A nurse in a long-term care facility is collecting data for an interdisciplinary care conference for a client who has Parkinson's disease. Which of the following findings is the priority for the nurse to report at the conference?

The client requires additional help to stand.

The client has increased difficulty dressing

The client reports insomnia.

The client has difficulty swallowing

Answer and Explanation

The Correct Answer is D

A. The client requires additional help to stand:

While needing additional help to stand is relevant information, it may be expected in Parkinson's disease due to issues with mobility and balance. It is not an immediate priority unless it signals a significant change or poses an immediate risk.

B. The client has increased difficulty dressing:

Increased difficulty dressing is a common manifestation of Parkinson's disease and is important to address but may not be as urgent as issues related to swallowing.

C. The client reports insomnia:

Insomnia is a common issue in Parkinson's disease but may not be an immediate priority unless it significantly impacts the client's overall well-being or contributes to other health concerns.

D. The client has difficulty swallowing:

This is the correct answer. Difficulty swallowing (dysphagia) in Parkinson's disease is a serious concern as it can lead to complications such as aspiration pneumonia and malnutrition. It requires prompt attention and intervention to ensure the client's safety and prevent potential complications.

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Correct Answer is B

Explanation

A. Flush the tube with 5 mL of water:

Explanation: Flushing the tube with water is a routine practice before and after administering medications or feedings to maintain tube patency. However, it is not the primary action to confirm tube placement.

B. Test the pH of fluid aspirated from the tube (Correct Answer):

Explanation: Testing the pH of aspirated fluid helps confirm that the tube is in the stomach. A pH between 1 and 5 is generally indicative of gastric placement.

C. Inject air through the tubing and auscultate for gurgling sounds:

Explanation: This method is an older practice and is not recommended as a reliable method for verifying tube placement. Testing the pH is a more accurate and preferred method.

D. Change the bag and tubing system every 12 hr:

Explanation: Changing the bag and tubing system every 12 hours is a routine practice to maintain the integrity of the enteral feeding system. However, it is not specifically related to the initial steps in verifying tube placement.

A. Complete medication reconciliation when a client moves to a new room on the same unit. B. Medication reconciliation should be completed whenever the nurse administers a medication. C. Medication reconciliation can be delegated to an assistive personnel. D. Include herbal supplements in the medication reconciliation.

Correct Answer is D

Explanation

A. Complete medication reconciliation when a client moves to a new room on the same unit:

While it's important to update the client's information when they change rooms, this may not necessitate a full medication reconciliation. Medication reconciliation is typically more comprehensive and involves a thorough review of the client's entire medication regimen.

B. Medication reconciliation should be completed whenever the nurse administers a medication:

While it's important to verify medications before administration, a full medication reconciliation involves a broader review of the client's entire medication history and should not necessarily be done each time a single medication is administered.

C. Medication reconciliation can be delegated to an assistive personnel:

Medication reconciliation is a complex process that involves a thorough review of the client's medication history, and it is generally considered a nursing responsibility. Delegating this task to assistive personnel may compromise accuracy and completeness.

D. Include herbal supplements in the medication reconciliation:

This is the correct answer. Herbal supplements can interact with prescribed medications and may impact the client's overall health. Including them in the medication reconciliation process ensures a comprehensive assessment of the client's medication regimen.

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A nurse in a long-term care facility is collecting data for an interdisciplinary care conference for a client who has Parkinson's disease. Which of the following findings is the priority for the nurse to report at the conference?

Nursing Test Bank

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Explanation

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Correct Answer is D

Explanation

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