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NCLEX · Basic Care and Comfort

A client with dysphagia (difficulty swallowing) is at risk for aspiration. Which nursing action is highest priority at mealtimes?

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Correct answer

Position the client upright at 90 degrees and keep upright for at least 30 minutes after meals; ensure thin liquids are thickened as ordered; feed slowly with small bites; have suction available

  1. A Position the client upright at 90 degrees and keep upright for at least 30 minutes after meals; ensure thin liquids are thickened as ordered; feed slowly with small bites; have suction available
  2. B Only provide liquid meals
  3. C Feed quickly to minimise choking time
  4. D Keep the bed flat during feeding

Why this is the answer

Aspiration precautions:

Positioning: 90° upright (not just slightly elevated) during and 30-45 min after meals — gravity assists swallowing and reduces reflux/aspiration risk.

Thickened liquids: Thin liquids are the most dangerous for dysphagia — thickening agents (nectar, honey, pudding consistency) as ordered by speech therapy.

Pace: Small bites, allow full swallow before next bite, no rushing.

Suction: Available at bedside in case of aspiration.

Monitoring: Watch for coughing, choking, wet/gurgly voice quality after swallowing (sign of aspiration).

Speech therapy: Dysphagia evaluation and specific dietary texture orders should be coordinated with SLP.

Pn scope: Implement and monitor aspiration precautions; report changes to RN; do not independently modify diet consistency orders.

Source: NCLEX-PN Physiological — Aspiration Precautions, Dysphagia

Practice more questions

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About this topic: Basic Care and Comfort

Basic care and comfort questions cover hygiene, mobility and positioning, nutrition and hydration, elimination, sleep, and non-pharmacological comfort measures — the daily care an LPN/LVN provides. This is one of 16 PN: Physiological Integrity questions on basic care and comfort, each with a full explanation on a single study page.

New to this exam? Our NCLEX exam guide explains the format, scoring, and how to prepare.

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