a nurse is planning care for a client who has acute dysphagia which of the following nursing interventions should be included in the plan of care
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1. A client has acute dysphagia. Which of the following nursing interventions should be included in the plan of care?

Correct answer: C

Rationale: Placing the client in semi-Fowler's position during meals is the correct intervention for a client with acute dysphagia. This position helps prevent aspiration by facilitating swallowing. Providing a straw for consumption of liquids (Choice A) can increase the risk of aspiration and is not recommended for clients with dysphagia. Encouraging larger bites (Choice B) can also increase the risk of choking and aspiration. Instructing the client to tilt the head forward when swallowing (Choice D) is not the recommended technique for managing dysphagia as it does not address the underlying issue effectively.

2. Why does Anita stand in front of the mirror while performing a Breast Self-Examination (BSE)?

Correct answer: C

Rationale: When performing a Breast Self-Examination (BSE), one of the reasons for standing in front of a mirror is to observe the size and contour of the breast (Choice C). This helps in identifying any visible changes or abnormalities such as dimpling, puckering, or changes in the size and shape of the breasts. While unusual discharges (Choice A) and thickness or lumps (Choice D) can be part of the changes a person might notice during a BSE, these are typically identified by palpation or by squeezing the nipple for discharge, not by just looking in the mirror. Choice B, checking for obvious malignancy, is too vague and not specific enough as malignancy is often not visible to the naked eye.

3. Which organ absorbs water and vitamin K and may be affected by ulcerative colitis?

Correct answer: C

Rationale: The large intestine is the organ that is primarily responsible for the absorption of water and vitamin K in the human body. A disease like ulcerative colitis can disrupt these functions by causing inflammation and ulcers in the lining of the large intestine, leading to digestive issues. The stomach (Choice A) primarily functions to break down and digest food, not to absorb water and vitamins. The pancreas (Choice B) secretes enzymes to aid in digestion and hormones to regulate blood sugar, but does not absorb water and vitamins. The small intestine (Choice D) is primarily responsible for absorbing nutrients from digested food, but not specifically water and vitamin K. Therefore, these other choices are incorrect.

4. A patient following a vegetarian diet might be at risk for deficiency in which nutrient?

Correct answer: B

Rationale: Vitamin B12 is primarily found in animal products, so vegetarians may need supplementation.

5. Before Dianne performs the formal research study, what do you call the pre-testing, small-scale trial run to determine the effectiveness of data collection and methodological problems that might be encountered?

Correct answer: D

Rationale: The correct answer is 'Pilot Study.' A pilot study is a small-scale trial run conducted before the formal research study to identify and address any issues related to data collection and methodology. This helps in determining the effectiveness of the research process and identifying potential problems that may arise. Choice A, 'Sampling,' refers to the process of selecting a subset of individuals from a larger population for research. Choice B, 'Pre-testing,' simply involves testing something before the main testing phase. Choice C, 'Pre-Study,' is not a commonly used term in research methodology and does not specifically refer to the small-scale trial run described in the question.

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