Nursing Elites

1. A client has acute dysphagia. Which of the following nursing interventions should be included in the plan of care?

• A. Providing a straw for consumption of liquids
• B. Encouraging larger bites
• C. Placing the client in semi-Fowler's position during meals
• D. Instructing the client to tilt head forward when swallowing

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. A client is planning eating strategies with a nurse who has nausea from equilibrium imbalance. Which of the following strategies should the nurse recommend?

• A. Encourage the client to eat, even if nauseated.
• B. Provide low-fat carbohydrates with meals.
• C. Limit fluid intake between meals.
• D. Serve hot foods at mealtime.

Correct answer: B

Rationale: The correct answer is B: Provide low-fat carbohydrates with meals. Low-fat carbohydrates are easier to digest and can help manage nausea without overloading the digestive system. Encouraging the client to eat even if nauseated (Choice A) may worsen their symptoms. Limiting fluid intake between meals (Choice C) may lead to dehydration, which can exacerbate nausea. Serving hot foods at mealtime (Choice D) may not necessarily address the underlying issue of equilibrium imbalance causing nausea.

3. What type of drug would most likely be given to a patient following a myocardial infarction?

• A. antiemetic
• B. anticoagulant
• C. anticonvulsant
• D. antibiotic

Correct answer: B

Rationale: Anticoagulants are the most suitable choice for a patient following a myocardial infarction. These medications are essential in preventing further blood clots from forming in the arteries, reducing the risk of complications such as strokes or recurrent heart attacks. Antiemetics are used to control nausea and vomiting, not directly related to myocardial infarction. Anticonvulsants are used to manage seizures, not typically indicated after a heart attack. Antibiotics are prescribed to treat bacterial infections, not routinely given after a myocardial infarction.

4. During an initial visit with an older adult client living alone and having difficulty preparing meals, what should the home health nurse do first?

• A. Discuss nutritional requirements with the client.
• B. Refer the client to a senior citizen center.
• C. Arrange for a home-delivered meal program.
• D. Perform a nutrition screening.

Correct answer: D

Rationale: Performing a nutrition screening is the most appropriate action for the nurse to take first. This allows the nurse to assess the client's current nutritional status and identify any specific needs. Discussing nutritional requirements with the client (Choice A) may be important but should come after the initial assessment. Referring the client to a senior citizen center (Choice B) or arranging for a home-delivered meal program (Choice C) are actions that may be considered later based on the findings of the nutrition screening.

5. A woman who has been following a vegan diet may need ____ supplements.

• A. vitamin C and vitamin A
• B. vitamin D and vitamin B12
• C. vitamin E and K
• D. vitamin D and niacin

Correct answer: B

Rationale: The correct answer is B: vitamin D and vitamin B12. Vegans may need to supplement vitamin D and B12 as these nutrients are mainly found in animal products. While choices A, C, and D are essential vitamins, they are not typically lacking in a vegan diet. Vitamin C can be obtained from various plant sources, vitamin A can be derived from beta-carotene in plants, and vitamin E and K are also found in plant-based foods. Niacin, although important, can be sourced from plant-based sources and is not a common deficiency in vegan diets.

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