A nurse is providing discharge teaching to a client who has Parkinson's disease. Which of the following instructions should the nurse include? (Select All that Apply.)

Take small bites of food.

Liquids should be thickened.

Sit slightly forward when eating.

Chew food thoroughly before swallowing.

Avoid having conversations while eating.

Answer and Explanation

Correct Answer : A,C,D

A. Take small bites of food: Taking small bites of food is important for clients with Parkinson's disease to reduce the risk of choking and aspiration. It allows better control of swallowing and reduces the likelihood of difficulty swallowing, which is common in Parkinson’s disease due to dysphagia (swallowing difficulty).
B. Liquids should be thickened: While thickening liquids is often recommended for clients with swallowing difficulties, it is not universally required for all Parkinson's patients. It would depend on the specific swallowing assessment and the client’s condition. Therefore, this is not an essential recommendation for every client.
C. Sit slightly forward when eating: Sitting slightly forward helps clients with Parkinson's disease improve their swallowing and reduce the risk of aspiration. This posture encourages a safer swallowing reflex and reduces the likelihood of food or liquids going into the airway.
D. Chew food thoroughly before swallowing: Thoroughly chewing food is vital for clients with Parkinson’s disease because it reduces the risk of choking and aspiration. This allows the food to break down into smaller pieces, making it easier to swallow and less likely to cause blockages in the throat.
E. Avoid having conversations while eating: While it is important to focus on eating to prevent choking, there is no strict guideline that clients with Parkinson’s must avoid conversation entirely. Talking while eating may be challenging for some, but it is not universally harmful. However, the client should be reminded to focus on swallowing to prevent aspiration.

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Correct Answer is B

Explanation

A. Distributive shock occurs due to loss of myocardial contractility: Loss of myocardial contractility is more associated with cardiogenic shock, not distributive shock. Distributive shock occurs due to vasodilation, which leads to inadequate perfusion despite normal heart function.
B. Distributive shock occurs due to systemic vasodilation: Distributive shock is characterized by widespread vasodilation, often resulting from conditions such as sepsis, anaphylaxis, or neurogenic shock. This vasodilation leads to a decrease in vascular resistance, causing poor blood flow and oxygen delivery to tissues.
C. Distributive shock occurs due to loss of blood volume: Loss of blood volume is characteristic of hypovolemic shock, not distributive shock. In hypovolemic shock, blood volume is reduced, whereas in distributive shock, the issue lies in vascular tone and vasodilation.
D. Distributive shock occurs due to increased systemic vascular resistance: In distributive shock, systemic vascular resistance decreases due to vasodilation, not increases. The decrease in vascular tone is what leads to the impaired tissue perfusion seen in this form of shock.

A. Metabolic alkalosis B. Metabolic acidosis, uncompensated C. Respiratory acidosis D. Respiratory alkalosis, partially compensated

Correct Answer is B

Explanation

A. Metabolic alkalosis: This condition is characterized by an elevated pH above 7.45 and an increased bicarbonate level. In this case, the pH is low and the HCO₃⁻ is also decreased, ruling out metabolic alkalosis.
B. Metabolic acidosis, uncompensated: A pH of 7.25 indicates acidemia, and a bicarbonate level of 16 mEq/L confirms a metabolic origin. The PaCO₂ is normal at 40 mmHg, indicating that respiratory compensation has not yet occurred, making this an uncompensated metabolic acidosis.
C. Respiratory acidosis: Respiratory acidosis involves a low pH and elevated PaCO₂ due to hypoventilation. This client’s PaCO₂ is within normal range, so respiratory causes can be ruled out.
D. Respiratory alkalosis, partially compensated: This condition presents with a high pH and low PaCO₂, typically due to hyperventilation. The client has an acidic pH and a normal PaCO₂, which does not support respiratory alkalosis.

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A nurse is providing discharge teaching to a client who has Parkinson's disease. Which of the following instructions should the nurse include? (Select All that Apply.)

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Naxlex Comprehensive Predictor Exams

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Explanation

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