Which of the following items on the tray should the nurse remove?
Vanilla pudding.
Cranberry juice.
Beef broth.
Orange gelatin.
Correct Answer : A,D
Choice A rationale
Vanilla pudding is often restricted in dysphagia diets due to its smooth, slippery texture, which can be difficult to control in the oral cavity and increases the risk of aspiration into the airway. Individuals with dysphagia may have impaired swallowing mechanisms, making thin, liquid-like consistencies particularly hazardous.
Choice B rationale
Cranberry juice is a thin liquid and poses a significant aspiration risk for a patient with dysphagia. Thin liquids are difficult to manage in the mouth and throat, increasing the likelihood of the liquid entering the trachea instead of the esophagus. Patients with swallowing difficulties often require thickened liquids to improve bolus control.
Choice C rationale
Beef broth is a clear liquid and, similar to cranberry juice, presents a high risk of aspiration for a patient with dysphagia. Its thin consistency makes it challenging for individuals with impaired swallowing to control its movement, potentially leading to it entering the airway and causing respiratory complications.
Choice D rationale
Orange gelatin, while seemingly semi-solid, often melts into a thin liquid in the mouth due to body temperature. This change in consistency makes it difficult to control and increases the risk of aspiration in patients with dysphagia. Gelatin's slippery texture further compounds this risk.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Securing the tube and retesting the pH in one hour is insufficient to confirm correct placement. While a pH of 3 suggests gastric placement (normal gastric pH is typically 1.5 to 3.5), it doesn't definitively rule out placement in the respiratory tract or intestines, as these can occasionally have acidic pH levels. Delaying definitive confirmation could lead to serious complications if the tube is misplaced.
Choice B rationale
Inserting the tube an additional 1-2 inches and retesting the pH is not a reliable method for confirming placement. Advancing the tube further without radiographic confirmation could increase the risk of trauma to the gastrointestinal tract or even pulmonary aspiration if the initial placement was incorrect. pH testing alone is not conclusive.
Choice C rationale
Auscultating for the "swoosh" of air while injecting air into the NG tube is an outdated and unreliable method for confirming placement. The sound can be misleading and may be heard even if the tube is incorrectly positioned in the esophagus or lungs. This method does not provide definitive proof of gastric placement and poses a risk of aspiration.
Choice D rationale
Obtaining an x-ray is the gold standard for confirming nasogastric tube placement. Radiographic imaging allows for direct visualization of the tube's trajectory and ensures that the distal tip is correctly positioned in the stomach or duodenum. This method provides the most accurate and reliable confirmation, minimizing the risk of complications such as aspiration or misadministration of feedings and medications.
Correct Answer is A
Explanation
Choice A rationale
Dried beans, such as lentils, kidney beans, and chickpeas, are excellent sources of plant-based protein. They contain a significant amount of amino acids, which are the building blocks of protein, making them a valuable addition to a vegetarian toddler's diet to support growth and development.
Choice B rationale
Cooked carrots are primarily a source of vitamins, particularly beta-carotene (a precursor to vitamin A), and fiber. They contain minimal amounts of protein and are not the best choice for increasing dietary protein intake in a vegetarian toddler.
Choice C rationale
Sliced bananas are a good source of carbohydrates, potassium, and some vitamins. However, they are low in protein and would not significantly contribute to increasing the dietary protein intake of a vegetarian toddler.
Choice D rationale
Whole wheat bread contains some protein, but it is not as concentrated a source as dried beans. While whole grains are important for fiber and overall nutrition, dried beans offer a higher protein content per serving, making them a better choice for increasing protein intake.
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