A nurse is assessing a client experiencing motor loss as the result of a left-sided stroke.
Which clinical manifestations would the nurse document?
Hemiparesis of the right side of the body and ataxia.
Spasticity of the client's left arm and apraxia.
Impulsive behavior and hostility toward family.
Homonymous hemianopia and diplopia.
The Correct Answer is A
Choice A rationale
Hemiparesis on the right side and ataxia are common manifestations of left-sided stroke, where the motor cortex affecting the contralateral side is impaired, leading to muscle weakness and coordination loss.
Choice B rationale
Spasticity of the left arm suggests motor impairment on the ipsilateral side, which is inconsistent with the nature of left-sided strokes affecting the contralateral side. Apraxia lacks relation to motor loss here.
Choice C rationale
Impulsive behavior and hostility are more indicative of frontal lobe involvement, not motor loss secondary to left-sided strokes. These behaviors do not represent motor manifestations.
Choice D rationale
Visual defects like homonymous hemianopia and diplopia may occur in stroke but are not direct indicators of motor loss. They relate to occipital lobe or optic pathway damage.
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Correct Answer is C
Explanation
Choice A rationale
Chronic head injuries can impair judgment, leading to non-compliance with care plans due to reduced awareness and impulse control. However, non-compliance alone is not a definitive behavioral characteristic of chronic head injury.
Choice B rationale
Rapid engagement in cognitively demanding tasks like chess within a week suggests intact neurological and cognitive function, which contradicts the expected deficits in chronic head injury patients.
Choice C rationale
Chronic head injuries commonly affect the frontal lobe, impairing executive functions such as planning, organizing, and controlling thoughts and behaviors. These deficits result from damage to neural pathways crucial for these cognitive tasks.
Choice D rationale
The ability to process multiple pieces of information simultaneously requires intact cognitive functioning, typically disrupted in chronic head injuries due to neuronal damage, particularly in the prefrontal cortex.
Correct Answer is D
Explanation
Choice A rationale
Absence of short-term memory loss may be desirable but depends on the injury's severity and therapy progression. Memory recovery is inconsistent and often impractical as a definitive short-term outcome goal.
Choice B rationale
Resuming construction work is unrealistic within three weeks considering potential cognitive and physical impairments. This task exceeds achievable rehabilitation milestones, emphasizing safety over rapid return to demanding roles.
Choice C rationale
Pre-injury personality traits may not fully return, as emotional and personality changes often result from cerebral insults. Emotional stability is feasible but pre-injury personality restoration is speculative.
Choice D rationale
Medication adherence reflects successful cognitive rehabilitation, supporting long-term health stability by preventing further complications. This outcome is realistic and appropriate for patients recovering from intracranial injuries. .
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