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 A

Explanation

Reasoning:

Choice A reason: The posterior pituitary gland is the primary site involved in SIADH, as it releases antidiuretic hormone (ADH). Excessive ADH secretion causes water retention, leading to hyponatremia. In SIADH, dysregulation of ADH release, often due to ectopic production or pituitary overstimulation, is the core pathophysiological mechanism.

Choice B reason: The anterior pituitary gland produces hormones like growth hormone and ACTH, not ADH. It is not involved in SIADH, which is specifically related to excessive ADH from the posterior pituitary or ectopic sources, causing water retention and dilutional hyponatremia, distinct from anterior pituitary functions.

Choice C reason: The thyroid gland regulates metabolism through thyroid hormones, not fluid balance. SIADH is caused by excessive ADH, which is unrelated to thyroid function. Thyroid disorders may cause metabolic symptoms but do not contribute to the water retention seen in SIADH.

Choice D reason: The adrenal gland produces cortisol and aldosterone, which regulate stress responses and sodium balance, not ADH. SIADH involves excessive ADH, leading to water retention, and is unrelated to adrenal function. Adrenal disorders like Addison’s disease affect sodium differently, not via ADH.

A. To prevent contractures and muscle atrophy, bed rest should not exceed 4 weeks B. The client should mobilize as soon as physically able C. The client should remain on bed rest until the client expresses a desire to mobilize D. Lack of mobility will greatly increase the client’s risk of stroke recurrence

Correct Answer is B

Explanation

Reasoning:

Choice A reason: Limiting bed rest to 4 weeks to prevent contractures and atrophy is not the primary principle. While prolonged immobility causes these issues, early mobilization post-stroke improves recovery and prevents complications like thromboembolism, making immediate mobilization the key focus rather than a time limit.

Choice B reason: Mobilizing as soon as physically able is critical post-ischemic stroke to enhance recovery. Early mobilization improves circulation, prevents thromboembolism, maintains muscle strength, and promotes neuroplasticity, reducing disability. This principle counters the family’s insistence on bed rest, which increases complication risks and hinders recovery.

Choice C reason: Waiting for the client to express a desire to mobilize delays recovery. Stroke patients may lack initiative due to neurological deficits or depression. Early mobilization, guided by physical ability, prevents complications like deep vein thrombosis and supports rehabilitation, making patient desire a poor criterion.

Choice D reason: Lack of mobility does not directly increase stroke recurrence risk, which is more tied to vascular risk factors like hypertension or diabetes. However, immobility increases complications like thromboembolism, which could indirectly contribute to stroke. Early mobilization is the priority to enhance overall recovery.

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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 nurse is providing care to a client diagnosed with the syndrome of inappropriate antidiuretic hormone (SIADH). The nurse understands that the primary problem involves which gland?

Correct Answer is A

Explanation

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?

Correct Answer is B

Explanation

A client has been diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following manifestations would be expected in this client?

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