A client is diagnosed with a right-sided stroke. The client is now experiencing hemianopsia. How can the nurse help the client manage potential sensory and perceptual difficulties?

Place the client’s clock on the affected side

Place the client’s extremities where the client can see them

Approach the client on the side where vision is impaired

Keep the lighting in the client’s room low

Answer and Explanation

The Correct Answer is B

Reasoning:

Choice A reason: Placing the clock on the affected side (left in right-sided stroke) worsens hemianopsia issues, as the client cannot see the left visual field. This increases neglect and disorientation. Positioning items in the intact visual field helps the client compensate for the visual deficit effectively.

Choice B reason: Placing extremities in the client’s intact visual field (right side in right-sided stroke) compensates for left hemianopsia. This helps the client maintain awareness of their body, reducing neglect and injury risk, as they cannot see the left side, improving safety and sensory integration.

Choice C reason: Approaching from the impaired side (left in right-sided stroke) increases disorientation and neglect in hemianopsia. Approaching from the intact right side ensures the client can see and respond, improving communication and reducing startle or confusion caused by unseen approaches.

Choice D reason: Keeping lighting low may reduce glare but does not address hemianopsia’s visual field loss. Adequate lighting in the intact field enhances visibility of objects and extremities, aiding compensation for the deficit. Low lighting could increase disorientation in clients with visual impairments.

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Correct Answer is A

Explanation

Reasoning:

Choice A reason: Sickle cell anemia is an inherited disorder caused by a genetic mutation in the hemoglobin gene, leading to abnormal hemoglobin (HbS). This causes red blood cells to sickle under stress, triggering hemolysis. The autosomal recessive inheritance pattern makes it a classic example of an inherited hemolytic anemia with chronic hemolysis.

Choice B reason: Hypersplenism is not an inherited disorder but a condition where an enlarged spleen sequesters and destroys red blood cells, causing anemia. It results from secondary causes like liver disease or portal hypertension, not genetic mutations, making it an acquired cause of hemolytic anemia.

Choice C reason: Cold agglutinin disease is typically acquired, often due to infections or autoimmune disorders, causing antibodies to agglutinate red blood cells at low temperatures, leading to hemolysis. While rare congenital forms exist, it is not primarily inherited, unlike sickle cell anemia’s genetic basis.

Choice D reason: Autoimmune hemolytic anemia is usually acquired, caused by autoantibodies attacking red blood cells, leading to hemolysis. It is associated with conditions like lupus or infections, not genetic mutations. Unlike sickle cell anemia, it lacks an inherited genetic component as its primary etiology.

A. Iron deficiency anemia B. Hemolytic anemia C. Sickle cell anemia D. Aplastic anemia

Correct Answer is D

Explanation

Reasoning:

Choice A reason: Iron deficiency anemia causes fatigue and anemia due to low iron, reducing hemoglobin synthesis. However, it does not typically cause neutropenia, thrombocytopenia, or left upper quadrant pain. Bruising may occur, but the triad of pancytopenia and recent infections points more strongly to bone marrow failure.

Choice B reason: Hemolytic anemia involves red blood cell destruction, causing anemia and fatigue, but neutropenia and thrombocytopenia are not typical. Left upper quadrant pain may suggest splenomegaly, but the full pancytopenia and infection history align better with bone marrow suppression than hemolytic processes alone.

Choice C reason: Sickle cell anemia causes hemolytic anemia and pain from vaso-occlusion, potentially in the spleen (left upper quadrant). However, it does not typically cause neutropenia or thrombocytopenia. The client’s pancytopenia and recurrent infections suggest a broader bone marrow issue, not specific to sickle cell disease.

Choice D reason: Aplastic anemia is characterized by bone marrow failure, leading to pancytopenia (anemia, neutropenia, thrombocytopenia), causing fatigue, bruising, and infection susceptibility. Left upper quadrant pain may indicate splenomegaly or bleeding. The history of recurrent infections supports neutropenia from bone marrow suppression, making this the most likely diagnosis.

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A client is diagnosed with a right-sided stroke. The client is now experiencing hemianopsia. How can the nurse help the client manage potential sensory and perceptual difficulties?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which type of hemolytic anemia is categorized as an inherited disorder?

Correct Answer is A

Explanation

Correct Answer is D

Explanation

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