A nurse is assisting in the care of a client who had an ischemic stroke. Which of the following observations by the nurse indicates a need for an occupational therapy referral?

The correct answer is choice D, Describe the food placement as though the plate were a clock. When delivering the client's meal tray, the nurse should describe the food placement as though the plate were a clock to help the client know where the food is located. This helps the client be more independent and participate actively at mealtime. Choice A is incorrect because arranging for assistive personnel to feed the client may take away the client's independence. Choice B is incorrect because discouraging conversations during the client's mealtime may make the client feel isolated. Choice C is incorrect because providing the client with small-handled adaptive utensils may not help the client locate food on the plate.

Other choices:

A. Arrange for assistive personnel to feed the client: Arranging for assistive personnel to feed the client may take away the client's independence.

B. Discourage conversations during the client's mealtime: Discouraging conversations during the client's mealtime may make the client feel isolated.

B. Provide the client with small-handled adaptive utensils: Providing the client with small-handled adaptive utensils may not help the client locate food on the plate.

The correct answer is choice C. Asthma.

Choice A rationale:

Glaucoma is not a contraindication for propranolol. Beta-blockers like propranolol can actually be used to manage glaucoma by reducing intraocular pressure.

Choice B rationale:

Irritable bowel syndrome (IBS) is not a contraindication for propranolol. There is no direct interaction between propranolol and IBS that would prevent its use.

Choice C rationale:

Asthma is a contraindication for propranolol. Propranolol is a non-selective beta-blocker, which means it can block beta-2 receptors in the lungs, leading to bronchoconstriction and potentially severe asthma exacerbations.

Choice D rationale:

Migraine headaches are not a contraindication for propranolol. In fact, propranolol is often prescribed as a preventive treatment for migraines.