The Patient Is Treated with Intravenous Fluids and Antibiotics, with Improvement

The patient is treated with intravenous fluids and antibiotics, with improvement in fever, leukocytosis, and hypotension.  On the third day of hospitalization, temperature is 36.7 C (98 F) , blood pressure is 122/78 mm Hg, and pulse is 86/min.  On examination, he is mildly lethargic and his voice is soft and breathy.  Rhonchi are still heard over the lower right lung.  There is left-sided facial droop and hemiparesis from his previous stroke.  Chest x-ray demonstrates dense air space opacities in the superior region of the right lower lobe.  Which of the following is the most likely underlying etiology of this patient's hospitalization?

A) Decreased enteral feeding
B) Extended immobility
C) Impaired cellular immunity
D) Reduced intercostal muscle strength
E) Swallowing muscle dysfunction

Correct Answer:

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