Editing Management of Care – RN Practice Questions (section)

==Question 15==
A client recovering from a stroke coughs and develops a wet, gurgling voice after taking sips of water. Which action should the registered nurse take '''first'''?
# Request a referral to the registered dietitian for a thickened-liquid diet.
# Stop oral intake, notify the provider, and request a swallow evaluation by speech-language pathology.
# Instruct the assistive personnel to feed the client more slowly.
# Teach the client to tuck the chin toward the chest while swallowing.

'''Answer:''' 2. Stop oral intake, notify the provider, and request a swallow evaluation by speech-language pathology.

''Rationale:'' Coughing and a wet vocal quality after swallowing are signs of aspiration. The immediate priority is to protect the airway by stopping oral intake, then to notify the provider and obtain a formal swallow evaluation, which is the speech-language pathologist's role. Option 1 identifies a useful team member but selects a diet modification before the swallowing deficit has been characterized. Option 3 continues oral intake in a client who is aspirating and delegates feeding of an at-risk client to unlicensed personnel. Option 4 is a compensatory technique that may be appropriate later, but only after evaluation and with the specific strategy recommended for that client.

[[Category:Management of Care]]
[[Category:Registered Nurse (NCLEX-RN)]]
{{Disclaimer}}