Certified Rehabilitation Registered Nurse (CRRN) Practice Exam

In the assessment of a patient with suspected swallowing difficulties, which symptom is considered the most critical?

1. Speech difficulties

2. Pocketing of food

3. Frequent coughing

4. Sudden weight loss

The correct answer is: Pocketing of food

In the assessment of a patient with suspected swallowing difficulties, pocketing of food represents a significant concern. This symptom indicates that the patient is unable to manage food in their mouth properly, which can lead to several complications. Pocketing occurs when food is held in the cheeks or other areas of the mouth instead of being moved to the throat for swallowing. This not only signifies a physical difficulty with the act of swallowing but also increases the risk of aspiration, where food or liquids enter the airway, potentially leading to aspiration pneumonia or choking. While symptoms like speech difficulties, frequent coughing, and sudden weight loss are important and can suggest swallowing issues, they do not directly reflect the act of swallowing itself as prominently as pocketing. Speech difficulties may relate to many factors, frequent coughing might indicate other conditions or be a reflex rather than a clear sign of swallowing difficulty, and sudden weight loss could imply that the patient is not eating adequately, but it does not identify the immediate mechanical issues occurring during swallowing. Therefore, pocketing of food is the most indicative symptom of swallowing difficulties, highlighting the need for further assessment and potential intervention.