Question

a nurse is caring for a client who has sustained a head injury and whose level of consciousness fluctuates. the provider prescribes a full liquid diet progressing to a pureed diet as tolerated. before initiating feedings, it is essential that this client undergo which of the following?

• chest x-ray
• swallowing examination
• nasogastric tube insertion
• olfactory nerve evaluation

Explanation:

The client has a fluctuating level of consciousness and a head injury, and is to start a full liquid then pureed diet. A swallowing examination (like a modified barium swallow) is essential to assess the client's ability to swallow safely, as impaired consciousness and head injury can affect swallowing, leading to aspiration risk. A chest x - ray is for lung - related issues, not directly for feeding initiation. Nasogastric tube insertion may not be needed if the client can swallow, and olfactory nerve evaluation is about smell, not feeding.

Answer:

B. Swallowing examination