A home health nurse is caring for an older adult client who reports. "I keep coughing when I try to swallow my food, but not at other times." Which of the following actions should the nurse take?

Instruct the client that this is due to increased salivary flow that occurs with aging

Encourage the client to increase fluid intake when the cough is present.

Recommend an antitussive 30 min prior to each meal

initiate a consultation with a speech-language pathologist

Answer and Explanation

The Correct Answer is D

Rationale:

A. Instruct the client that this is due to increased salivary flow that occurs with aging: While aging can affect swallowing, persistent coughing specifically during meals suggests dysphagia or aspiration risk, not just increased saliva. Dismissing it as normal aging could delay necessary evaluation and intervention.

B. Encourage the client to increase fluid intake when the cough is present: Increasing fluids without assessing swallowing ability could worsen aspiration risk. Proper evaluation of swallowing mechanics is necessary before recommending fluid intake adjustments.

C. Recommend an antitussive 30 min prior to each meal: Suppressing the cough reflex can be dangerous in clients with swallowing difficulties, as the cough helps prevent aspiration. Using antitussives in this situation may increase the risk of choking or pneumonia.

D. Initiate a consultation with a speech-language pathologist: A speech-language pathologist can perform a swallowing assessment, identify aspiration risk, and recommend safe feeding strategies. Referral ensures proper evaluation and helps prevent complications such as aspiration pneumonia.

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Correct Answer is C

Explanation

Rationale:

A. Provide the child with electronics to watch movies: While distraction can be helpful in managing anxiety or discomfort, it does not directly address the child’s feelings about hair loss. Emotional support specific to the child’s concern is more appropriate in this situation.

B. Tell the child there's no need to cry because this is expected: Minimizing the child’s feelings invalidates their emotional experience and can increase distress. Acknowledging and supporting the child’s emotions is essential for coping during hair loss caused by radiation therapy.

C. Provide the child with a doll that does not have any hair: Giving a doll without hair helps the child normalize hair loss and provides a concrete way to express and cope with feelings. This action demonstrates understanding, empathy, and age-appropriate support for the child’s emotional needs.

D. Tell the child not to worry about their hair loss because their hair will grow back: While it is true that hair often regrows after treatment, reassurance alone does not address the child’s immediate emotional reaction. Supporting the child’s feelings and providing relatable coping strategies is more effective.

A. History of severe menorrhagia B. Desire to become pregnant in 1 to 2 years C. Takes antiretroviral therapy for HIV D. Report of unprotected sex in the past 24 hr

Correct Answer is A

Explanation

Rationale:

A. History of severe menorrhagia: A copper IUD can increase menstrual bleeding and cramping. Clients with a history of severe menorrhagia are at higher risk for exacerbated bleeding and anemia, making this a contraindication to IUD insertion. Alternative contraceptive methods should be considered for these clients.

B. Desire to become pregnant in 1 to 2 years: While the client’s future fertility plans may influence contraceptive choice, it is not a medical contraindication. The IUD can be removed at any time, allowing fertility to return quickly, so this does not preclude insertion.

C. Takes antiretroviral therapy for HIV: HIV infection or antiretroviral therapy is not a contraindication to IUD use. Clients with HIV can safely use intrauterine contraception, provided there are no active pelvic infections.

D. Report of unprotected sex in the past 24 hr: Recent unprotected intercourse is not a contraindication, but the nurse should assess the risk of pregnancy and consider emergency contraception if appropriate. It does not medically prevent IUD insertion.

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A home health nurse is caring for an older adult client who reports. "I keep coughing when I try to swallow my food, but not at other times." Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a 6-year-old child who is receiving radiation therapy. The child is crying because their hair is falling out. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

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