# A client recovering from a stroke passed the bedside swallow screen and will now take the first oral meal. Which action should the nurse take?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522688&lang=en  
> language: en  
> subject: Nutrition and Oral Hydration  
> category: BCC

## Question

A client recovering from a stroke passed the bedside swallow screen and will now take the first oral meal. Which action should the nurse take?

## Option

1. Offer thin liquids through a straw so the client can control the flow
2. Seat the client upright and begin with small amounts of the ordered texture **✔ Correct answer**
3. Ask the family to feed the client so that the meal is finished more quickly
4. Give the oral medications first so they are taken before the client tires

**Correct answer: 2**

## Explanation

Upright positioning with small amounts of the prescribed texture protects the airway during the first oral intake. Volume and independence increase only after swallowing is observed to be safe.

## In-depth explanation

Quick answer
Sit the client fully upright and start with small amounts of the ordered texture.

Why this is correct
Passing a screen shows that oral intake may begin, not that swallowing is normal. Upright posture uses gravity to protect the airway, and small amounts let the nurse observe each swallow while the risk is still limited.

Easy analogy or mental picture
It is a test drive at low speed rather than a highway merge. The image conveys graded exposure and does not mean the client is kept from eating.

Memory hook
First meal after a stroke: upright, small, and observed.

NCLEX decision rule
Begin oral intake after a passed screen with the client upright, using the prescribed texture in small amounts under direct observation. Speed and independence come after safe swallowing is demonstrated.

Why the other choices are wrong
A straw, family assistance, and early medication administration each appear helpful, but each of them increases the volume or pace before swallowing has been observed.References

- [1]NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing

- [2]MedlinePlus: Swallowing ProblemsU.S. National Library of Medicine

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