A nurse notices smoke coming from a client's room and discovers a fire in the wastebasket.
After moving the client to safety, which of the following is the priority action?

Notify the facility operator.

Close the fire doors on the unit.

Turn off oxygen sources.

Put out the fire with the appropriate extinguisher.

Answer and Explanation

The Correct Answer is C

A. Notifying the facility operator is important, but it is not the immediate priority when there is a fire endangering the client's safety.

B. While closing fire doors can help contain the fire, it is not the priority action after ensuring the client's immediate safety.

C. Turning off oxygen sources is crucial because oxygen can fuel the fire and cause it to spread rapidly. This action helps prevent the fire from worsening.

D. Putting out the fire with the appropriate extinguisher is important, but it comes after ensuring the fire's fuel source is cut off to prevent further escalation of the fire.

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Correct Answer is C

Explanation

A: Tucking the chin while swallowing can actually help prevent aspiration in clients with dysphagia, as it narrows the tracheal opening and helps direct food away from the airway.

B: Sitting upright during meals is a recommended practice to reduce the risk of aspiration. It allows gravity to assist with the movement of food, reducing the likelihood of it entering the airway.

C: Pocketing food on one side of the mouth can be a sign of reduced sensation or motor control on that side, often a result of a stroke. This can lead to unnoticed accumulation of food which may then be aspirated.

D: A cough reflex is a protective mechanism against aspiration. If food enters the airway, the cough reflex should trigger, helping to expel the food from the airway and prevent aspiration.

A. "You looked like you would be the most likely to talk back with me." B. "Let's go see what activities are going on outside." C. "Why shouldn't I talk to you? You looked lonely." D. "You're curious why I am interested in you and not the others?"

Correct Answer is D

Explanation

A. This response does not address the adolescent's underlying question and may come across as dismissive.

B. This response avoids addressing the adolescent's question and suggests changing the subject.

C. This response is somewhat confrontational and does not explore the adolescent's feelings or concerns.

D. This response acknowledges the adolescent's curiosity and opens the door for further discussion about why the nurse chose to engage with them. It invites the adolescent to explore their feelings and thoughts.

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A nurse notices smoke coming from a client's room and discovers a fire in the wastebasket.After moving the client to safety, which of the following is the priority action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who experienced a stroke and has dysphagia. Which of the following findings should indicate to the nurse the client is at risk for aspiration?

Correct Answer is C

Explanation

Correct Answer is D

Explanation

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A nurse notices smoke coming from a client's room and discovers a fire in the wastebasket.
After moving the client to safety, which of the following is the priority action?