A speech therapist is performing a swallowing assessment on a ...

[madam-professor]

A speech therapist is performing a swallowing assessment on a 72-year-old man who has suffered a stroke 3 weeks ago. The man has been NPO (nothing by mouth) since his stroke, and the health care team is considering the introduction of oral food.
 
  The speech therapist is cueing the client to swallow to preclude either aspiration of food or pocketing of food in the sides of his mouth. The client most likely to have conscious control over which of the following processes listed below involved in swallowing?
  A)
  Initiation of primary peristalsis
  B)
  Moving the epiglottis back to cover the larynx
  C)
  Moving a bolus to the posterior wall of the pharynx
  D)
  Moving the bolus backward in the esophagus

Question 2

A family physician is providing care for a 61-year-old obese male who has a history of diabetes and hypertension. Blood work has indicated that the man has a GFR of 51 mL/minute with elevated serum creatinine levels.
 
  Which of the following statements will the physician most likely provide the client in light of these results?
  A)
  We will regularly monitor your kidney function, but most likely your kidneys will be able to compensate on their own and intervention is not required.
  B)
  You likely have chronic kidney disease, and there may be urine in your blood until it is controlled.
  C)
  Your chronic kidney disease has likely been caused by your diabetes and high blood pressure.
  D)
  You're in kidney failure, and I'll be starting dialysis treatment immediately.

[DHRUVSHAH]

Answer to Question 1

Ans:
C

Feedback:

Moving a bolus to the posterior wall of the pharynx is a component of the oral, or voluntary, phase of swallowing. Initiation of primary peristalsis, moving the epiglottis back to cover the larynx, and moving the bolus backward in the esophagus are all involuntary components of the pharyngeal and esophageal phases of swallowing.

Answer to Question 2

Ans:
C

Feedback:

Diabetes and hypertension are conditions that can cause chronic kidney disease (CKD). While the kidneys do have a remarkable ability to compensate for impaired function, this fact does not mean that treatment would not be undertaken. Hematuria is not a common manifestation of CKD, and the client's GFR of 51 mL/minute does not indicate kidney failure or the need for dialysis.