A nurse is caring for a group of clients. Which of the following clients should the nurse identify as having an increased risk of aspiration while eating? (Select all that apply)

A client who has had radiation therapy for head and neck cancer

A client who has had prolonged diarrhea

A client who has had a cerebrovascular accident

A client who has lactose intolerance

A client who is 4 hr postoperative following a leg amputation with general anesthesia

Answer and Explanation

Correct Answer : A,C,E

These clients have impaired swallowing, gag reﬂex, or level of consciousness, which increase their risk of aspiration while eating.

The other options are not correct because:

b. A client who has had prolonged diarrhea does not have a direct risk factor for aspiration, as diarrhea aﬀects the lower gastrointestinal tract and not the upper airway or esophagus.

d. A client who has lactose intolerance does not have a risk factor for aspiration, as lactose intolerance causes abdominal cramps, bloating, gas, or diarrhea when consuming dairy products, but does not aﬀect the ability to swallow or protect the airway.

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Correct Answer is D

Explanation

Keeping the drainage system below the level of the client's chest prevents backﬂow of ﬂuid or air into the pleural space and maintains negative pressure in the system.

a) Disconnecting the chest tube from the drainage system during transport is dangerous and can cause pneumothorax, infection, or bleeding. The chest tube should remain connected to the drainage system at all times unless ordered by the provider.
b) Emptying the collection chamber prior to transport is unnecessary and can interfere with accurate measurement of drainage. The collection chamber should be emptied only when it is full or at the end of each shift.
c) Clamping the chest tube prior to transferring the client to a wheelchair is contraindicated and can cause tension pneumothorax, as it prevents air from escaping the pleural space. The chest tube should only be clamped for a brief period when changing the drainage system or checking for air leaks, and only with a provider's order.

A. "Expect your sputum cultures to be negative after 6 months of therapy." B. "Drink at least 8 ounces of water when you take the pyrazinamide tablet." C. "Provide a sputum specimen every 2 weeks to the clinic for testing." D. "Take isoniazid with an antacid."

Correct Answer is B

Explanation

Answer: B

Rationale:

A) "Expect your sputum cultures to be negative after 6 months of therapy":

While sputum cultures may become negative after a period of effective therapy, it is not always guaranteed to happen within exactly 6 months. Tuberculosis (TB) treatment usually involves several months of medication, and sputum cultures are monitored periodically to assess treatment efficacy, not solely at the 6-month mark.

B) "Drink at least 8 ounces of water when you take the pyrazinamide tablet":

Drinking plenty of water with pyrazinamide is important to prevent dehydration and to help minimize potential side effects, such as hyperuricemia or gout. Adequate hydration can also aid in the effective elimination of the medication from the body, thus reducing the risk of adverse effects.

C) "Provide a sputum specimen every 2 weeks to the clinic for testing":

Sputum specimens are typically provided less frequently than every 2 weeks, usually monthly, to monitor the progress of TB treatment. Testing frequency may vary depending on the client's condition and the healthcare provider's recommendations.

D) "Take isoniazid with an antacid":

Isoniazid should not be taken with antacids, as antacids can interfere with the absorption of isoniazid. It is usually advised to take isoniazid on an empty stomach, and clients should be instructed to wait at least 1 hour after taking isoniazid before consuming antacids.

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A nurse is caring for a group of clients. Which of the following clients should the nurse identify as having an increased risk of aspiration while eating? (Select all that apply)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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