A nurse in a long-term care facility is caring for a client who reports the assistive personnel repositioned him in bed using excessive force. Which of the following actions should the nurse take?

Contact the nurse manager.

Call risk management to interview the client.

Reassure the client that the staff is well trained.

Document in the client's chart that an incident report has been filed.

Answer and Explanation

The Correct Answer is A

A.   Contacting the nurse manager allows for immediate notification of the incident to someone in authority who can initiate appropriate follow-up and investigation.
B.   Involving risk management might be necessary but should come after informing the immediate supervisor or manager.
C.   Reassuring the client, while important, should not be the primary action; addressing the issue and initiating appropriate steps should take precedence.
D.   Documenting the incident report in the client's chart is important but should follow the immediate notification of the supervisor or manager.

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Correct Answer is B

Explanation

A: Providing a 10-minute rest period prior to meals can be beneficial for some clients, but it is not specifically related to the prevention of aspiration in clients with dysphagia. Rest periods do not directly facilitate safer swallowing processes.

B: Elevating the head of the client's bed to 30° during mealtime is the correct technique for a client with dysphagia. This position helps prevent aspiration, which can occur if food or liquids enter the lungs instead of going down the esophagus. The semi-upright position aids in the proper alignment of the esophagus and reduces the risk of choking.

C: Withholding fluids until the end of the meal is not an appropriate technique for a client with dysphagia. Fluids are often needed to help swallow and clear the mouth of food particles. Additionally, providing fluids throughout the meal can help prevent dehydration.

D: Instructing the client to place her chin toward her chest when swallowing can help prevent aspiration in clients with dysphagia. However, this technique should be used in conjunction with other methods, such as the correct positioning of the bed, to ensure safety and effectiveness.

A. A newly admitted client who has diabetes mellitus and requires initial teaching on self- administration of insulin B. A client who is scheduled for an endoscopy later today and requires an enema C. A newly admitted client who has sickle cell anemia and requires the development of an initial plan of care D. A client who had a myocardial infarction and will be transferring to the unit from the CCU.

Correct Answer is B

Explanation

- A: This client requires initial teaching, which is typically the responsibility of a registered nurse due to the educational aspect and the need to assess the client's understanding.
- B: Administering an enema is a task that falls within the scope of practice for a licensed practical nurse and does not require the advanced assessment skills of a registered nurse.
- C: Developing an initial plan of care involves comprehensive assessment and critical thinking, which are responsibilities of a registered nurse.
- D: A client transferring from the CCU after a myocardial infarction would require close monitoring and assessment, which are beyond the scope of practice for a licensed practical nurse.

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A nurse in a long-term care facility is caring for a client who reports the assistive personnel repositioned him in bed using excessive force. Which of the following actions should the nurse take?

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