Progressive Care Nursing Certification (PCCN) Practice Exam

What is the highest risk complication for a patient in the first 24 hours after a stroke?

1. Bleeding

2. Decreased level of consciousness

3. Aspiration

4. Speech abnormality

The correct answer is: Aspiration

The highest risk complication in the first 24 hours after a stroke is aspiration. This risk arises from the potential impact of the stroke on swallowing mechanisms, which can lead to difficulties in safely managing oral intake. The neurological impairment resulting from a stroke may affect the patient's ability to coordinate the muscles involved in swallowing, increasing the likelihood of food or liquids entering the airway instead of the esophagus. Aspiration is particularly concerning because it can lead to severe consequences such as aspiration pneumonia, which is a common complication in stroke patients. Monitoring for signs of aspiration, such as coughing, difficulty breathing, or changes in vocal quality during feeding, is critical in the early management of stroke patients to prevent further complications. While decreased level of consciousness, bleeding, and speech abnormality are also important considerations in the acute care of stroke patients, they do not carry the immediate high-risk status associated with aspiration within the first day following the event. Decreased consciousness may indicate a worsening of the patient's neurological status, bleeding could be a concern in cases of hemorrhagic stroke, and speech abnormalities may become evident as the patient recovers, but aspiration poses an immediate risk that has direct implications for the patient’s airway and respiratory function. Thus, aspiration stands out as the most critical complication