A nurse is planning care for a client who reports increasing difficulty swallowing food. Which of the following interventions should the nurse plan to take?

Instruct the client to lie down after a meal.

Encourage the client to rest prior to mealtimes.

Turn on the client's television during meals.

Place the client into a semi-reclined position for meals.

Answer and Explanation

The Correct Answer is B

A. Instruct the client to lie down after a meal: Lying down after meals increases the risk of aspiration in clients with difficulty swallowing. It impairs gravity-assisted esophageal emptying and allows food or liquids to reflux, increasing the chance of choking or aspiration pneumonia.
B. Encourage the client to rest prior to mealtimes: Resting before meals conserves the client's energy, allowing them to focus on eating slowly and carefully, which promotes safer swallowing. Fatigue increases the risk of aspiration because muscle coordination during swallowing becomes impaired.
C. Turn on the client's television during meals: Turning on the television is a distraction that can reduce the client’s attention during chewing and swallowing. This lack of focus increases the risk of aspiration or choking, especially in clients with dysphagia.
D. Place the client into a semi-reclined position for meals: A semi-reclined position may hinder proper swallowing mechanics and promote aspiration. Clients with swallowing difficulty should ideally be in an upright 90-degree sitting position to reduce aspiration risk during meals.

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Correct Answer is C

Explanation

A. "You are experiencing gastric retention due to total parenteral therapy.": Gastric retention is not a typical effect of TPN, which bypasses the gastrointestinal tract. Since nutrients are delivered directly into the bloodstream, it is unrelated to gastric motility or retention issues.
B. "You are not consuming enough dietary fiber.": Clients receiving total parenteral nutrition are usually not consuming food orally, so fiber intake is not relevant. Diarrhea in these clients is more likely linked to the composition or administration of the TPN solution.
C. "Your total parenteral therapy solution was too cold during administration.": Administering a cold TPN solution can irritate the gastrointestinal system and stimulate peristalsis, leading to diarrhea. Warming the solution to room temperature prior to administration can help prevent this adverse effect.
D. "You have had inadequate fluid intake.": TPN solutions contain fluids and electrolytes, and clients receiving them typically have carefully regulated intake. Dehydration is unlikely to be the cause of diarrhea in this context, and other factors should be considered first.

A. "I use soup broth instead of butter to flavor food." B. "I have started cooking most of my meals." C. "I eat cheese cubes and crackers as snack." D. "I add canned vegetables to my homemade soup."

Correct Answer is A

Explanation

A. "I use soup broth instead of butter to flavor food.": This reflects a positive dietary change aimed at reducing saturated fat and sodium intake, both important in managing hypertension. Using broth adds flavor without the added fat and calories of butter, supporting heart health.
B. "I have started cooking most of my meals.": While home-cooked meals can promote healthier eating, the nutritional value depends on the ingredients and methods used. This statement alone does not confirm whether low-sodium or low-fat cooking practices are being followed.
C. "I eat cheese cubes and crackers as snack.": Cheese and many crackers are high in sodium and saturated fats, which can worsen hypertension. This snack choice suggests the client has not yet adopted heart-healthy dietary practices recommended during counseling.
D. "I add canned vegetables to my homemade soup.": Canned vegetables often contain high amounts of sodium unless labeled low-sodium or rinsed before use. Including them without modifications could increase salt intake and negatively affect blood pressure management.

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A nurse is planning care for a client who reports increasing difficulty swallowing food. Which of the following interventions should the nurse plan to take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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