A nurse is assessing a client who has had a left-hemisphere stroke. Which of the following findings should the nurse expect?

Expressive aphasia

Poor impulse control

Left hemiparesis

Disorientation to place

Answer and Explanation

The Correct Answer is A

Choice A Reason:

Expressive aphasia, also known as Broca’s aphasia, is a common symptom of a left-hemisphere stroke. This condition affects the person’s ability to produce speech, although their comprehension may remain intact. The left hemisphere of the brain is typically responsible for language and speech functions, so damage to this area often results in expressive aphasia.

Choice B Reason:

Poor impulse control is more commonly associated with right-hemisphere strokes. The right hemisphere is involved in controlling behavior and emotions, so damage to this area can lead to impulsivity and poor judgment.

Choice C Reason:

Left hemiparesis, or weakness on the left side of the body, is typically a result of a right-hemisphere stroke. Strokes affect the opposite side of the body from the hemisphere where the stroke occurred. Therefore, a left-hemisphere stroke would more likely cause right-sided weakness or paralysis.

Choice D Reason:

Disorientation to place can occur with strokes affecting either hemisphere, but it is not a specific hallmark of left-hemisphere strokes. Cognitive impairments such as disorientation are more generalized and can result from various types of brain injuries.

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Correct Answer is B

Explanation

Choice A Reason:

Respiratory acidosis is characterized by a low pH (below 7.35) and an elevated PaCO₂ (above 45 mm Hg). This condition occurs when there is an accumulation of carbon dioxide in the blood due to hypoventilation or impaired lung function. In this case, the client’s pH is elevated, and PaCO₂ is low, which does not align with respiratory acidosis.

Choice B Reason:

Respiratory alkalosis is indicated by a high pH (above 7.45) and a low PaCO₂ (below 35 mm Hg). This condition results from hyperventilation, which causes excessive exhalation of carbon dioxide. The client’s ABG results show a pH of 7.50 and a PaCO₂ of 29 mm Hg, consistent with respiratory alkalosis.

Choice C Reason:

Metabolic acidosis is characterized by a low pH (below 7.35) and a low HCO₃ (below 21 mEq/L). This condition occurs due to an accumulation of acids or a loss of bicarbonate in the body. The client’s pH is elevated, and HCO₃ is within the normal range, which does not indicate metabolic acidosis.

Choice D Reason:

Metabolic alkalosis is indicated by a high pH (above 7.45) and a high HCO₃ (above 28 mEq/L). This condition results from an excess of bicarbonate or a loss of acids. The client’s pH is elevated, but HCO₃ is within the normal range, which does not support a diagnosis of metabolic alkalosis.

A. Decreasing leg strength B. Decreasing voice volume C. Decreased deep tendon reflexes D. Decreased sensation in the arms

Correct Answer is B

Explanation

Choice A Reason:

Decreasing leg strength is a common symptom of Guillain-Barré syndrome (GBS) and indicates the progression of muscle weakness. While it is concerning and should be monitored, it is not as immediately critical as respiratory complications.

Choice B Reason:

Decreasing voice volume can indicate involvement of the cranial nerves and potential respiratory muscle weakness, which can lead to respiratory failure. This is an urgent finding that requires immediate attention to prevent respiratory complications.

Choice C Reason:

Decreased deep tendon reflexes are a hallmark of GBS and are expected in the progression of the disease. While they should be documented and monitored, they do not require immediate reporting unless accompanied by other critical symptoms.

Choice D Reason:

Decreased sensation in the arms is another common symptom of GBS due to peripheral nerve involvement. It should be monitored, but it is not as urgent as signs of respiratory compromise.

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A nurse is assessing a client who has had a left-hemisphere stroke. Which of the following findings should the nurse expect?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is hyperventilating and has the following ABG results: pH 7.50 (7.35 to 7.45), PaCO₂ 29 mm Hg (35 to 45 mm Hg), and HCO₃ 25 mEq/L (21 to 28 mEq/L). The nurse should identify that the client has which of the following acid-base imbalances?

Correct Answer is B

Explanation

A nurse is assessing a client who has Guillain-Barré syndrome. Which of the following findings should the nurse report to the provider immediately?

Correct Answer is B

Explanation

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