A nurse is teaching about safe positioning with the caregiver of a client who has right-sided hemiplegia following a stroke. Which of the following statements by the caregiver indicates an understanding of the teaching?

"I will ensure their neck is flexed backwards when they're lying on their stomach."

"I will support their feet with a rolled pillow when they are lying on their back."

"I will rest their heels on the mattress when they are sitting up in bed."

"I will use a thick pillow under their head to support the neck."

Answer and Explanation

The Correct Answer is B

B. Supporting the feet with a rolled pillow helps prevent foot drop (a common issue in hemiplegia). It maintains the ankle in a neutral position, preventing contractures.
A. When lying on the stomach (prone position), the neck should be neutral (neither flexed nor extended). Flexing the neck backward can strain the cervical spine and compromise airway alignment.
C. For a client with right-sided hemiplegia, the affected leg (right leg) should be supported to prevent foot drop.
D. A thick pillow under the head can cause neck hyperextension.
The head should be supported with a small, firm pillow to maintain a neutral neck position.

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Correct Answer is A

Explanation

A. Malnutrition can lead to inadequate intake of essential nutrients, such as vitamins and minerals, which are necessary for maintaining healthy hair growth.
B. Double vision, or diplopia, is more commonly associated with neurological or ocular conditions rather than malnutrition.
C. Malnutrition may result in dry, flaky skin due to deficiencies in essential fatty acids and other nutrients.
D. While malnutrition can affect various physiological processes, increased salivation is not a common manifestation of mal

A. tightness in chest that radiates to left arm B. pain as 7 on a scale of 0 to 10 C. feel nauseous after breakfast D. Client is diaphoretic and short of breath E. Heart rate is irregular and tachycardic F. Lungs clear to auscultation in all lobes G. Bowel sounds are present in all 4 quadrants H. +1 pedal pulses. I. Capillary refill less than 2 seconds J. Skin is cool to touch.

Correct Answer is ["A","B","C","D","E","J"]

Explanation

The client is having typical signs and symptoms of acute coronary syndrome - pain radiating to the left arm, nausea, diaphoresis, shortness of breath and tachycardia

Her diet history - daily bacon and eggs increases her cardiovascular risk

Her cool skin and weak peripheral pulses is an indication of poor perfusion due to impaired myocardial contractility due to myocardial infarction.

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A nurse is teaching about safe positioning with the caregiver of a client who has right-sided hemiplegia following a stroke. Which of the following statements by the caregiver indicates an understanding of the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has anorexia. Which of the following findings should the nurse identify as a manifestation of malnutrition?

Correct Answer is A

Explanation

Correct Answer is ["A","B","C","D","E","J"]

Explanation

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