Medical Surgical Stroke #3


The nurse will collaborate with the interdisciplinary team on communication assist with a client with expressive aphasia. The team decided on which intervention to help with communication?


  1. Make sure all staff know to speak slowly and in short sentences.
    • Rationale:

      This answer is not correct because although this may be helpful, it is not the most therapeutic intervention listed. Using short sentences helps the client concentrate on one thing at a time but it is important to remember expressive aphasia does not affect cognition or intelligence, only the ability to express oneself.

  2. Make sure all staff speak loudly for the client to hear.
    • Rationale:

      This answer is not correct because speaking loudly or slowly is nontherapeutic. Expressive aphasia does not have the characteristics of having difficulty hearing, but having difficulty expressing oneself or speaking. This type of communication may diminish the client’s dignity.

  3. Make sure all staff write on a clipboard for the client to read communication.
    • Rationale:

      This answer is not correct because having staff to be the only ones to write implies one-way communication that is staff-driven and not client-need driven. Also the client’s ability to read and write may be affected.

  4. Make sure all staff assist the client with use of a picture board which is client driven.
    • Rationale:

      This answer is correct because a picture or communication board helps the client, as the client can point to or direct others towards objects on the board for wants and needs. The focus is client-centered care and the client should be encouraged to express needs and wants through therapeutic means.


Expressive aphasia is when the client knows what they want to say but has trouble saying it. For that reason, the use of a picture board is helpful to clients with expressive aphasia.


Learning Outcomes

Neurological damage to the Broca’s area of the brain is the cause of expressive aphasia, also known as Broca’s aphasia. With expressive aphasia, or Broca’s aphasia, comprehension is unimpaired. It is the execution of words where the client will have difficulty. Interventions include allowing client time to communicate, utilizing communication boards, observing for signals of fatigue, and consulting speech pathology. It is important not to “talk around” or exclude the client from conversation. The client understands what is being said, but is just not able to communicate verbally. Educating caregivers is key, letting them know that the client understands what is being said, but cannot express themselves verbally.

Test Taking Tip

Dignity places a huge role with clients who are challenged in the area caring for themselves, or ADLs (activities of daily living). Refer back to Maslow’s Hierarchy of Needs under the psychological needs.

Video Rationale