A nurse is caring for a client who had a stroke involving the right cerebral hemisphere. The nurse should monitor for which of the following findings?

Poor impulse control

Deficits in the right visual field

Unable to discriminate words and letters

Motor retardation

Answer and Explanation

The Correct Answer is A

Choice A reason: A stroke involving the right cerebral hemisphere can affect the cognitive and emotional functions of the brain, such as judgment, impulse control, and emotional regulation³. This can lead to risky or inappropriate behaviors, such as acting impulsively or disregarding social norms. Therefore, the nurse should monitor the client for poor impulse control and provide appropriate interventions, such as education, cueing, feedback, and environmental modifications.
Choice B reason: A stroke involving the right cerebral hemisphere can affect the visual functions of the brain, such as depth perception, spatial orientation, and visual recognition³. However, the deficits are usually in the left visual field, not the right, because the right side of the brain controls the left side of the body and the environment. Therefore, the nurse should monitor the client for deficits in the left visual field, not the right.
Choice C reason: A stroke involving the right cerebral hemisphere can affect the abstract reasoning functions of the brain, such as understanding metaphors, humor, or sarcasm. However, the ability to discriminate words and letters is more related to the language functions of the brain, which are mainly controlled by the left cerebral hemisphere. Therefore, the nurse should monitor the client for language deficits, such as aphasia or dysarthria, if the stroke involves the left cerebral hemisphere, not the right.
Choice D reason: A stroke involving the right cerebral hemisphere can affect the motor functions of the brain, such as movement, coordination, and balance³. However, the motor retardation, which is a slowing down of physical and mental activity, is more related to the mood functions of the brain, which are mainly controlled by the frontal lobe of the brain. Therefore, the nurse should monitor the client for motor retardation if the stroke involves the frontal lobe, not the right cerebral hemisphere.

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Correct Answer is B

Explanation

The correct answer is: d. On the nonoperative side

Choice A: Prone

Reason: Placing a patient in the prone position (lying face down) after a pneumonectomy is generally not recommended. This position can compromise respiratory function by restricting chest expansion and increasing the risk of respiratory complications. Additionally, it can place undue pressure on the surgical site, potentially leading to complications such as impaired wound healing or increased pain.

Choice B: Semi-Fowler’s

Reason: The Semi-Fowler’s position (head of the bed elevated to 30-45 degrees) is often used to promote lung expansion and reduce the risk of aspiration. While it can be beneficial for general postoperative care, it is not the optimal position for a patient who has undergone a pneumonectomy. This position does not specifically address the need to prevent fluid accumulation in the remaining lung.

Choice C: Sims

Reason: The Sims position (lying on the side with one leg bent) is typically used for procedures such as enemas or to facilitate drainage of oral secretions. It is not suitable for a postoperative pneumonectomy patient because it does not provide the necessary support to the remaining lung and can increase the risk of fluid shifting to the nonoperative side.

Choice D: On the nonoperative side

Reason: Placing the patient on the nonoperative side is the correct position. This position helps to prevent fluid from accumulating in the remaining lung and reduces the risk of complications such as mediastinal shift or respiratory distress. By positioning the patient on the nonoperative side, gravity helps to keep the remaining lung expanded and functional.

A. Overflow incontinence B. Urge incontinence C. Stress incontinence D. Reflex incontinence

Correct Answer is D

Explanation

Choice A reason: Overflow incontinence is not the type of urinary incontinence that the client is experiencing. Overflow incontinence occurs when the bladder is overfilled and cannot empty properly, causing frequent or constant dribbling of urine. It can be caused by a blockage in the urinary tract, such as an enlarged prostate or a kidney stone, or by a weak bladder muscle that cannot contract enough to empty the bladder.

Choice B reason: Urge incontinence is not the type of urinary incontinence that the client is experiencing. Urge incontinence occurs when the bladder muscle contracts involuntarily and causes a sudden and strong urge to urinate, followed by an involuntary loss of urine. It can be caused by an infection, a neurological disorder, or an overactive bladder.

Choice C reason: Stress incontinence is not the type of urinary incontinence that the client is experiencing. Stress incontinence occurs when the pelvic floor muscles or the urethral sphincter are weakened or damaged and cannot hold urine in the bladder when there is increased abdominal pressure, such as from coughing, sneezing, laughing, or exercising. It can be caused by pregnancy, childbirth, menopause, or surgery.

Choice D reason: Reflex incontinence is the type of urinary incontinence that the client is experiencing. Reflex incontinence occurs when the bladder muscle contracts without the sensation or control of the person, causing urine to leak without warning or awareness. It can be caused by nerve damage that affects the communication between the bladder and the brain, such as from a spinal cord injury, a stroke, or multiple sclerosis..

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A nurse is caring for a client who had a stroke involving the right cerebral hemisphere. The nurse should monitor for which of the following findings?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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