Which one of the following patients is at the greatest risk for aspiration?
A) A stroke patient with dysarthria
B) An ambulatory patient with Alzheimer's disease
C) A 92-year-old patient who needs help with activities of daily living (ADLs)
D) A patient with severe, deforming rheumatoid arthritis
Ans: A
Feedback: The muscles that become paralyzed in dysarthria are the same ones used for swallowing. This increases the patient's risk of aspiration. Patients with Alzheimer's disease who are still ambulatory probably don't have the voluntary muscle problems that occur later in the disease. Patients who need help with ADLs or have severe arthritis shouldn't have difficulty swallowing unless it exists secondary to another problem.
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