A nurse in a long-term care facility is managing the care of an older adult client who has difficulty swallowing and occasional choking during meals. The nurse should initiate a referral to which of the following members of the interprofessional care team?
Speech-language pathologist
Social worker
Respiratory therapist
Occupational therapist
The Correct Answer is A
A. Speech-language pathologist: Speech-language pathologists (SLPs) specialize in evaluating and treating swallowing disorders (dysphagia). They can assess the client’s swallowing ability, recommend appropriate diet modifications, and provide strategies to reduce choking risk.
B. Social worker: Social workers provide support for psychosocial needs, discharge planning, and community resources, but they do not assess or manage swallowing difficulties. Referral to a social worker may be appropriate for broader care needs but not for dysphagia.
C. Respiratory therapist: Respiratory therapists focus on airway management, ventilation, and pulmonary function. While they can assist if aspiration leads to respiratory complications, they do not primarily assess swallowing function.
D. Occupational therapist: Occupational therapists help clients with activities of daily living and adaptive equipment. Although they may assist with feeding techniques or positioning, they are not specialized in assessing or treating swallowing disorders.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale:
A. A blister-like area: Blistering is not the expected reaction used to interpret a Mantoux test. The result is based on the presence and size of induration, not the formation of blisters.
B. A cool, blanched area: Coolness and blanching are not indicators of a positive test. These findings may reflect poor circulation or local skin reaction unrelated to tuberculosis screening.
C. An elevated, hardened area: Induration (elevated, firm area) at the injection site, measured in millimeters, is the basis for determining a positive result. The size threshold for positivity depends on the client’s risk factors for tuberculosis.
D. An area of ecchymosis: Bruising at the site is a local skin reaction that can occur after any injection and is unrelated to the diagnostic criteria for a positive Mantoux test.
Correct Answer is B
Explanation
Rationale:
A. How to change the tracheostomy dressing using clean technique: Tracheostomy dressings should be changed using sterile technique, not clean technique, to prevent infection and protect the airway. Teaching clean technique would be inappropriate.
B. How to operate the portable suction machine: Suctioning is a critical skill for maintaining airway patency and preventing respiratory complications. Teaching the partner how to operate the suction machine ensures they can assist safely at home if needed.
C. How to change the nondisposable tracheostomy tube daily: Nondisposable tracheostomy tubes are not typically changed daily; frequent changes can damage the stoma or airway. Tube changes are usually performed by trained healthcare personnel.
D. How to secure the tracheostomy tube with ties at the back of the neck: Ties should be secured in a way that avoids pressure or friction on the back of the neck, typically fastening at the sides. Focusing on back-of-neck placement could lead to skin breakdown or discomfort.
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