A client who recently suffered a stroke suffers from right-sided homonymous hemianopsia. What is the best action for the nurse to take when caring for the client during mealtime?

Choice A Reason: "I ate shellfish about 2 weeks ago at a local restaurant." supports the medical diagnosis of hepatitis A, which is an infection of the liver caused by the hepatitis A virus (HAV). HAV is transmitted by fecal-oral route, meaning that it can be contracted by ingesting contaminated food or water, such as raw or undercooked shellfish from polluted waters. The incubation period for hepatitis A is about two to six weeks.

Choice B Reason: "I was an intravenous drug abuser in the past and shared needles." does not support the medical diagnosis of hepatitis A, but may indicate exposure to hepatitis B or C, which are infections of the liver caused by the hepatitis B virus (HBV) or hepatitis C virus (HCV). HBV and HCV are transmitted by blood or body fluids, meaning that they can be contracted by sharing needles, syringes, or other injection equipment with infected people.

Choice C Reason: "I had a blood transfusion in 1980 after major abdominal surgery." does not support the medical diagnosis of hepatitis A, but may indicate exposure to hepatitis B or C, which are infections of the liver caused by the hepatitis B virus (HBV) or hepatitis C virus (HCV). HBV and HCV are transmitted by blood or body fluids, meaning that they can be contracted by receiving blood transfusions or organ transplants from infected donors. However, since 1992, all donated blood in the United States has been screened for HBV and HCV.

Choice D Reason: "I have had unprotected sex with multiple partners." does not support the medical diagnosis of hepatitis A, but may indicate exposure to hepatitis B or C, which are infections of the liver caused by the hepatitis B virus (HBV) or hepatitis C virus (HCV). HBV and HCV are transmitted by blood or body fluids, meaning that they can be contracted by having unprotected sex with infected people. However, sexual transmission of HAV is rare, unless there is contact with fecal matter.

Choice A reason: This is correct because avoiding swimming underwater can help prevent the worsening of Meniere's disease. Meniere's disease is a disorder of the inner ear that causes episodes of vertigo, tinnitus, hearing loss, and fullness in the ear. Swimming underwater can increase pressure in the ear and trigger an attack. The nurse should advise the client to avoid activities that involve changes in altitude or pressure, such as flying, diving, or climbing.
Choice B reason: This is incorrect because wearing earphones when in crowded places can worsen Meniere's disease. Earphones can increase noise exposure and damage hearing, which is already impaired by Meniere's disease. The nurse should advise the client to avoid loud noises and use hearing aids if needed.
Choice C reason: This is incorrect because keeping eyes open during an acute attack can increase vertigo and nausea. Vertigo is a sensation of spinning or moving when still, which can be caused by Meniere's disease. Keeping eyes open can make vertigo worse by creating a visual mismatch with vestibular signals from the inner ear. The nurse should advise the client to close their eyes or focus on a stationary object during an attack.
Choice D reason: This is correct because sitting or lying down if whirling occurs can help prevent falls or injuries due to vertigo. Whirling is another term for vertigo, which can affect balance and coordination. Sitting or lying down can reduce movement and stabilize posture during an attack. The nurse should advise
the client to avoid driving or operating machinery when experiencing vertigo.
Choice E reason: This is correct because we do not know the exact cause of Meniere's disease. Meniere's disease is thought to be related to abnormal fluid balance or pressure in the inner ear, but what triggers this condition is unknown. The nurse should educate the client about possible risk factors, such as genetics, infections, allergies, autoimmune disorders, or head trauma, but also acknowledge the uncertainty and variability of the disease.
Choice F reason: This is incorrect because damage to the ear from excess noise is not the cause of Meniere's disease. Damage to the ear from excess noise can cause noise-induced hearing loss, which is a type of sensorineural hearing loss that affects the cochlea or the auditory nerve. Meniere's disease is a type of mixed hearing loss that affects both the cochlea and the middle ear. The nurse should not confuse or misinform the client about the cause of their condition.