A nurse is instructing a client’s family members about feeding safety for a client who has dysphagia following a stroke. Which of the following instructions should the nurse include?

Encourage brief exercise before meals to promote appetite.

Encourage the client to take small bites.

Place the client with the head reclined back to facilitate swallowing.

Place food in the affected side of the mouth.

Answer and Explanation

The Correct Answer is B

Choice A reason: Encourage brief exercise before meals to promote appetite. This answer is incorrect because exercise before meals can increase fatigue and decrease appetite in some clients with dysphagia. Exercise can also affect the blood flow to the brain and the muscles involved in swallowing .

Choice B reason: Encourage the client to take small bites. This answer is correct because taking small bites can help the client swallow more easily and reduce the risk of choking or aspiration.

Choice C reason: Place the client with the head reclined back to facilitate swallowing. This answer is incorrect because placing the client with the head reclined back can impair the swallowing mechanism and increase the risk of aspiration. The client should be placed with the head tilted slightly forward to help the food move down the throat.

Choice D reason: Place food in the affected side of the mouth. This answer is incorrect because placing food in the affected side of the mouth can cause the food to remain in the mouth and not be swallowed properly. The client should be encouraged to use both sides of the mouth to chew and swallow food.

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Correct Answer is A

Explanation

Choice A reason: Attaching a humidifier bottle to the base of the flow meter is a correct action for the nurse to take for a client who has pneumonia and a prescription for oxygen therapy at 5 L/min via nasal cannula. A humidifier bottle adds moisture to the oxygen gas, which can prevent dryness and irritation of the nasal passages and the mucous membranes. A humidifier bottle is recommended for oxygen flow rates above 4 L/min.

Choice B reason: Securing the oxygen tubing to the bed sheet near the client’s head is not a correct action for the nurse to take for a client who has pneumonia and a prescription for oxygen therapy at 5 L/min via nasal cannula. Securing the oxygen tubing to the bed sheet can cause the tubing to kink or twist, which can reduce the oxygen flow or delivery. The nurse should secure the oxygen tubing to the client’s clothing or gown, and ensure that there is enough slack to allow the client to move comfortably.

Choice C reason: Applying petroleum jelly to the nares as needed to soothe mucous membranes is not a correct action for the nurse to take for a client who has pneumonia and a prescription for oxygen therapy at 5 L/min via nasal cannula. Petroleum jelly is a flammable substance that can ignite when exposed to oxygen. The nurse should avoid using petroleum jelly or any other oil-based products on the client’s face or nose when using oxygen therapy. The nurse should use water-based products, such as saline gel or nasal spray, to moisturize the nares and mucous membranes.

Choice D reason: Removing the nasal cannula while the client eats is not a correct action for the nurse to take for a client who has pneumonia and a prescription for oxygen therapy at 5 L/min via nasal cannula. Removing the nasal cannula can cause hypoxia, which is a low level of oxygen in the blood. The nurse should keep the nasal cannula in place while the client eats, and monitor the client’s oxygen saturation and respiratory status. The nurse should also assist the client with eating, and encourage small bites and sips to prevent aspiration.

A. Budesonide via dry powder inhaler B. Cromolyn via metered dose inhaler C. Albuterol via jet nebulizer D. Montelukast orally

Correct Answer is C

Explanation

Choice A reason: Budesonide via dry powder inhaler is not a suitable medication for an acute asthma exacerbation. Budesonide is an inhaled corticosteroid that helps to reduce inflammation and prevent asthma attacks. It is taken daily as a maintenance therapy and does not work quickly enough to relieve the symptoms of an acute asthma exacerbation.

Choice B reason: Cromolyn via metered dose inhaler is not an effective medication for an acute asthma exacerbation. Cromolyn is a mast cell stabilizer that helps to prevent the release of inflammatory mediators that cause asthma symptoms. It is taken daily as a preventive therapy and does not work quickly enough to relieve the symptoms of an acute asthma exacerbation.

Choice C reason: Albuterol via jet nebulizer is a recommended medication for an acute asthma exacerbation. Albuterol is a short acting beta 2 agonist that helps to relax the smooth muscles of the airways and improve breathing. It is taken as needed as a rescue therapy and works quickly to relieve the symptoms of an acute asthma exacerbation.

Choice D reason: Montelukast orally is not a preferred medication for an acute asthma exacerbation. Montelukast is a leukotriene modifier that helps to reduce inflammation and prevent asthma attacks and exercise induced bronchoconstriction. It is taken once a day as an adjunctive therapy and does not work quickly enough to relieve the symptoms of an acute asthma exacerbation.

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A nurse is instructing a client’s family members about feeding safety for a client who has dysphagia following a stroke. Which of the following instructions should the nurse include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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