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. Removing a mask after phototherapy: Removing a mask after phototherapy does not involve contact with bodily fluids or potentially contaminated surfaces. Clean gloves are not required for this activity because the risk of transmission is minimal.

B. Applying an identification bracelet: Applying a bracelet involves only superficial contact with the newborn’s skin and does not pose a risk of exposure to blood or body fluids. Standard hand hygiene is sufficient; gloves are not needed.

C. Measuring axillary temperature: Taking an axillary temperature involves minimal contact with the skin and does not expose the AP to blood or body fluids. Clean gloves are not necessary for this procedure unless there is visible soiling or open lesions.

D. Changing wet diapers: Diaper changes involve direct contact with urine and feces, which are potential sources of pathogens. Wearing clean gloves protects the AP from contamination and helps prevent the spread of infection, making glove use essential for this procedure.

A. "I should dispose of my used syringes in the household trash." B. "I will store my current bottle of insulin in the refrigerator." C. "I will hold the needle at a 15° angle to my skin." D. "I should use an injection site that is 1 inch from the previous site."

Correct Answer is D

Explanation

A. "I should dispose of my used syringes in the household trash.": Used insulin syringes are considered sharps and must be disposed of in an approved, puncture-resistant sharps container to prevent injury and potential disease transmission. Discarding them in regular trash poses a safety risk to household members and waste handlers.

B. "I will store my current bottle of insulin in the refrigerator.": Open insulin in use can generally be kept at room temperature for a limited period (usually 28 days for most types) to prevent discomfort during injection and reduce the risk of injection site irritation. Refrigeration is recommended for unopened insulin, but ongoing use at room temperature is safe and more comfortable.

C. "I will hold the needle at a 15° angle to my skin.": Subcutaneous insulin injections are typically administered at a 90° angle to ensure proper delivery into the subcutaneous tissue. A 15° angle would be too shallow, increasing the risk of intradermal injection and affecting insulin absorption.

D. "I should use an injection site that is 1 inch from the previous site.": Rotating injection sites within the same area by at least 1 inch helps prevent lipohypertrophy and tissue damage, ensuring consistent absorption of insulin. This practice demonstrates proper understanding of safe and effective insulin administration.

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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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