A nurse is assisting a client who had a recent stroke with getting dressed for physical therapy. The client looks at each piece of clothing before putting it on the body. The client states, “This is how I know what item I am holding.” What impairment is this client likely experiencing?

Homonymous hemianopsia

Receptive aphasia

Hemiplegia

Agnosia

Answer and Explanation

The Correct Answer is D

Reasoning:

Choice A reason: Homonymous hemianopsia causes loss of half the visual field, affecting object recognition due to visual impairment, not cognitive processing. The client’s need to inspect clothing to identify it suggests a sensory processing deficit, not a visual field loss, making agnosia more likely.

Choice B reason: Receptive aphasia impairs language comprehension, affecting the ability to understand spoken or written words, not object recognition. The client’s ability to identify clothing by inspection, not language, points to a sensory processing issue, ruling out aphasia as the primary impairment.

Choice C reason: Hemiplegia, or paralysis of one side, affects movement, not object recognition. The client’s difficulty identifying clothing is cognitive, not motor, as they can manipulate items but need visual inspection to understand them, indicating agnosia rather than a physical impairment like hemiplegia.

Choice D reason: Agnosia, a post-stroke impairment, prevents recognition of objects despite intact sensory input. The client’s need to inspect clothing to identify it suggests visual agnosia, where the brain fails to process familiar objects, matching the described behavior and indicating a perceptual deficit from stroke.

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Correct Answer is B

Explanation

Reasoning:

Choice A reason: Hair loss may not significantly decline with successful Cushing’s syndrome treatment. Excess cortisol causes hirsutism or hair thinning due to androgen excess or protein catabolism. Treatment reduces cortisol, but hair changes may persist due to slow hair growth cycles or irreversible follicular damage.

Choice B reason: Successful treatment of Cushing’s syndrome lowers serum glucose levels. Excess cortisol induces insulin resistance and gluconeogenesis, causing hyperglycemia. Reducing cortisol through treatment (e.g., surgery or medication) restores insulin sensitivity and reduces glucose production, normalizing blood sugar levels, a key indicator of effective management.

Choice C reason: Bone demineralization may not decline quickly with treatment. Chronic cortisol excess inhibits osteoblast activity and calcium absorption, causing osteoporosis. While treatment halts further bone loss, reversal is slow due to the time required for bone remodeling, making this less immediate than glucose normalization.

Choice D reason: Menstrual flow may not immediately increase with treatment. Cortisol excess disrupts gonadotropin release, causing amenorrhea. Restoring normal cortisol levels may improve menstrual cycles, but hormonal recovery is gradual, and changes in flow are less immediate or reliable than glucose level declines as a treatment outcome.

A. Megaloblastic anemia B. Hemophilia C. Thrombocytopenia D. Sickle cell disease

Correct Answer is A

Explanation

Reasoning:

Choice A reason: Megaloblastic anemia, caused by vitamin B12 or folate deficiency, impairs DNA synthesis, leading to macrocytic red blood cells. Fatigue results from reduced oxygen-carrying capacity, and a smooth, beefy red tongue (glossitis) is a classic sign due to mucosal cell turnover disruption, matching the client’s symptoms.

Choice B reason: Hemophilia, a bleeding disorder due to clotting factor deficiencies, causes bleeding tendencies like hemarthrosis, not fatigue or glossitis. It does not affect red blood cell production or mucosal tissues, making it inconsistent with the client’s symptoms of anemia and tongue changes.

Choice C reason: Thrombocytopenia, or low platelet count, causes bleeding and bruising, not fatigue or a beefy red tongue. It affects hemostasis, not red blood cell production or mucosal integrity, making it an unlikely cause of the client’s hematologic symptoms described in the scenario.

Choice D reason: Sickle cell disease causes hemolytic anemia and vaso-occlusive pain, not a smooth, beefy red tongue. Fatigue occurs from anemia, but glossitis is specific to megaloblastic anemia due to B12 or folate deficiency, not the hemoglobinopathy of sickle cell disease.

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A nurse is assisting a client who had a recent stroke with getting dressed for physical therapy. The client looks at each piece of clothing before putting it on the body. The client states, “This is how I know what item I am holding.” What impairment is this client likely experiencing?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is being successfully treated for Cushing's syndrome. The nurse should expect a decline in:

Correct Answer is B

Explanation

The nurse is assessing a new client with reports of acute fatigue and a sore tongue that is visibly smooth and beefy red. This client is demonstrating signs and symptoms associated with what form of hematologic disorder?

Correct Answer is A

Explanation

Which clinical sign is associated with diabetes insipidus?

Thrombolytic therapy should be initiated within what time frame of an ischemic stroke to achieve the best functional outcome?

A client who has experienced an ischemic stroke has been admitted to the medical unit. The client’s family is adamant that the client remain on bed rest to hasten recovery and to conserve energy. What principle of care should inform the nurse’s response to the family?

A nurse is caring for a client with the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which finding would indicate that the client has developed fluid overload?

The nurse should advise a client with iron deficiency anemia to take which action to prevent staining of the teeth?

A nurse is developing a care plan for a client with disseminated intravascular coagulation (DIC). Which nursing intervention should the nurse include?

Nursing care during the immediate recovery period from an ischemic stroke should normally prioritize which intervention?