A nurse is caring for a client who had a stroke and has manifestations of dysphagia. Which of the following interventions should the nurse take?

Use liquids to clear food from the client's mouth.

Tilt the client's head backwards to facilitate swallowing.

Add a thickening agent to liquids.

Place the client in a semi-Fowler's position.

Answer and Explanation

The Correct Answer is C

Choice A reason: Using liquids to clear food from the client's mouth is not a safe intervention for dysphagia. Liquids can easily enter the airway and cause aspiration, which is the inhalation of food or fluids into the lungs. Aspiration can lead to pneumonia, respiratory distress, and death.

Choice B reason: Tilting the client's head backwards to facilitate swallowing is not a safe intervention for dysphagia. This position can also increase the risk of aspiration, as it opens the airway and allows food or fluids to flow into it.

Choice C reason: Adding a thickening agent to liquids is a safe and effective intervention for dysphagia. Thickened liquids are easier to swallow and control, as they move more slowly through the mouth and throat. They also reduce the risk of aspiration, as they are less likely to enter the airway.

Choice D reason: Placing the client in a semi-Fowler's position is not a safe intervention for dysphagia. This position can also increase the risk of aspiration, as it lowers the head and neck and reduces the closure of the airway. A better position for dysphagia is upright or high-Fowler's, which elevates the head and neck and enhances the closure of the airway.

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Correct Answer is ["58"]

Explanation

Step 1: Convert the weight from kilograms to pounds. 70 kg × 2.2 lbs/kg = 154 lbs Result at each step = 154 lbs

Step 2: Convert the height from meters to inches. 1.1 m × 39.37 inches/m = 43.307 inches Result at each step = 43.307 inches

Step 3: Convert the height from inches to feet. 43.307 inches ÷ 12 inches/foot = 3.609 feet Result at each step = 3.609 feet

Step 4: Calculate the BMI using the formula: BMI = weight (lbs) ÷ (height (inches))^2 × 703 BMI = 154 lbs ÷ (43.307 inches)^2 × 703 Result at each step = 154 lbs ÷ 1874.48 × 703 Result at each step = 0.0821 × 703 Result at each step = 57.7

Step 5: Round the BMI to the nearest whole number. Result at each step = 58

The client’s Body Mass Index (BMI) is 58.

A. Dietary restrictions will eventually allow the intake of gluten to resume. B. This condition may cause secondary lactose intolerance. C. Nutritional therapy for this condition includes limiting proteins and calories. D. A normal diet can resume after a period of remission.

Correct Answer is B

Explanation

Choice A reason: Dietary restrictions will not eventually allow the intake of gluten to resume. Gluten is a protein found in wheat, barley, rye, and some oats. It causes damage to the small intestine in people with celiac disease. The only treatment for celiac disease is a lifelong gluten-free diet.

Choice B reason: This condition may cause secondary lactose intolerance. Lactose is a sugar found in milk and dairy products. It is broken down by an enzyme called lactase in the small intestine. People with celiac disease may have reduced levels of lactase due to the damage to the small intestine caused by gluten. This can lead to lactose intolerance, which is the inability to digest lactose properly. Symptoms of lactose intolerance include bloating, gas, diarrhea, and abdominal pain after consuming dairy products.

Choice C reason: Nutritional therapy for this condition does not include limiting proteins and calories. People with celiac disease need adequate amounts of proteins and calories to maintain their health and prevent malnutrition. They also need to ensure that they get enough vitamins, minerals, and fiber from gluten-free sources.

Choice D reason: A normal diet cannot resume after a period of remission. Celiac disease is a chronic autoimmune disorder that does not have a cure. Even if the symptoms improve or disappear, the damage to the small intestine can still occur if gluten is consumed. Therefore, a strict gluten-free diet must be followed for life.

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A nurse is caring for a client who had a stroke and has manifestations of dysphagia. Which of the following interventions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse measures a client's weight as 70 kg and height as 1.1 m. What is the client's body mass index? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["58"]

Explanation

A nurse is providing dietary teaching to a client newly diagnosed with celiac disease. Which of the following information should the nurse include in the teaching?

Correct Answer is B

Explanation

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