Association of Rehabilitation Nurses

Dysphagia

The ARN-CAT provides real-time assessment results. To survey your competency level in this subject area, click on the button corresponding to the correct answer for each question. When you are finished, click on the "Score Assessment" button.

You will be asked to login (if you are a returning customer) or register (if you are a new customer). You will then be given your assessment results immediately, including rationale and resources for each question.

Please print the results page as a record of completion for this competency area.

Each assessment can be completed as many times as is deemed necessary and the results page will include the user's name and the number of times they have completed an assessment for that competency. It is recommended that each supervisor determine a satisfactory score for their staff and develop a means for tracking the information.

This competency area has 10 questions. All questions must be answered before receiving your results.

1.	Select the clients who are at highest risk for dysphagia.
	a.	infants, persons with digestive disturbances and patients taking antibiotics
	b.	young children, persons with autoimmune disorders and patients with facial fractures
	c.	middle aged adults, persons with morbid obesity and patients with a history of depression
	d.	elderly, persons with cranial nerve dysfunction and patients who have had radiation therapy to the head and neck

2.	Select the nursing diagnosis that is the highest priority for a client with dysphagia.
	a.	disturbance in body image
	b.	risk for aspiration
	c.	ineffective health maintenance
	d.	risk for imbalanced fluid volume

3.	Food remaining in the throat, prolonged chewing, nasal regurgitation, and hoarseness after swallowing are all signs of problems in which phase of swallowing?
	a.	oral preparatory
	b.	oral
	c.	pharyngeal
	d.	esophageal

4.	Confirmation of the tendency for food to divert to the trachea is best done with
	a.	CT scan
	b.	chest X-ray
	c.	barium swallow
	d.	bronchial washings

5.	Which findings should the nurse expect when assessing a client with dysphagia?
	a.	A. coughing, gurgle sounding voice, and choking
	b.	B. pocketing food in both cheeks, heartburn, and burping
	c.	C. losing food from the lips, indigestion, and vomiting
	d.	D. drooling, nausea, and feeling of fullness

6.	What information should be included in a teaching plan for clients with dysphagia?
	a.	avoid foods that are highly seasoned and tend to produce flatus
	b.	serve foods on plates with suction cups and that have metal plate guards
	c.	eat all meals sitting in a chair or in a High Fowler’s position in bed
	d.	ingest the meat entrée first followed by the bread, vegetable, and dessert

7.	7. Which of the following interferes with effective swallowing and reduces the cough and gag reflexes?
	a.	alcohol
	b.	soft poached eggs
	c.	pureed fruits
	d.	milk

8.	Select the four levels of liquid foods in the ‘national dysphagia diet.’
	a.	thin, nectar-like, honey-like and spoon thick
	b.	watery, broth-like, molasses-like, and custard thick
	c.	juicy, syrup-like, pulp-like, and applesauce thick
	d.	frothy, soup-like, cream-like, and paste thick

9.	The nurse learns about feeding the client with dysphagia. Which statement indicates the need for further instruction?
	a.	give mouth care immediately before meals
	b.	use a syringe to place liquids into the client’s mouth
	c.	reduce distractions at mealtimes
	d.	serve foods either hot or cold instead of at room temperature

10.	A primary concern for the client on a thickened liquid diet is the potential for
	a.	gaining weight
	b.	dehydration
	c.	over hydration
	d.	vomiting