A nurse is caring for a client who had a stroke and has manifestations of dysphagia. Which of the following interventions should the nurse take?
Use liquids to clear food from the client's mouth.
Tilt the client's head backwards to facilitate swallowing.
Add a thickening agent to liquids.
Place the client in a semi-Fowler's position.
The Correct Answer is C
Choice A reason: Using liquids to clear food from the client's mouth is not a safe intervention for dysphagia. Liquids can easily enter the airway and cause aspiration, which is the inhalation of food or fluids into the lungs. Aspiration can lead to pneumonia, respiratory distress, and death.
Choice B reason: Tilting the client's head backwards to facilitate swallowing is not a safe intervention for dysphagia. This position can also increase the risk of aspiration, as it opens the airway and allows food or fluids to flow into it.
Choice C reason: Adding a thickening agent to liquids is a safe and effective intervention for dysphagia. Thickened liquids are easier to swallow and control, as they move more slowly through the mouth and throat. They also reduce the risk of aspiration, as they are less likely to enter the airway.
Choice D reason: Placing the client in a semi-Fowler's position is not a safe intervention for dysphagia. This position can also increase the risk of aspiration, as it lowers the head and neck and reduces the closure of the airway. A better position for dysphagia is upright or high-Fowler's, which elevates the head and neck and enhances the closure of the airway.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: 1 slice of bread is equivalent to 1 oz of grains, not protein. Bread is a good source of carbohydrates, fiber, and B vitamins, but it does not provide enough protein for a toddler.
Choice B reason: 1 scrambled egg is equivalent to 1 oz of protein. Egg is a complete protein, meaning it contains all nine essential amino acids that the body cannot make. Egg is also a good source of iron, choline, and vitamin D.
Choice C reason: 1/2 cup peas is equivalent to 1/2 oz of protein and 1/2 cup of vegetables. Peas are an incomplete protein, meaning they lack some essential amino acids. Peas are also a good source of fiber, vitamin C, and folate.
Choice D reason: 2 tbsp peanut butter is equivalent to 2 oz of protein. Peanut butter is an incomplete protein, but it can be combined with bread or crackers to form a complete protein. Peanut butter is also a good source of fat, magnesium, and niacin.
Correct Answer is D
Explanation
Choice A reason: Soaking fruits in water before peeling them is not a good practice for retaining nutrients because it can cause water-soluble vitamins, such as vitamin C and B-complex vitamins, to leach out into the water. It is better to wash fruits briefly under running water and peel them as thinly as possible.
Choice B reason: Cooking vegetables for the week and reheating them at each meal is not a good practice for retaining nutrients because it can cause nutrient losses due to exposure to heat, light, air, and water. It is better to cook vegetables as close to the time of consumption as possible and use minimal water and cooking time.
Choice C reason: Boiling vegetables on the stove until they are soft is not a good practice for retaining nutrients because it can cause significant nutrient losses due to high temperature and long cooking time. It is better to steam, microwave, or stir-fry vegetables until they are crisp-tender and retain their color and texture.
Choice D reason: Keeping ripe fruits refrigerated until eating them is a good practice for retaining nutrients because it can slow down the ripening process and prevent spoilage. Refrigeration can preserve the freshness, flavor, and nutritional value of fruits. However, some fruits, such as bananas, tomatoes, and avocados, should not be refrigerated because they can lose their quality and taste.
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