A client is admitted to an acute care facility with a suspected dysfunction of the lower brain stem. The nurse should monitor this client closely for:

Choice A rationale

Tactile agnosia is the inability to recognize objects through touch, not vision. This condition affects the somatosensory cortex, impacting tactile processing.

Choice B rationale

Ataxia involves the loss of full control of bodily movements and coordination, not the inability to identify objects visually. It typically results from cerebellar dysfunction.

Choice C rationale

Visual agnosia is the inability to recognize familiar objects by sight despite having intact visual functioning. This condition often results from damage to the occipital or temporal lobes.

Choice D rationale

Positive Romberg sign indicates balance issues, typically seen when a client sways or falls when standing with eyes closed. It does not pertain to visual recognition deficits.

Choice A rationale

A 5% deficit in body weight and increased caloric need alone do not warrant the initiation of parenteral nutrition (PN). PN is typically reserved for situations where oral or enteral feeding is not feasible or safe.

Choice B rationale

Significant risk of aspiration and decreased level of consciousness may necessitate alternative feeding methods, such as enteral feeding via a nasogastric or gastrostomy tube. PN is considered when enteral feeding is not possible.

Choice C rationale

Calorie deficit, muscle wasting, and low electrolyte levels indicate malnutrition, but PN is initiated when other feeding methods are inadequate or unsafe.

Choice D rationale

Inability to take in adequate oral food or fluids within 7 days is a clear indication for initiating PN. This ensures the patient receives essential nutrients and prevents further deterioration of their nutritional status.