Nokea
A client has acute dysphagia. Which of the following nursing interventions should be included in the plan of care?
- A. Providing a straw for consumption of liquids
- B. Encouraging larger bites
- C. Placing the client in semi-Fowler's position during meals
- D. Instructing the client to tilt head forward when swallowing
Correct Answer: C
Rationale: Placing the client in semi-Fowler's position during meals is the correct intervention for a client with acute dysphagia. This position helps prevent aspiration by facilitating swallowing. Providing a straw for consumption of liquids (Choice A) can increase the risk of aspiration and is not recommended for clients with dysphagia. Encouraging larger bites (Choice B) can also increase the risk of choking and aspiration. Instructing the client to tilt the head forward when swallowing (Choice D) is not the recommended technique for managing dysphagia as it does not address the underlying issue effectively.
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A nurse is providing teaching to the parent of an infant about introducing solid foods. The nurse should recommend that which of the following foods be introduced first?
- A. Strained fruits
- B. Pureed meats
- C. Cooked egg whites
- D. Iron-fortified cereal
Correct Answer: D
Rationale: When introducing solid foods to infants, it is recommended to start with iron-fortified cereal as it is easily digestible and a good source of iron, an important nutrient for infants around 6 months of age. Strained fruits are usually introduced later due to their natural sugars. Pureed meats can be introduced after iron-fortified cereals to provide additional protein and iron. Cooked egg whites should be avoided until the infant is at least one year old to reduce the risk of allergies.
A nurse is providing teaching to a client with gastroesophageal reflux. Which of the following statements by the client indicates a need for further teaching?
- A. I should elevate the head of my bed while sleeping.
- B. I drink no more than 4 cups of coffee a day.
- C. I take my time when I am eating.
- D. I avoid foods and drinks made with chocolate.
Correct Answer: B
Rationale: The correct answer is B: 'I drink no more than 4 cups of coffee a day.' Excessive coffee consumption can aggravate gastroesophageal reflux due to its acidic nature. Choices A, C, and D are all appropriate self-care measures for managing gastroesophageal reflux. Elevating the head of the bed while sleeping helps prevent acid reflux, eating slowly can reduce reflux episodes, and avoiding trigger foods like chocolate can help alleviate symptoms.
A client is being taught about foods to include in a low-fiber diet. Which statement indicates the client understands the teaching?
- A. "A fresh pear would be a good snack option."?
- B. "I can prepare refried beans for supper."?
- C. "Bran cereal would be a good breakfast choice."?
- D. "I should choose white rice as a side dish."?
Correct Answer: D
Rationale: The correct answer is "I should choose white rice as a side dish." In a low-fiber diet, foods that are low in fiber are recommended to reduce gastrointestinal irritation. White rice is a low-fiber option suitable for this diet. Choices A, B, and C are high-fiber options and not suitable for a low-fiber diet. A fresh pear, refried beans, and bran cereal are all high in fiber, which should be avoided in a low-fiber diet.
A nurse is caring for a client who has cancer and is receiving total parenteral nutrition (TPN). Which of the following lab values indicates the treatment is effective?
- A. Hct 43%
- B. WBC 8,000/uL
- C. Albumin 4.2 g/dL
- D. Calcium 9.4 mg/dL
Correct Answer: C
Rationale: The correct answer is Albumin 4.2 g/dL. Albumin is a protein produced by the liver and is a key indicator of nutritional status. In a client receiving total parenteral nutrition (TPN), an increase in albumin level indicates that the treatment is effective in providing adequate nutrition support. Hct (hematocrit), WBC (white blood cell count), and calcium levels are not direct indicators of the effectiveness of TPN in this context.
A nurse is caring for a client who is to receive a mechanically altered diet. Which of the following client food choices necessitates intervention by the nurse?
- A. Scrambled eggs
- B. Cottage cheese
- C. Piece of wheat toast
- D. Sliced banana
Correct Answer: D
Rationale: The correct answer is 'Sliced banana.' A mechanically altered diet is designed for clients who have difficulty chewing or swallowing. Sliced bananas, due to their texture and potential choking hazard for clients with swallowing difficulties, would necessitate intervention by the nurse. Scrambled eggs, cottage cheese, and a piece of wheat toast are softer and safer options for clients on a mechanically altered diet, making them appropriate choices.