A charge nurse is observing a licensed practical nurse assist a client who has dysphagia while eating. Which of the following actions by the LPN should the charge nurse identify as providing safe care?

Places food on the stronger side of the client’s mouth

Positions the client at a 30 degree angle prior to eating

Instructs the client to hyperextend their neck when swallowing

Has the client sit upright for 20 min following meals

Answer and Explanation

The Correct Answer is A

A. Places food on the stronger side of the client’s mouth: Placing food on the stronger side of the mouth helps the client chew and swallow more effectively and safely. This compensates for weakness on one side, reducing the risk of choking and aspiration.

B. Positions the client at a 30-degree angle prior to eating: A 30-degree angle is insufficient to reduce the risk of aspiration in clients with dysphagia. The client should be positioned in an upright sitting position (90 degrees) to facilitate safer swallowing and reduce the risk of choking or aspirating food.

C. Instructs the client to hyperextend their neck when swallowing: Hyperextending the neck (tilting the head back) can actually increase the risk of aspiration by opening the airway, making it easier for food or liquids to enter the lungs. The client should be encouraged to tuck the chin slightly when swallowing to protect the airway.

D. Has the client sit upright for 20 minutes following meals: While sitting upright after meals is beneficial for preventing reflux and aspiration, 20 minutes is not sufficient. The client should remain upright for at least 30 minutes after meals to further reduce the risk of aspiration.

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Correct Answer is B

Explanation

a. A system for tracking client information:

Having a system for tracking client information is essential for effective disaster management, including during bioterrorism events. This system allows healthcare providers to monitor and manage the care of affected individuals, track exposure to biological agents, and coordinate response efforts. It facilitates communication and collaboration among healthcare teams and enables timely and accurate documentation of patient information, including symptoms, treatment, and outcomes.

b. A sufficient supply of personal protective equipment (PPE):

Personal protective equipment is critical in protecting healthcare workers and first responders from exposure to biological agents during a bioterrorism event. PPE includes items such as masks, gloves, gowns, and eye protection, which create a barrier between individuals and potentially hazardous substances. Having an adequate supply of PPE ensures that healthcare providers can safely care for affected individuals, minimize the risk of infection or contamination, and prevent the spread of disease within healthcare settings and the community.

c. A mental health specialist on the response team:

A mental health specialist plays a vital role in addressing the psychological and emotional needs of individuals affected by a bioterrorism event. Such events can cause fear, anxiety, trauma, and grief among survivors, healthcare workers, and the community. A mental health specialist provides support, counseling, and crisis intervention to help individuals cope with stress, trauma, and loss. They also assist in addressing psychosocial factors that may impact recovery and resilience, such as social support, coping mechanisms, and access to mental health services.

d. A network for communication between staff members and families:

Effective communication is essential for coordinating response efforts, disseminating information, and providing updates to staff members, patients, and their families during a bioterrorism event. A network for communication facilitates real-time communication and collaboration among healthcare teams, emergency responders, public health agencies, and community partners. It enables the sharing of critical information, such as situational updates, safety protocols, resource allocation, and instructions for affected individuals and their families. This communication network ensures that everyone receives timely and accurate information, reduces uncertainty and confusion, and enhances overall coordination and response effectiveness.

A. “A nurse can disclose information to a family member with the client’s permission.” B. “A nurse is responsible for informing clients about treatment options.” C. “A nurse can apply restraints on a PRN basis.” D. “A nurse can administer medications without consent to a client as part of a research study.”

Correct Answer is ["A"]

Explanation

A. Nurses are permitted to share a client’s information with family members only if the client grants permission. This aligns with the Health Insurance Portability and Accountability Act (HIPAA) and ensures the client’s right to privacy and confidentiality is upheld.

B.While nurses play a critical role in client education, it is the provider’s responsibility to explain treatment options, including risks, benefits, and alternatives. Nurses can reinforce this information and answer questions but are not the primary party responsible for obtaining informed consent.

C.Restraints must never be applied on a "PRN" (as needed) basis. They require a specific, time-limited order from a provider, and their use must be justified and continually reassessed. This ensures that client rights and safety are maintained.

D.Participation in a research study requires informed consent from the client. Administering medications without consent is a violation of the client’s rights and ethical standards, even in research settings.

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A charge nurse is observing a licensed practical nurse assist a client who has dysphagia while eating. Which of the following actions by the LPN should the charge nurse identify as providing safe care?

Nursing Test Bank

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