The nurse is caring for the client who has dysphagia following an ischemic stroke. The client is ordered a pureed diet starting today. Which intervention would be appropriate for this client?
Delegate the feeding to the nursing student.
Place the food on the affected side of the mouth.
Keep the television off while feeding the client.
Ensure the client's head of the bed is less than 30 degrees.
The Correct Answer is C
A. While the nursing student may assist with feeding, the nurse should always assess the client's swallowing ability and provide direct supervision to ensure the client's safety.
B. Placing food on the affected side of the mouth can increase the risk of aspiration. The food should be placed on the unaffected side of the mouth.
C. Distractions can impair the client's ability to focus on swallowing and increase the risk of aspiration. A quiet environment can help the client concentrate on eating.
D. The head of the bed should be elevated to at least 30 degrees during and after feeding to reduce the risk of aspiration.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. While applying heat may help alleviate discomfort, it is not the primary recommendation for managing epididymitis. The treatment often involves rest, elevation of the scrotum, and possibly cold packs rather than heat. Therefore, while this statement may reflect some understanding, it is not the best indicator of comprehensive knowledge about managing epididymitis.
B. While some mild cases may improve spontaneously, most cases of epididymitis require treatment, especially if they are caused by infections, which are common. Untreated epididymitis can lead to complications, so this statement does not reflect an accurate understanding of the condition.
C. If epididymitis is caused by a sexually transmitted infection (STI), it is important that sexual partners be evaluated and treated as well to prevent reinfection. This indicates a proper understanding of the implications of the condition, particularly in the context of STIs.
D. It seems to reference concerns related to radiation therapy, which is unrelated to the management or understanding of epididymitis. This indicates a lack of focus on the current diagnosis and its implications.
Correct Answer is A
Explanation
A. Asking yes or no questions can help facilitate communication, as they require less verbal output from the client and can help the nurse understand the client’s needs or thoughts without overwhelming them
B. This option is somewhat useful, as practicing words can help the client regain some verbal skills. However, it may not be the most effective immediate intervention. Clients with expressive aphasia often struggle to produce speech rather than understand it, and they may not benefit as much from this approach without additional support from speech therapy.
C. This intervention is not beneficial for improving communication. Tracking time spent speaking could create additional pressure on the client and may contribute to frustration rather than facilitate communication. It does not address the underlying issue of expressive aphasia.
D. This is not an appropriate intervention. Changing the subject can confuse or frustrate the client further, making it more difficult for them to communicate. It does not support their efforts to express themselves and may discourage them from trying to communicate altogether.
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