate fluids is essential in diabetes insipidus to replace the large volumes of water lost through polyuria due to ADH deficiency. Adequate hydration prevents dehydration, maintains electrolyte balance, and alleviates excessive thirst, supporting the body’s compensatory mechanisms to manage the high urine output characteristic of this condition.

Choice B reason: Daily IV fluid therapy is not a practical or necessary intervention for diabetes insipidus. While severe dehydration may require IV fluids, oral hydration is sufficient for most patients to manage polyuria. Regular clinic visits for IV therapy are invasive, costly, and not standard for controlling thirst or fluid loss.

Choice C reason: Limiting fluid intake at night is counterproductive in diabetes insipidus, as it exacerbates dehydration caused by excessive urine output. Patients need to maintain hydration to compensate for water loss and reduce thirst. Restricting fluids could worsen symptoms and lead to complications like hypernatremia or hypovolemia.

Choice D reason: Daily weighing monitors fluid status but does not directly control thirst or compensate for urine loss in diabetes insipidus. While useful for assessing treatment response, it is a passive measure and does not address the active need to replace fluid losses through adequate oral intake to manage symptoms.

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A client with a neurological disorder has difficulty swallowing. The nurse should take special care with the client’s diet because of a potential risk of imbalanced nutrition. Which measure may be taken by the nurse to ensure that the client’s diet allows for easy swallowing?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is being successfully treated for Cushing's syndrome. The nurse should expect a decline in:

Correct Answer is B

Explanation

What interventions can the nurse encourage the client with diabetes insipidus to implement to control thirst and compensate for urine loss?

Correct Answer is A

Explanation

The nurse is planning care for a client diagnosed with immune thrombocytopenia. Which nursing intervention should be included in the plan of care?

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Which disorder is characterized by a group of symptoms produced by an excess of free circulating cortisol from the adrenal cortex?

A client is brought to the emergency department with symptoms of a cerebrovascular accident (CVA). The nurse would anticipate which diagnostic evaluation to be completed prior to initiation of treatment?

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