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.

Answer and Explanation

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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Correct Answer is A

Explanation

A. After a thyroidectomy and when receiving levothyroxine, it is essential for the patient to have regular follow-ups and blood tests (specifically TSH and free T4 levels) to ensure the dosage of levothyroxine is appropriate and to monitor for any complications related to the thyroid hormone levels.
B. Levothyroxine is a thyroid hormone replacement and, when taken appropriately, should help maintain a normal metabolism, potentially preventing weight gain. Weight changes can occur, but they are more likely to be due to improper dosing or underlying issues rather than a direct side effect of the medication itself.
C. Levothyroxine should be taken on an empty stomach, typically 30 to 60 minutes before breakfast, to ensure optimal absorption. Taking it with food can reduce its effectiveness.
D. While there are no strict dietary restrictions for most patients on levothyroxine, certain foods (such as those high in soy or fiber) can interfere with absorption if consumed around the time of taking the medication. Patients should be informed to take levothyroxine consistently and to wait a while before consuming certain foods that may impact absorption.

A. reduce the risk of blood vessel spasm. B. prevent platelet aggregation. C. dissolve the blood clot. D. prevent infection in the brain.

Correct Answer is C

Explanation

A. While blood vessel spasms can occur after a stroke, t-PA does not directly affect them.
B. Platelet aggregation is the process by which platelets stick together to form a clot. t-PA dissolves clots, but it does not prevent their formation.
C. Tissue plasminogen activator (t-PA) is a medication that can dissolve blood clots. In the case of a thrombotic stroke, a blood clot has blocked blood flow to the brain. By dissolving the clot, t-PA can restore blood flow and limit brain damage.
D. t-PA does not have any direct effect on the risk of infection in the brain.

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Blood Cell	Normal Ranges
Red blood cells (mature, circulating)	Male 4.51-6.01 million/mm3 Female: 4.01-5.51 million/mm3
Hemoglobin	Adult (15-64 yr) Male 14-17.3 g/dL Female 11.7-15.5 g/dL
Hematocrit	42% -52% in males 36% -48% in females
Reticulocytes	0.5% -2.5% of total RBC count
White blood cells (total)	4.5-11.1 103/mm3
Neutrophils	59% Bands 3% Segs-56%
Eosinophils	2.7%
Basophils	0.5%
Lymphocytes	34%
Monocytes	4%
Platelets	150,000-450,000/mm3

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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following statements should the nurse include in the postoperative teaching for a patient diagnosed with thyroid cancer who had a thyroidectomy and is receiving levothyroxine?

Correct Answer is A

Explanation

The nurse is caring for a client who had a thrombotic stroke in the Emergency Department. It has been less than 3 hours since the onset of symptoms. The rationale for using tissue plasminogen activator (t-PA) for this client is to:

Correct Answer is C

Explanation

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