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The nurse is caring for an older adult who needs to limit sodium intake. Which food should the nurse encourage the client to avoid?

Bananas.

Ground sirloin.

Cottage cheese.

Broccoli.

Answer and Explanation

The Correct Answer is B

Choice A

Bananas are incorrect. Bananas are naturally low in sodium.

Choice B

Ground sirloin is correct. For an older adult who needs to limit sodium intake, the nurse should encourage avoiding foods that are high in sodium. Processed meats, including ground meats like ground sirloin, are often higher in sodium due to added preservatives and flavourings. These additives can significantly contribute to sodium content. Encouraging the client to choose lean meats and to avoid processed meats can help reduce sodium intake.

Choice C

Cottage cheese is incorrect. While cottage cheese might contain some sodium, it's usually lower in sodium compared to processed meats.

Choice D

Broccoli is incorrect. Broccoli is a vegetable that is naturally low in sodium.

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Correct Answer is B

Explanation

Choice A

Client with a nasogastric tube to low, intermittent suction is not correct. While there is a risk of aspiration with a nasogastric tube in place, the tube is intended to help drain stomach contents, reducing the risk of aspiration. However, if the tube is not properly positioned or managed, there could still be some risk.

Choice B

Client who has sensory aphasia and is receiving a clear liquid diet is correct. Sensory aphasia refers to a language disorder that affects a person's ability to understand language and communication. This client may have difficulty swallowing safely and effectively, which increases the risk of aspiration. Additionally, a clear liquid diet consists of thin liquids that are more likely to be aspirated compared to thicker fluids.

Choice C

Client receiving 30% oxygen via a non-rebreather face mask is not correct. Oxygen therapy can increase the risk of drying the airways and potentially increasing the risk of aspiration, but if the oxygen mask is properly fitted and humidified, the risk may be minimized.

Choice D

Client experiencing dysphagia who is prescribed a full liquid diet is not correct. Dysphagia refers to difficulty swallowing, which can increase the risk of aspiration. However, a full liquid diet includes thicker liquids that are less likely to be aspirated compared to thin liquids. Still, the risk of aspiration exists, especially if the client has severe dysphagia.

A. Send fluid specimen to the lab. B. Withdraw the NGT and reinsert. C. Connect the NGT to wall suction. D. Determine pH value of specimen.

Correct Answer is A

Explanation

Choice A

Sending fluid specimen to the lab should be implemented. Cloudy green fluid aspirated from a nasogastric tube (NGT) can indicate that the tube is in the wrong place, likely in the respiratory tract (trachea) instead of the gastrointestinal tract (stomach). The green colour suggests the presence of bile, which is normally found in the stomach but not in the respiratory tract. This is a serious situation that requires immediate attention.

The most appropriate intervention in this case is to send the fluid specimen to the lab for analysis. This is important for confirmation of the content and to guide further steps. The nurse should also consult the healthcare provider to determine the appropriate course of action, which might involve removing and reinserting the NGT correctly.

Choice B

Withdrawing the NGT and reinsert should not be implemented. If the NGT is in the wrong place, reinserting it without further assessment could worsen the situation. The nurse should not reinsert the NGT until the correct placement is confirmed.

Choice C

Connecting the NGT to wall suction should not be implemented. Connecting the NGT to wall suction without verifying its placement could cause harm, especially if the tube is in the respiratory tract.

Choice D

Determine pH value of specimen should not be implemented. While assessing the pH of aspirated fluid can help confirm the location of the NGT, sending the specimen to the lab for analysis is a more comprehensive action in this situation, as it allows for more detailed examination and guidance for appropriate next steps.

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The nurse is caring for an older adult who needs to limit sodium intake. Which food should the nurse encourage the client to avoid?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which client is at greatest risk for aspiration?

Correct Answer is B

Explanation

While assessing placement of a nasogastric tube (NGT), the nurse aspirates cloudy green fluid into a syringe. Which intervention should the nurse implement?

Correct Answer is A

Explanation

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