A nurse is assisting with the care of a male client in the unit.
Complete the following sentence by using the list of options.
The client is at risk for developing
The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}
Choice A rationale:
While hoarseness can be a symptom of aspiration pneumonia, it is not a direct cause. Hoarseness alone does not necessarily lead to aspiration pneumonia.
Choice B rationale:
Coughing when eating is a direct risk factor for aspiration pneumonia. Coughing indicates that food or liquid may be entering the airway, which can lead to aspiration pneumonia.
Choice C rationale:
Dysphagia (difficulty swallowing) can be a risk factor for aspiration pneumonia, but in this case, the client's symptoms (coughing when eating and hoarseness) are more directly associated with aspiration pneumonia.
Choice D rationale:
While coughing when eating can be a symptom of dysphagia, the primary concern here is the risk of aspiration pneumonia due to the same symptom.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Placing the cap of a sterile solution on a clean surface with the inside facing down can contaminate the cap. It should be placed with the inside facing up to maintain sterility.
Choice B rationale
Placing a sterile instrument within 1.3 cm (0.5 in) of the edge of the sterile field risks contamination, as the edges are considered non-sterile. Instruments should be placed well within the sterile field.
Choice C rationale
Opening the top flap of the sterile tray package away from their body ensures that the sterile contents are not contaminated by the nurse's clothing or body, maintaining the sterility of the field.
Choice D rationale
Dropping sterile objects onto the field from a height of 5 cm (2 in) can cause contamination due to the potential for the objects to fall outside the sterile field. Objects should be placed gently onto the field without dropping them.
Correct Answer is D
Explanation
Choice A rationale
Encouraging a partner to eat three large meals each day may not be appropriate in end-of-life care. Clients often have reduced appetite, and small, frequent meals are usually recommended to avoid overwhelming them.
Choice B rationale
Opioids are commonly used in end-of-life care to manage pain and distress. Even if respiratory distress occurs, opioids are not typically restricted, but rather adjusted to balance pain relief and respiratory function.
Choice C rationale
Using an electric blanket can pose safety risks, including burns or electrical hazards, especially if the client is unable to communicate discomfort. Instead, alternative methods such as warm blankets are safer.
Choice D rationale
Assuming the partner can hear even if they do not respond is important. Hearing is believed to be one of the last senses to fade, and speaking to the client can provide comfort and connection.
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