A nurse is updating a postoperative client's plan of care. The nurse should include which of the following as the priority interventions?

Reposition the client frequently.

Instruct the client to use the incentive spirometer.

Increase the amount of time the client spends out of bed each day.

Ensure the client consumes an adequate amount of fluids.

Answer and Explanation

The Correct Answer is B

A.   Reposition the client frequently: While repositioning is important for preventing pressure ulcers and maintaining comfort, it may not be the priority immediately postoperatively compared to other interventions.
B.   Instruct the client to use the incentive spirometer: This is the correct answer. Incentive spirometry helps prevent atelectasis and respiratory complications postoperatively, making it a priority intervention to include in the plan of care.
C.   Increase the amount of time the client spends out of bed each day: Early ambulation is important for preventing complications such as deep vein thrombosis and pneumonia, but it may not be the priority immediately postoperatively depending on the client's condition and surgical procedure.
D.   Ensure the client consumes an adequate amount of fluids: While hydration is important for postoperative recovery, ensuring adequate fluid intake may not be the priority compared to interventions aimed at preventing respiratory complications such as atelectasis.

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Correct Answer is B

Explanation

- A. Bite block: This is not the correct choice. A bite block is used to prevent a patient from biting down on tubes or other equipment, not typically required for a patient with dysphagia.
- B. Yankauer suction device: This is the correct choice. A Yankauer suction device is used to clear the oral cavity of secretions or food particles, which is essential for a patient with dysphagia to prevent aspiration.
- C. Large-handled utensils: While these may be helpful for a patient with dysphagia to feed themselves more easily, they are not as critical as ensuring the airway is clear of obstructions.
- D. Nasal cannula and oxygen: This equipment would be necessary if the patient had respiratory issues, but it is not specifically related to the management of dysphagia.

A. The client has extreme difficulty swallowing. B. The client requires assistance getting dressed. C. The client is experiencing dysarthria. D. The client has four new medications.

Correct Answer is B

Explanation

A. The client has extreme difficulty swallowing: Difficulty swallowing (dysphagia) is typically addressed by a speech-language pathologist, not an occupational therapist.
B. The client requires assistance getting dressed: Occupational therapists often address activities of daily living (ADLs), including dressing, bathing, and grooming, to help clients regain
independence and function after a stroke.

C. The client is experiencing dysarthria: Dysarthria, which affects speech production, is typically addressed by a speech-language pathologist.
D. The client has four new medications: Medication management may be addressed by various members of the healthcare team, but it is not typically within the scope of practice of an occupational therapist.

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A nurse is updating a postoperative client's plan of care. The nurse should include which of the following as the priority interventions?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A charge nurse is assessing the room of a newly admitted client who has dysphagia. Which of the following pieces of equipment should the nurse ensure is available in the client's room?

Correct Answer is B

Explanation

A nurse is attending an interprofessional team conference for a client who experienced a stroke. For which of the following findings should the team request a prescription for a referral to the occupational therapist?

Correct Answer is B

Explanation

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