Solutions
A client who experienced a thrombotic stroke and has residual hemiparesis of the right
side is undergoing rehabilitation. the nurse caring for this client reinforces occupational
therapy recommendations bu placing items for personal hygiene:
1. On the overbed table on the right side
2. On the overbed table on the left side
3. one foot away from the bed on the right side
4. one foot away from the bed on the left side ✅2
The nurse reads in an admission note that the physical examination of a client revealed
an impairment of cranial nerve II. the nurse instructs ancillary caregivers to do which of
the following when caring for this client
1. whisper to the client
2. serve food at room temperature
3. clear the clients path of obstacles
4. report difficulty swallowing ✅3
TIAs are:
1. unilateral neurologic deficits that slowly resolve
2. generalized neurologic deficits that occur a few seconds every hour
3. focal neurologic deficits that develop suddenly, last more than an hour, and clear
without evidence of infarct
4. neurologic deficits that slowly evolve or develop ✅3
The nurse planning care for a client who suffered a CVA with residual dysphagia would
write on the care plan to avoid doing which of the following during meals
1. feed the client slowly
2. give the client frequent liquids
3. give foods with a consistency of oatmeal
4. place food on the unaffected side of the mouth ✅2
An unconscious client who is receiving continuous internal feedings has a sudden onset
of adventitious breath sounds. which of the following nursing diagnoses is a priority for
the client
1. risk for aspiration
2. risk for fluid volume overload
3. risk for imbalanced nutrition: less than body requirements
4. risk for electrolyte imbalance ✅1