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. Nonnutritive sweeteners are not metabolized by microorganisms and do not promote dental caries. Products made with a nonnutritive sweetener can be used as frequently as 8 to 10 times per day.

Correct answer: C

Rationale: The first statement is true; nonnutritive sweeteners do not promote caries. However, the second statement is false because products with nonnutritive sweeteners should still be consumed in moderation.

3. To ensure client safety before starting blood transfusions, the following are needed before the procedure can be done EXCEPT:

Correct answer: D

Rationale: To ensure client safety before starting blood transfusions, taking baseline vital signs, warming the blood to room temperature, and having two nurses verify client identification, blood type, unit number, and expiration date of blood are crucial steps. Consent for blood transfusion is required but is typically obtained before the procedure. The focus before the procedure should be on confirming the right client, blood product, and ensuring the blood is prepared correctly to minimize risks of transfusion reactions.

4. A client who is postpartum and has been diagnosed with iron deficiency anemia should be taught to consume which of the following dietary recommendations?

Correct answer: C

Rationale: The correct answer is spinach and beef. Both spinach and beef are high in iron, making them excellent choices to help combat iron deficiency anemia. Yogurt, mozzarella, milk, turkey slices, fish, and cottage cheese are not as rich in iron compared to spinach and beef, so they are not the most suitable dietary recommendations for a client with iron deficiency anemia.

5. What is the primary function of a written nursing care plan?

Correct answer: D

Rationale: A written nursing care plan fundamentally serves to facilitate the development of a nursing diagnosis. This procedure involves analyzing patient data and identifying health problems that nurses can address independently. This analysis then aids in determining the most appropriate nursing interventions for the identified health issues. Although evaluating the achievement of nursing care goals is an important aspect, it is not the primary function of a nursing care plan. Similarly, while delivering quality nursing care is crucial, it is a broader concept that includes many other facets beyond just the initial nursing diagnosis and interventions.

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