The nurse identifies the client problem of Impaired Verbal Communication for a client following a stroke who exhibits expressive aphasia. An appropriate nursing intervention to help the client to communicate is to:

A. Trisomy 21 is a chromosomal disorder resulting in Down syndrome. While individuals with Down syndrome have an increased risk of developing certain leukemias (such as acute lymphoblastic leukemia), it is not directly associated with CML.
B. Fragile X syndrome is a genetic condition caused by a mutation in the FMR1 gene on the X chromosome, leading to intellectual disability and other developmental issues. It is not associated with CML or any form of leukemia. This option is unrelated to the genetic abnormalities seen in CML.
C. The BRCA1 gene mutation is associated with an increased risk of breast and ovarian cancers. While mutations in BRCA1 can affect cancer susceptibility, they are not linked to Chronic Myelogenous Leukemia. Thus, this option does not apply to CML.
D. The Philadelphia chromosome is a specific genetic abnormality found in the majority of patients with CML. It results from a translocation between chromosomes 9 and 22, creating the BCR-ABL fusion gene, which produces a tyrosine kinase that drives the proliferation of leukemic cells.

A. Asking yes or no questions can help facilitate communication, as they require less verbal output from the client and can help the nurse understand the client’s needs or thoughts without overwhelming them
B. This option is somewhat useful, as practicing words can help the client regain some verbal skills. However, it may not be the most effective immediate intervention. Clients with expressive aphasia often struggle to produce speech rather than understand it, and they may not benefit as much from this approach without additional support from speech therapy.
C. This intervention is not beneficial for improving communication. Tracking time spent speaking could create additional pressure on the client and may contribute to frustration rather than facilitate communication. It does not address the underlying issue of expressive aphasia.
D. This is not an appropriate intervention. Changing the subject can confuse or frustrate the client further, making it more difficult for them to communicate. It does not support their efforts to express themselves and may discourage them from trying to communicate altogether.