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 C

Explanation

C. Nicotine is a vasoconstrictor, meaning it causes narrowing of blood vessels. Therefore, using a nicotine transdermal patch can exacerbate Raynaud's attacks by promoting vasoconstriction and reducing blood flow to the extremities.
A. While herpes zoster (shingles) is a viral infection caused by the varicella-zoster virus, it is not directly associated with triggering Raynaud's attacks.
B. Amlodipine is a calcium channel blocker medication commonly used to treat hypertension.

D. While diet can potentially influence overall health and vascular function, there is no direct evidence to suggest that a strict vegetarian diet would trigger exacerbations of Raynaud's disease.

A. Dextrose 5% in water (DSW) intravenous at 5 ml/kg/hr for 4 hr B. Potassium chloride 20 mEq/L intravenous PRN potassium less than 5.0 mEq/L C. Regular insulin continuous intravenous infusion, titrate per diabetic ketoacidosis (DKA) protocol once potassium is greater than 3.3 mEq/L D. Regular insulin 20 units subcutaneously E. Blood glucose checks every 4 hr F. Initiate cardiac monitoring G. Insert indwelling urinary catheter H. 0.9% sodium chloride at 15 ml/kg/hr for 1 hr and then reduce to 10 ml/kg/hr

Correct Answer is ["B","C","F","H"]

Explanation

The client has diabetes ketoacidosis (DKA) as seen in the lab findings. The management of DKA involves fluid rehydration with isotonic crystalloids such as normal saline, glycemic control with intravenous insulin infusion and electrolyte supplementation specifically potassium if it is normal or low.

This is because administration of insulin drives potassium ions into the cells leading to hypokalemia Cardiac monitoring is vital to ensure that any dysrhythmias due to electrolyte disturbances are recognized early.

Blood sugar monitoring should be done more frequently- preferably every 1 hour. Although monitoring of output is key, catheterization is unnecessary when the client is awake.

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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

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A nurse is taking an admission history from a client who reports Raynaud's disease. Which of the following assessment findings should the nurse identify as a potential trigger for exacerbations of Raynaud's?

Correct Answer is C

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Correct Answer is ["B","C","F","H"]

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