A nurse is caring for a client who recently had a stroke and states, "I am having trouble swallowing my food." To which of the following members of the interprofessional team should the nurse initiate a referral?

Speech-language pathologist

Physical therapist

Social worker

Occupational therapist

Answer and Explanation

The Correct Answer is A

A. Speech-language pathologist: Speech-language pathologists (SLPs) are trained to assess and manage dysphagia, including swallowing difficulties after a stroke. They evaluate swallowing function, recommend safe feeding techniques, and provide exercises to improve swallowing ability, directly addressing the client’s expressed concern.

B. Physical therapist: Physical therapists focus on mobility, balance, and strengthening exercises. While important for post-stroke rehabilitation, they do not specialize in swallowing assessment or management. Referral to a PT would not address the client’s immediate swallowing difficulties.

C. Social worker: Social workers provide support for psychosocial needs, discharge planning, and community resources. Although valuable for overall care, they are not responsible for evaluating or treating swallowing disorders.

D. Occupational therapist: Occupational therapists assist with activities of daily living, adaptive equipment, and fine motor skills. While they may help with feeding techniques, the primary assessment and management of dysphagia require an SLP.

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Correct Answer is D

Explanation

A. "Call a shelter in another county.": While contacting a shelter can be part of a safety plan, specifying another county is not necessary unless there is a need for increased distance from the abuser. The instruction should be individualized, and calling local resources may be more immediately practical and safer.

B. "Leave your partner immediately.": Immediate departure is not always safe and may increase the risk of harm if done impulsively. Safety planning emphasizes strategic, well-thought-out actions rather than abrupt decisions that could escalate danger.

C. "Keep a packed bag by your front door.": Having a packed bag ready is a precautionary measure, but it is only effective if the client also has a safe, rehearsed plan and access to secure transportation. Without a concrete strategy, this step alone may not reduce risk effectively.

D. "Rehearse your escape route.": Practicing an escape route helps the client respond quickly and safely in an emergency situation. Rehearsal allows the client to identify safe exits, plan for transportation, and anticipate obstacles, which is a central component of an effective safety plan for partner violence.

A. Frequently remind the client of the expectations for her behavior. B. Encourage the client to participate in a group activity in the dayroom. C. Allow the client to pick her own choice of clothing. D. Encourage the client to increase physical activity during the day.

Correct Answer is A

Explanation

A. Frequently remind the client of the expectations for her behavior: Clients experiencing mania may have impaired judgment, impulsivity, and difficulty focusing. Repeated, calm reminders of behavioral expectations help set limits, maintain safety, and reduce the risk of disruptive or harmful actions while promoting structure in the therapeutic environment.

B. Encourage the client to participate in a group activity in the dayroom: Group activities can be overstimulating for a client in the manic phase, increasing agitation, distractibility, and risk of conflict with others. Individual or low-stimulation interventions are safer and more appropriate during acute mania.

C. Allow the client to pick her own choice of clothing: While autonomy is generally encouraged, a manic client may make choices that are socially inappropriate, unsafe, or erratic. Guiding clothing selections may help maintain dignity and safety without restricting personal expression entirely.

D. Encourage the client to increase physical activity during the day: Although physical activity can be beneficial, clients in a manic state may already have excessive energy and impulsivity. Additional encouragement for activity could exacerbate agitation, increase risk of injury, and worsen overstimulation.

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A nurse is caring for a client who recently had a stroke and states, "I am having trouble swallowing my food." To which of the following members of the interprofessional team should the nurse initiate a referral?

Nursing Test Bank

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