A nurse is teaching the partner of a client who had a stroke about dysphagia. Which of the following statements by the client's partner should indicate to the nurse that the teaching was effective?

Choice A rationale Coughing during swallowing is a clinical sign of aspiration or airway penetration, which indicates that the swallowing mechanism is failing to protect the trachea. In a client with dysphagia, the goal is to swallow safely without any reflexive coughing. Encouraging a cough while food is in the pharynx could actually increase the risk of inhaling particles into the lungs, leading to aspiration pneumonia or acute airway obstruction. Choice B rationale Food should be placed on the stronger, unaffected side of the mouth to allow for better control and manipulation of the bolus. The weaker side often has diminished sensation and muscle tone, which leads to pocketing of food in the cheek or an inability to move the food toward the esophagus effectively. Using the stronger side maximizes the use of intact cranial nerve functions and reduces the risk of choking. Choice C rationale For safe swallowing, a client should be seated upright at a 90 degree angle, not 30 degrees. A 30 degree angle is insufficient to prevent gravity from pulling secretions or food toward the airway before the swallow reflex is fully triggered. Proper positioning involves keeping the torso vertical and the head in a neutral or slightly flexed position to ensure the esophagus is the primary path for the food bolus. Choice D rationale Tilting the head forward, often called the chin-tuck maneuver, is a standard technique used in dysphagia management to narrow the airway entrance. This position pushes the tongue base backward toward the pharyngeal wall and shifts the epiglottis into a more protective position over the glottis. It helps ensure that food and liquids pass into the esophagus rather than entering the larynx and trachea, significantly reducing the risk of silent or overt aspiration.