Practice Question
A nurse in a rehabilitation facility is assisting in the care of a client who was admitted the previous day.
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Rationale:
🔷The client reports food feeling “stuck” and has a hoarse (wet) vocal quality, classic signs of oropharyngeal dysphagia indicating impaired airway protection during swallowing.
🔷Coexisting left-sided weakness suggests a recent neurologic insult (e.g., stroke) that can disrupt bulbar and laryngeal coordination, increasing the likelihood of penetration/aspiration of oral contents.
🔷In dysphagia, ineffective epiglottic closure and reduced laryngeal elevation allow residue in the valleculae and pyriform sinuses to spill into the airway, including silent aspiration without a strong cough.
🔷Early aspiration can present subtly (e.g., voice change, throat clearing, mild desaturation) before overt complications; here, the drop in SpO₂ from 100% → 96% plus a low-grade temperature rise may be early red flags in context.
🔷Preventing aspiration is a priority safety goal because it leads to aspiration pneumonia, hypoxemia, and respiratory failure; immediate measures include NPO until swallow screen, upright positioning (≥90°), oral care, and SLP evaluation.
🔷The presence of beta-blocker therapy (metoprolol) can blunt tachycardic responses to aspiration or infection, making clinical vigilance and objective screening even more critical to detect deterioration early.
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This question is from PN Fundamentals 2023 Exam Sept which contains 72 questions.
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Question Details
- Category: LPN Nursing Exam(s)
- Subcategory: LPN ATI Exams
- Domain: Fundamentals of Nursing
- Answer Choices: 0