Exhibits
A nurse is providing discharge teaching. Which of the following client statements indicate an understanding of the teaching?
Client Statements
"I will look up at the ceiling when I swallow."
"I will have to stop watching television while I eat."
"My food will have to be the consistency of pudding."
"I can have cream soups on this diet."
"I shouldn't drink liquids while I have food in my mouth."
"I won't be able to eat nuts anymore."
Correct Answer : B,C,E,F
A. "I will look up at the ceiling when I swallow.". The recommended position for swallowing is typically sitting upright with the chin slightly tucked.
B. "I will have to stop watching television while I eat." This indicates an understanding of the importance of focusing on eating and avoiding distractions.
C. "My food will have to be the consistency of pudding." This indicates understanding of the Level 3 dysphagia diet, which requires foods to be moist and easily swallowed.
D. "I can have cream soups on this diet." While cream soups might seem like a good option, they can be too thick for a Level 3 dysphagia diet. The consistency should be more like a thin purée.
E. "I shouldn't drink liquids while I have food in my mouth." This demonstrates understanding of the importance of avoiding choking hazards.
F. "I won't be able to eat nuts anymore." This indicates understanding of the restrictions on hard, crunchy foods on a Level 3 dysphagia diet.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["5.3"]
Explanation
1 pound = 0.453592 kilograms
28 pounds = 28 * 0.453592 = 12.7 kilograms
Dose = weight in kg * prescribed dose Dose = 12.7 kg * 10 mg/kg = 127 mg
The medication is availableas 120 mg/5 mL. To find the volume for 127 mg:
Volume = (desired dose / concentration) * volume Volume = (127 mg / 120 mg) * 5 mL
Volume ≈ 5.29 mL
Therefore, the nurse should administer approximately 5.3 mL of acetaminophen.
Correct Answer is ["B","C","G","H"]
Explanation
A. Obtain a wound culture: While important, it is not the immediate priority compared to fluid resuscitation, antibiotic administration, and lactate level measurement.
B. Early administration of antibiotics is crucial in sepsis management to prevent further tissue damage and organ dysfunction.
C. Fluid resuscitation is essential to improve blood pressure and organ perfusion. Rapid administration of fluids is necessary to stabilize the patient.
D. Inserting a nasogastric (NG) tube might be necessary later if the patient develops gastrointestinal issues, but it's not an immediate priority.
E. While blood transfusion might be necessary if the patient becomes severely hypotensive, it's not the initial step. Fluid resuscitation is attempted first.
F. Urine culture can be helpful in identifying the source of infection but is not the immediate priority.
G. Lactate levels are a biomarker for tissue hypoxia and can help assess the severity of sepsis.
H. Blood cultures are essential to identify the causative organism for targeted antibiotic therapy.
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