A nurse is assessing a client who had a stroke 2 days ago. Which of the following findings should the nurse identify as a need for a referral to speech-language pathology?

Diminished hand-to-mouth coordination

Impaired voluntary cough

Altered level of consciousness

Unilateral ptosis

Answer and Explanation

The Correct Answer is B

Choice A reason: Diminished hand-to-mouth coordination is not a finding that requires a referral to speech-language pathology, as it is related to the motor function of the upper extremities. The nurse should refer the client to physical therapy or occupational therapy for this issue.

Choice B reason: Impaired voluntary cough is a finding that requires a referral to speech-language pathology, as it indicates a possible dysfunction of the swallowing mechanism or the vocal cords. The nurse should refer the client to speech-language pathology for a swallowing evaluation and intervention.

Choice C reason: Altered level of consciousness is not a finding that requires a referral to speech-language pathology, as it is related to the neurological function of the brain. The nurse should monitor the client's Glasgow Coma Scale score and report any changes to the provider.

Choice D reason: Unilateral ptosis is not a finding that requires a referral to speech-language pathology, as it is related to the cranial nerve function of the eye. The nurse should assess the client's pupillary response and eye movements and report any abnormalities to the provider.

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Correct Answer is C

Explanation

Choice A reason: This is not the correct choice because this response is inaccurate and misleading. Respite services do not provide medical care or treatment for the client, but rather temporary relief and support for the family caregivers. The nurse should not give false hope or unrealistic expectations to the client's partner.

Choice B reason: This is not the correct choice because this response is incomplete and vague. Respite services may include some practical assistance such as meal delivery or housekeeping, but their main purpose is to provide emotional and social support for the family caregivers. The nurse should explain how respite services can help the client's partner cope with the stress and challenges of caregiving.

Choice C reason: This is the correct choice because this response is accurate and clear. Respite services can provide the client's partner with some time off from their caregiving duties, which can help them recharge their energy, attend to their own needs, and maintain their well-being. The nurse should emphasize the benefits of respite services for the client's partner and their relationship with the client.

Choice D reason: This is not the correct choice because this response is confusing and irrelevant. Respite services do not offer psychological interventions for the client or the family, but rather companionship and support. The nurse should not imply that the client's partner needs therapy or counseling, which may be perceived as judgmental or insensitive.

A. Inform the client that she cannot leave without a discharge prescription from the provider. B. Ask the client if she would like a sedative to help her relax. C. Assign a security officer to the client's room until the provider can speak with the client. D. Have the client sign the Against Medical Advice form.

Correct Answer is D

Explanation

Choice A reason: This is not the correct choice because this action is not legally required or ethically appropriate. The client has the right to refuse treatment and leave the hospital at any time, as long as she is competent and informed of the risks and consequences. The nurse should not coerce or threaten the client to stay against her will.

Choice B reason: This is not the correct choice because this action is not helpful or respectful. The client may have valid reasons for wanting to go home, such as personal or financial issues. The nurse should not assume that the client is anxious or irrational and offer her a sedative, which may impair her judgment and consent.

Choice C reason: This is not the correct choice because this action is not necessary or professional. The client is not a threat to herself or others, and does not need to be restrained or guarded by a security officer. The nurse should not use intimidation or force to prevent the client from leaving.

Choice D reason: This is the correct choice because this action is the best practice and the standard procedure. The nurse should explain to the client the benefits of staying and the risks of leaving, and document the conversation. The nurse should also ask the client to sign the Against Medical Advice form, which states that the client understands the implications of her decision and releases the hospital and the provider from liability.

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A nurse is assessing a client who had a stroke 2 days ago. Which of the following findings should the nurse identify as a need for a referral to speech-language pathology?

Nursing Test Bank

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