The unlicensed assistive personnel (UAP) is feeding a client with dysphagia. What action would cause the nurse to intervene?

Offering thickened liquids.

Placing client in upright position.

Providing large, frequent bites.

Allowing ample time between choices.

Answer and Explanation

The Correct Answer is C

This action would cause the nurse to intervene because it increases the risk of choking and aspiration for a client with dysphagia, which is difficulty swallowing. The nurse would instruct the UAP to feed the client small amounts of food slowly, allowing time for chewing and swallowing.

Choice A is wrong because offering thickened liquids is a safe practice for a client with dysphagia. Thickened liquids allow for easier swallowing and less choking, thus decreasing the chance of aspiration.

Choice B is wrong because placing the client in an upright position is also a safe practice for a client with dysphagia. This position helps prevent food from entering the airway and facilitates swallowing.

Choice D is wrong because allowing ample time between bites is another safe practice for a client with dysphagia. This helps the client avoid feeling rushed or overwhelmed and reduces the risk of aspiration.

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Correct Answer is D

Explanation

Take this medication at least 30 minutes before ingesting any food or medication.

This is because alendronate (Fosamax) is a bisphosphonate that works by inhibiting the breakdown and reabsorption of bone. However, it has a very low bioavailability, which means that only a small amount of the drug is absorbed into the bloodstream when taken orally. Therefore, taking it with food or other medications can interfere with its absorption and reduce its effectiveness.

The other choices are wrong because:

A. Chew the tablet well and report any difficulty swallowing. This is wrong because alendronate tablets should not be chewed or crushed, but swallowed whole with a full glass of plain water. Chewing or crushing the tablets can increase the risk of irritation or damage to the esophagus (the tube that connects the mouth to the stomach). Difficulty swallowing is a possible side effect of alendronate and should be reported to the doctor, but it is not an instruction for taking the medication.

B. Take the medication with six to eight ounces of milk. This is wrong because milk contains calcium, which can bind to alendronate and prevent its absorption. Alendronate should not be taken with any beverages other than plain water.

C. Lie down for 15 to 30 minutes after taking the medication. This is wrong because lying down after taking alendronate can increase the risk of esophageal irritation or

ulceration. Alendronate should be taken in the morning, at least 30 minutes before eating or drinking anything, and the person should remain upright (sitting or standing) for at least 30 minutes after taking it.

Normal ranges for bone density are expressed as T-scores, which compare a person’s bone density to that of a healthy young adult of the same sex. A T-score of -1.0 or above is normal, a T-score between -1.0 and -2.5 indicates low bone density (osteopenia), and a T-score of -2.5 or below indicates osteoporosis.

A. Maintain trust and avoid behaviors that may increase agitation. B. Order the client to go to their room & alert security. C. Tell the client to sit down or risk isolation and loss of privileges. D. Sedate the client after collecting a lithium level.

Correct Answer is A

Explanation

Maintain trust and avoid behaviors that may increase agitation. This is because the client is likely experiencing a manic episode, which is characterized by increased activity, rapid speech, and decreased need for sleep. The nurse should use a calm and supportive approach, provide a safe and structured environment, and avoid confrontation or criticism.

Choice B is wrong because ordering the client to go to their room and alerting security would escalate the situation and violate the client’s rights.

Choice C is wrong because telling the client to sit down or risk isolation and loss of privileges would be threatening and punitive, which could increase the client’s agitation and anger.

Choice D is wrong because sedating the client after collecting a lithium level would be premature and inappropriate without a physician’s order and without assessing the client’s vital signs, mental status, and medication history. Lithium is a mood stabilizer that can cause toxicity if the level is too high.

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The unlicensed assistive personnel (UAP) is feeding a client with dysphagia. What action would cause the nurse to intervene?

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