A community health nurse is visiting an older adult client who recently moved into an assisted living apartment. Which of the following client statements indicates difficulty accepting their transition?

"The food is not great, but it is nice not having to do all of my own cooking."

"I don't want to go to the activity room because none of the other residents can hear."

"The staff sometimes have to remind me to use a cane when I walk in the hall."

"When I go out, I've been using public transportation since I can't drive anymore

Answer and Explanation

The Correct Answer is B

Correct answer: B

A. "The food is not great, but it is nice not having to do all of my own cooking.":

This statement acknowledges a minor issue with the food but overall expresses satisfaction with the convenience of not having to cook, indicating some level of acceptance of the transition.

B. "I don't want to go to the activity room because none of the other residents can hear."

This statement suggests a feeling of disconnection or dissatisfaction with the activities available in the assisted living facility. The client may be expressing frustration or a sense of isolation because the other residents cannot hear, which could hinder their ability to engage socially and participate in activities. Difficulty accepting the transition may manifest as resistance or reluctance to participate in aspects of facility life, such as group activities, due to perceived limitations or barriers.

C. "The staff sometimes have to remind me to use a cane when I walk in the hall.":

While this statement may indicate some adjustment to the need for assistance or reminders, it does not necessarily suggest difficulty accepting the transition. Instead, it reflects a willingness to comply with safety recommendations provided by the staff.

D. "When I go out, I've been using public transportation since I can't drive anymore":

This statement acknowledges a change in transportation habits due to inability to drive, which may be a practical adaptation to the client's circumstances rather than a sign of difficulty accepting the transition to assisted living.

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Correct Answer is D

Explanation

A. Occupational therapist: While occupational therapists may be involved in the client's care post-stroke to address functional abilities and activities of daily living, including feeding and meal preparation, they are not specifically trained to assess and treat swallowing disorders like a speech-language pathologist.

B. Physical therapist: Physical therapists focus on improving mobility, strength, balance, and coordination. While they play a crucial role in stroke rehabilitation, particularly in addressing gait and motor deficits, they are not typically involved in the assessment and treatment of swallowing disorders.

C. Social worker: Social workers provide support and resources to clients and their families to address psychosocial and practical concerns related to illness, disability, and rehabilitation. While they may be involved in the client's care for broader support needs, they are not specifically trained to address swallowing disorders like a speech-language pathologist.

D. Speech-language pathologist

A speech-language pathologist specializes in evaluating and treating communication and swallowing disorders. In this scenario, the client's coughing during swallowing indicates a potential swallowing disorder, known as dysphagia, which is common after a stroke. The speech-language pathologist is trained to assess the client's swallowing function, identify any impairments, and develop a treatment plan to improve swallowing safety and efficiency. They may recommend strategies and exercises to address the client's coughing and prevent complications such as aspiration pneumonia.

A. The client adjusts the head of their bed to 90°, B. The client drinks their thickened juice with a straw. C. The client tucks their chin when they swallow. D. The client takes frequent breaks while eating.

Correct Answer is B

Explanation

A. The client adjusts the head of their bed to 90°: Adjusting the head of the bed to 90° is a correct action for clients with dysphagia as it helps facilitate swallowing by promoting an upright position, reducing the risk of aspiration.

B. The client drinks their thickened juice with a straw.

Drinking thickened liquids with a straw is not recommended for clients with dysphagia. Straws can increase the risk of aspiration, as they bypass the natural protection mechanisms in the mouth and throat that help prevent liquids from entering the airway. Therefore, the nurse should intervene and provide the client with an appropriate drinking cup instead of a straw when consuming thickened liquids.

C. The client tucks their chin when they swallow: Tucking the chin when swallowing is a recommended technique for clients with dysphagia, as it helps close off the airway and directs the food or liquid toward the esophagus, reducing the risk of aspiration.

D. The client takes frequent breaks while eating: Taking frequent breaks while eating is a beneficial strategy for clients with dysphagia, as it allows them to rest and swallow safely without feeling rushed or overwhelmed by large amounts of food or liquid.

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A community health nurse is visiting an older adult client who recently moved into an assisted living apartment. Which of the following client statements indicates difficulty accepting their transition?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who had a stroke and coughs frequently when swallowing. The nurse should identify that which of following members of the interdisciplinary team?

Correct Answer is D

Explanation

A nurse is caring for a client who has dysphagia. When assisting the client during breakfast, which of the following actions by the client indicates the nurse should intervene?

Correct Answer is B

Explanation

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