A nurse is supervising an assistive personnel (AP) who is feeding a client who has dysphagia.Which of the following actions by the AP should the nurse identify as correct technique?

Providing a 10 min rest period prior to meals

Elevating the head of the client's bed to 30° during mealtime

Withholding fluids until the end of the meal

Instructing the client to place her chin toward her chest when swallowing

Answer and Explanation

The Correct Answer is B

A: Providing a 10-minute rest period prior to meals can be beneficial for some clients, but it is not specifically related to the prevention of aspiration in clients with dysphagia. Rest periods do not directly facilitate safer swallowing processes.

B: Elevating the head of the client's bed to 30° during mealtime is the correct technique for a client with dysphagia. This position helps prevent aspiration, which can occur if food or liquids enter the lungs instead of going down the esophagus. The semi-upright position aids in the proper alignment of the esophagus and reduces the risk of choking.

C: Withholding fluids until the end of the meal is not an appropriate technique for a client with dysphagia. Fluids are often needed to help swallow and clear the mouth of food particles. Additionally, providing fluids throughout the meal can help prevent dehydration.

D: Instructing the client to place her chin toward her chest when swallowing can help prevent aspiration in clients with dysphagia. However, this technique should be used in conjunction with other methods, such as the correct positioning of the bed, to ensure safety and effectiveness.

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Correct Answer is C

Explanation

A. Contacting the provider may be part of the process, but it does not directly address the conflict between the family members' wishes and the health care surrogate's legal authority.
B. While the ethics committee can be a valuable resource in resolving disputes, it is not the first step in this situation, as the health care surrogate has the legal right to make decisions on behalf of the unconscious client.
C. The health care surrogate is legally designated to make health care decisions for the client when they are unable to do so themselves. This includes decisions about life-sustaining treatments such as a feeding tube.
D. Reviewing the client's advance directives is important, but it does not supersede the authority of the health care surrogate unless the directives explicitly limit the surrogate's decision-making power.

A. Ask the client if she would like a sedative to help her relax. B. Inform the client that she cannot leave without a discharge prescription from the provider. C. Assign a security officer to the client's room until the provider can speak with the client. D. Have the client sign the Against Medical Advice form.

Correct Answer is B

Explanation

A. Offering a sedative might not address the situation appropriately; the client's decision to leave needs to be managed through proper channels.
B. Informing the client about the discharge process and the requirement of a discharge prescription from the provider is appropriate and educates the client on the necessary steps.
C. Assigning a security officer might not be necessary unless there are safety concerns or imminent risks.
D. Having the client sign the Against Medical Advice (AMA) form might be necessary if the client insists on leaving against medical advice, but explaining the proper discharge process should be attempted first.

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A nurse is supervising an assistive personnel (AP) who is feeding a client who has dysphagia.Which of the following actions by the AP should the nurse identify as correct technique?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

A nurse is caring for a client who has been admitted and diagnosed with type 1 diabetes mellitus. The client tells the nurse she has decided to go home. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

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