A nurse is caring for a client who has hemiparesis following a right-sided stroke. Which of the following actions should the nurse take?
Place objects within reach on the client's right side.
Encourage the client to repeat phonetic sounds.
Pause to allow the client time to respond to questions.
Frequently orient the client to time, place, and surroundings.
The Correct Answer is A
Choice A rationale:
Placing objects within the client's reach on the right side helps to compensate for the hemiparesis and facilitates the client's ability to independently access items.
Choice B rationale:
Encouraging the client to repeat phonetic sounds might be more appropriate for speech therapy and may not directly address hemiparesis.
Choice C rationale:
Pausing to allow the client time to respond to questions is a communication technique but does not address the physical effects of hemiparesis.
Choice D rationale:
Frequently orienting the client to time, place, and surroundings is important for cognitive support but does not specifically address hemiparesis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A: Expecting heavier menstrual bleeding while using the patch is not a typical instruction given to clients. The patch may actually result in lighter, more regular bleeding.
B: The patch should not be placed on the upper thigh. According to the guidelines, the patch should be applied to clean, dry skin on the belly, buttocks, or back, and can also be placed on the outer part of the upper arm.
C: Applying the first patch within 24 hours of starting the menstrual cycle is correct. This ensures that the patch begins to work in sync with the client's natural cycle, providing immediate contraceptive protection.
D: A new patch should not be applied at the same time each day. Instead, it should be changed once a week on the same day, known as the "patch change day" to maintain consistent contraceptive coverage.
Correct Answer is B
Explanation
Choice A rationale:
A positive Rheumatoid factor is associated with rheumatoid arthritis and is not an adverse effect of methotrexate.
Choice B rationale:
A low WBC count (leukopenia) is an adverse effect of methotrexate and can increase the risk of infection.
Choice C rationale:
A hemoglobin level of 14.8 g/dL is within a normal range and is not an adverse effect of methotrexate.
Choice D rationale:
An erythrocyte sedimentation rate (ESR) of 24 mm/hr is within a normal range and is not an adverse effect of methotrexate.
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