06-16-2008, 12:30 PM
42. Twelve days after sustaining a cerebral infarction, a 72-year-old man has fever and cough. Initial symptoms included inability to move his right arm and leg, swallow, speak, or respond to questions. He has been receiving a diet of pureed foods since he recovered his ability to swallow 3 days ago. He is wearing false teeth. His temperature now is 38.8°C (101.8°F), blood pressure is 135/85 mm Hg, pulse is 94/min, and respirations are 28/min. Examination shows moderate weakness of the facial muscles and right extremities. Gag reflex is absent. Breath sounds are decreased, and there is dullness to percussion over the right lung base posteriorly. An x-ray film of the chest shows an infiltrate in the posterior basal segment of the right lung. Which of the following is most likely to prevent recurrence of this patient's lung condition?
O A) Removal of false teeth
O B) Suppression of gastric acid production
O C) Chronic antibiotic prophylaxis
O D) Administration of metoclopramide to increase gastrointestinal motility
O E) Insertion of a feeding jejunostomy tube
O A) Removal of false teeth
O B) Suppression of gastric acid production
O C) Chronic antibiotic prophylaxis
O D) Administration of metoclopramide to increase gastrointestinal motility
O E) Insertion of a feeding jejunostomy tube