1. Why would the nurse provide special instructions to nursing assistive personnel (NAP) before feeding a patient with dysphagia?

1. To reduce the risk of aspirating food or fluids
2. To ensure that an accurate intake measurement is reported
3. To encourage the patient to eat more of the food items on the meal tray
4. To ensure that the NAP knows which foods to avoid when feeding the patient

2. What output will the nurse direct nursing assistive personnel (NAP) to measure for a hospitalized patient for whom intake and output measurement is prescribed?

1. Nasogastric tube drainage
2. Chest tube drainage
3. Urine collection drainage
4. Ileostomy bag drainage

3. A patient is admitted to your unit for dehydration. Which of the following assessments would the nurse identify as a possible sign of fluid imbalance?

1. Heart rate at 80 beats per minute
2. Capillary refill of less than 2 seconds
3. Reduced turgor of the skin
4. B/P of 118/78 mmHg

4. A patient has consumed three 100-mL cups of ice chips and 4 ounces of ginger ale. What will nursing assistive personnel (NAP) document as this patient’s oral intake?

1. 120 mL
2. 170 mL
3. 220 mL
4. 270 mL

5. What would the nurse instruct nursing assistive personnel (NAP) to report while feeding any patient on aspiration precautions?

1. Amount of food ingested
2. Coughing
3. Poor appetite
4. Food preferences

6. Which statement reflects the nurse’s understanding of the importance of accurate urinary output measurement for a patient with acute renal failure?

1. “If the output begins to decrease, I will notify the physician immediately.”
2. “Increasing his fluid intake both orally and intravenously should boost his urine output.”
3. “I will use a collection system with an hourly measurement device added.”
4. “I will explain to the patient and family why the I&O is being measured and recorded.”

7. A patient is told the home care nurse will be measuring and recording intake and output (I&O) at home. What will the home care nurse do first?

1. Supply a urine hat.
2. Explain to the patient why I&O has been ordered.
3. Assess the patient’s ability to self-monitor and record I&O.
4. Provide the patient’s family with instructions.

8. What is the most effective way of preventing aspiration?

1. Observe the patient closely for coughing, gagging, choking, and voice alteration.
2. Monitor oxygen saturation with pulse oximetry.
3. Put any at-risk patient on NPO status until a dysphagia evaluation can be conducted by a speech and language pathologist.
4. Watch for subtle signs that aspiration may have occurred, such as lack of speech, depressed alertness, wet quality to the voice, difficulty controlling secretions, and absence of a gag reflex.

9. When assisting a patient who has self-feeding difficulties, why would the nurse ask the patient to try to self-feed?

1. To determine what kind of assistance the patient needs with feeding
2. To identify which food item is causing the trouble
3. To identify which hand the patient uses for utensils
4. To promote the patient’s sense of self-confidence

10. Which food item would not be given to a patient on a dysphagia diet?

1. Egg salad sandwich on wheat bread
2. Biscuits and gravy with scrambled eggs
3. Chicken noodle soup
4. Rice pudding

11. Which patient is least at risk for dysphagia?

1. A 22-year-old patient with a traumatic brain injury (TBI) sustained during combat
2. A 40-year-old woman undergoing stroke rehabilitation who had been smoking and taking oral contraceptives
3. A 76-year-old patient with dementia
4. A 55-year-old patient with pancreatic cancer who is receiving palliative care

12. While feeding a patient recovering from a stroke, a nursing assistive personnel (NAP) becomes distracted and does not watch the patient swallow a bite of food. What would the NAP do to ensure that the patient safely swallowed the food?

1. Give the patient a drink to wash down the food.
2. Check the patient’s mouth for pocketing.
3. Suction the patient’s mouth.
4. Give the patient the next bite of food.

13. While feeding a patient, the nurse puts the fork down on the tray and turns on the suction machine. Why might the nurse perform this action?

1. The patient is tilting the head backward while drinking.
2. The patient is choking.
3. Food has dripped or spilled onto the patient’s clothing.
4. The nurse determines that this is the wrong diet for the patient.

14. What would the nurse instruct nursing assistive personnel (NAP) to do to ensure safety when feeding Salisbury steak to a dependent patient?

1. Lower the head of the bed to a 30-degree angle.
2. Encourage the patient to drink all fluids first.
3. Cut the steak into small, bite-size pieces.
4. Ensure that the steak is steaming hot.

15. Why would the nurse want to determine if the patient is passing flatus before giving a meal?

1. To ensure that the previous meal has been fully digested
2. To ensure that the meal won't make the patient feel uncomfortably full
3. To determine whether the GI tract is functioning.
4. To determine whether the patient tolerated the foods given during the previous meal