Certified Rehabilitation Registered Nurse (CRRN) Practice Exam

Teaching dysphagia management strategies will be most challenging in a patient demonstrating which condition?

1. Neglect

2. Apraxia

3. Anosodiaphoria

4. Asteregnosis

The correct answer is: Apraxia

Teaching dysphagia management strategies is most challenging in a patient with apraxia because this condition directly affects the individual's ability to plan and execute the movements necessary for swallowing. Apraxia is a motor disorder that impairs the ability to perform purposeful movements, even when the individual has the desire and physical capability to carry out those actions. This means that a person with apraxia may struggle to coordinate the complex series of muscle movements required for effective swallowing, making it difficult for them to understand and implement dysphagia management strategies. In contrast, other conditions, while potentially impacting overall functioning and interaction with therapy, do not specifically hinder the patient’s ability to follow through with the physical act of swallowing. For instance, neglect may involve an insensitivity to part of the body or environment, but it does not directly interfere with the neuromuscular execution of swallowing. Anosodiaphoria, which involves a lack of emotional concern about physical disabilities, and astereognosis, the inability to identify objects by touch while the vision is occluded, also do not have the same direct impact on the motor processes involved in swallowing. Therefore, the specific nature of apraxia makes it particularly challenging for nursing professionals to successfully teach and ensure that patients grasp