A nurse is caring for a client who has left homonymous hemianopsia. Which of the following is an appropriate nursing intervention for this client?

Place the wheelchair on the client's left side.

Orient the client to the food on the plate using the clock method.

Teach the client to turn scan to the right to see objects on the right side of the body.

Place the bedside table on the right side of the bed.

Answer and Explanation

The Correct Answer is C

Choice A reason:

Placing the wheelchair on the client's left side is not helpful for someone with left homonymous hemianopsia, as the client will have difficulty seeing the left side. This intervention does not address the visual deficit properly.

Choice B reason:

Orienting the client to the food on the plate using the clock method is beneficial for clients with visual impairments, but it is not specific to addressing left homonymous hemianopsia. It does not help the client scan their environment effectively.

Choice C reason:

Teaching the client to turn their head to scan to the right helps compensate for the left-sided visual field loss. This strategy allows the client to detect objects in their blind spot and improves their ability to navigate their environment safely.

Choice D reason:

Placing the bedside table on the right side of the bed ensures it is within the client’s field of vision and easily accessible, which is a supportive measure. However, teaching scanning techniques is more critical in helping the client adjust to their visual deficit.

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Correct Answer is D

Explanation

Choice A reason:

Hypoglycemia, or low blood sugar, is not a typical adverse effect of furosemide. While careful monitoring of blood glucose levels may be necessary in general, furosemide primarily affects electrolyte and fluid balance rather than glucose metabolism.

Choice B reason:

Hypertension is not an adverse effect of furosemide; rather, this medication is used to treat conditions like hypertension and edema by promoting the excretion of sodium and water. The intended effect of furosemide is to lower blood pressure, not increase it.

Choice C reason:

Hypervolemia, or fluid overload, is contrary to the action of furosemide, which is a diuretic intended to reduce excess fluid in the body. Monitoring for hypervolemia would not be a primary concern with this medication; instead, the nurse should watch for signs of dehydration or electrolyte imbalance.

Choice D reason:

Hypokalemia, or low potassium levels, is a well-known adverse effect of furosemide. This diuretic can lead to significant potassium loss through increased urine output, making it crucial to monitor the client's potassium levels to prevent complications such as muscle weakness, cramping, and cardiac arrhythmias.

A. 600 mL B. 740 mL C. 800 mL D. 900 mL E. None F. None

Correct Answer is B

Explanation

Choice A reason:

Calculating the total intake includes converting ounces to milliliters and adding all fluid intakes. 4 oz juice equals 120 mL, 6 oz hot tea equals 180 mL, ice chips are counted as half their volume, so 100 mL ice chips equals 50 mL, 150 mL IV bolus, and 8 oz broth equals 240 mL. Adding these up: 120 + 180 + 50 + 150 + 240 = 740 mL. Choice A, 600 mL, underestimates the total intake, excluding necessary details in the calculation.

Choice B reason:

Let’s calculate step by step:

Juice: 4 oz × 30 mL = 120 mL
Tea: 6 oz × 30 mL = 180 mL
Ice chips: 100 mL × 0.5 = 50 mL (since only half of the volume of ice is counted as fluid)
IV bolus: 150 mL
Broth: 8 oz × 30 mL = 240 mL

Now add them:
120 + 180 + 50 + 150 + 240 = 740 mL

Choice C reason:

800 mL inaccurately inflates the total intake. Accurate calculation yields 740 mL as the total fluid intake, considering all conversions and additions. Choice C misrepresents this value.

Choice D reason:

900 mL is another overestimate. Proper conversion and summation of all fluids indicate the total intake is 740 mL. Choice D is significantly higher than this calculated total, demonstrating the importance of precise conversion and addition for accurate records.

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A nurse is caring for a client who has left homonymous hemianopsia. Which of the following is an appropriate nursing intervention for this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has heart failure and a new prescription for the diuretic furosemide. For which adverse effect should the nurse monitor?

Correct Answer is D

Explanation

A nurse is completing an 8-hour intake and output (I&O) record for a client who consumed 4 oz juice, 6 oz hot tea, 100 mL ice chips, an IV bolus of 150 mL, and 8 oz broth. The nurse should record how many mL of intake on the client's record?

Correct Answer is B

Explanation

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