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ATI Nutrition
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. What is considered fast breathing in a 13-month-old child if the respiratory rate (RR) exceeds which value?
- A. 40 breaths per minute
- B. 50 breaths per minute
- C. 60 breaths per minute
- D. 30 breaths per minute
Correct answer: C
Rationale: In the context of pediatric care, a respiratory rate of more than 60 breaths per minute in a child aged 13 months is considered fast breathing, hence option 'C' is correct. Options 'A', 'B', and 'D' are incorrect as they do not meet the specified criteria for fast breathing in a 13-month-old. Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, including monitoring respiratory rates, to ensure that interventions are appropriately targeted and outcomes are optimized.
3. All of the following are contraindications when giving Immunization except:
- A. BCG Vaccine can be given to a child with AIDS
- B. BCG Vaccine can be given to a child with Hepatitis B
- C. DPT can be given to a child that had convulsion 3 days after being given the first DPT dose
- D. DPT can be given to a child with active convulsion or other neurological disease
Correct answer: B
Rationale: The correct answer is B. BCG vaccine can be given to a child with Hepatitis B, as there is no contraindication for this. Choice A, C, and D all present contraindications for administering immunizations. Choice A is incorrect because giving BCG vaccines to a child with AIDS is a contraindication. Choice C is incorrect as convulsions after the first DPT dose indicate a contraindication to subsequent doses. Choice D is incorrect because active convulsions or other neurological diseases are contraindications to receiving the DPT vaccine.
4. The law which regulated the practice of nursing profession in the Philippines is:
- A. R.A 9173
- B. LOI 949
- C. Patient’s Bill of Rights
- D. Code of Ethics for Nurses
Correct answer: A
Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.
5. What health instruction will enhance regulation of a colostomy (defecation) of clients?
- A. Irrigate after lunch everyday
- B. Eat fruits and vegetables in all three meals
- C. Eat balanced meals at regular intervals
- D. Restrict exercise to walking only
Correct answer: A
Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.
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