a nurse is updating a plan of care after evaluating a client who has dysphagia which interventions should the nurse include in the plan
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ATI LPN

PN ATI Capstone Fundamentals Quiz

1. A nurse is updating a plan of care after evaluating a client who has dysphagia. Which interventions should the nurse include in the plan?

Correct answer: C

Rationale: The correct intervention for a client with dysphagia is to have them sit upright for 1 hour following meals. This position facilitates swallowing and reduces the risk of aspiration. Choice A is incorrect because having the client lie down after meals can increase the risk of aspiration. Choice B is incorrect as talking while eating can lead to choking. Choice D is incorrect as thin liquids may be harder for a client with dysphagia to swallow safely.

2. A nurse is assessing a client who has a femur fracture and is in skeletal traction. Which of the following findings should the nurse report to the provider?

Correct answer: C

Rationale: The correct answer is C. Severe pain that is not relieved by analgesics may indicate neurovascular compromise or other complications and requires immediate attention by the provider. Choices A, B, and D are incorrect because clear fluid drainage from the pin sites is expected in skeletal traction, intermittent muscle spasms are common in this situation, and traction weights hanging freely indicate proper traction alignment.

3. A nurse is providing discharge teaching for a client newly prescribed methadone. Which statement indicates a need for further teaching?

Correct answer: B

Rationale: The correct answer is B. Trouble sleeping is not a typical side effect of methadone; the nurse should clarify this misunderstanding. Choices A, C, and D are all correct statements regarding methadone. Methadone can indeed slow breathing, so it is important for the client to be aware of this effect. Avoiding alcohol while taking methadone is crucial due to the increased risk of central nervous system depression when alcohol is combined with methadone. Additionally, changing positions slowly can help prevent dizziness, which can be a side effect of methadone.

4. A client is admitted for observation and has full range of motion. Which is the best manner to encourage the client to void?

Correct answer: D

Rationale: The correct answer is D: Client Bathroom. Encouraging the client to use the bathroom is the best way to promote independence and privacy, maintaining normal function. In this case, since the client has full range of motion, using the client bathroom would be the most appropriate choice. Options A, B, and C (Urinal, Bedpan, Bedside Commode) are not the best choices as they may restrict the client's independence and privacy, which can impact their psychological well-being and normal voiding function.

5. A healthcare professional is preparing to administer a flu vaccine. Which of the following should the healthcare professional verify?

Correct answer: C

Rationale: The healthcare professional should verify the client's vaccination history to ensure they are due for the flu vaccine. Verifying the client's age (choice A) is important for other vaccines but not specifically for the flu vaccine. While allergy to eggs (choice B) is relevant as the flu vaccine is traditionally produced in eggs, it is not the top priority for verification. The client's weight (choice D) is not directly related to the administration of the flu vaccine.

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