A client diagnosed with a stroke is experiencing homonymous hemianopia. The most appropriate nursing intervention to help the client learn to compensate for this deficit during rehabilitation period would be to:

use a cold compress on both eyes.

teach the client scanning techniques.

apply an eye patch to the affected eye.

use eye drops in both eyes daily

Answer and Explanation

The Correct Answer is B

A.   Using a cold compress is typically employed for reducing swelling or discomfort, but it does not address the visual deficits associated with homonymous hemianopia. This intervention would not assist the client in compensating for their visual field loss.
B.   Teaching scanning techniques involves training the client to actively search for visual information from their affected side. This can include turning their head and using their eyes to scan to the left (for right homonymous hemianopia) or to the right (for left homonymous hemianopia). This compensatory strategy is crucial for helping the client navigate their environment safely and effectively during rehabilitation.
C.   Applying an eye patch is not appropriate for homonymous hemianopia, as it may further limit visual input. In fact, patching could exacerbate difficulties by reducing overall vision and is generally more relevant for conditions like amblyopia or for treating diplopia (double vision), rather than compensating for a visual field deficit.
D.   Using eye drops is typically for treating dry eyes, redness, or other ocular conditions, and does not directly address the issues related to homonymous hemianopia. This intervention would not help the client learn to compensate for their visual field loss.

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Correct Answer is C

Explanation

A. Warfarin is an anticoagulant used to prevent blood clots. While it may be prescribed for certain patients at risk for stroke, it is not typically the first-line medication for managing TIA or hyperlipidemia. It is more often used in patients with specific types of atrial fibrillation or mechanical heart valves.
B. Simethicone is an anti-foaming agent used to relieve gas and bloating. It does not have any role in managing hyperlipidemia or preventing strokes. Thus, this option is not relevant to the client's condition.
C. Simvastatin is a statin medication used to lower cholesterol levels and reduce the risk of cardiovascular events, including stroke. For a client with hyperlipidemia and a history of TIA, simvastatin would be an appropriate medication to help manage cholesterol and decrease the risk of future ischemic events.
D. Enoxaparin is a low-molecular-weight heparin used for anticoagulation, often in the context of deep vein thrombosis or pulmonary embolism. It may not be the first choice for TIA management. While it has its uses in preventing clot formation, it is not the standard treatment for a patient who has had a TIA.

A. changing the surgical dressing when it becomes saturated with drainage. B. encouraging the client to obtain permanent breast prosthesis as soon as she is discharged from the hospital. C. placing a limb alert bracelet on the right wrist as warning against blood pressure or venipunctures. D. teaching the client to use the prescribed patient-controlled analgesia (PCA) every 20 mintues for the best pain relief.

Correct Answer is C

Explanation

A. While it's important to monitor the surgical dressing, changing it too frequently can increase the risk of infection and disrupt healing. Instead, nurses typically assess the dressing regularly and only change it if it's overly saturated or if ordered by a physician. It’s essential to follow specific protocols regarding dressing changes.
B. A While breast prostheses can be an important part of post-mastectomy care for some clients, it is usually recommended that clients wait until they have fully healed and received counseling regarding their options. Immediate encouragement may be premature, as physical and emotional adjustments take time after surgery.
C. This is an appropriate intervention. After axillary lymph node dissection, there is a risk of lymphedema in the affected arm. Placing a limb alert bracelet serves as a reminder to healthcare providers to avoid taking blood pressure or performing venipunctures on the affected arm, thus helping prevent complications.
D. While PCA can be an effective method for managing postoperative pain, the timing and dosage should be based on the specific prescription and the client's individual needs. It’s crucial to educate the client about the PCA device and its use, but the specific interval may vary based on the medication's parameters and the patient's condition.

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A client diagnosed with a stroke is experiencing homonymous hemianopia. The most appropriate nursing intervention to help the client learn to compensate for this deficit during rehabilitation period would be to:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The client diagnosed with hyperlipidemia has experienced a transient ischemic attack (TIA). Which medication would the nurse anticipate being ordered for the client on discharge?

Correct Answer is C

Explanation

A client returns to the surgical unit following a right modified radical mastectomy with dissection of axillary lymph nodes. An appropriate nursing intervention in the postoperative care for the client includes:

Correct Answer is C

Explanation

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