A nurse is caring for a client who has a history of hypertension. Which of the following findings should the nurse recognize is indicative of transient ischemic attacks?
Epigastric pain
Seizure activity
Sudden loss of vision in one eye
Pain radiating down the left arm
The Correct Answer is C
Choice A reason: Epigastric pain suggests GI issues, not TIAs. In hypertension, TIAs affect cerebral vessels, causing neurological deficits, not abdominal symptoms like this.
Choice B reason: Seizures stem from cortical irritation, not typical TIA vascular occlusion. Hypertension-related TIAs produce transient deficits, not convulsive activity usually.
Choice C reason: Sudden monocular vision loss (amaurosis fugax) is a classic TIA sign in hypertension. It reflects temporary retinal artery occlusion, resolving quickly.
Choice D reason: Left arm pain mimics cardiac issues, not TIAs. Hypertension TIAs target brain circulation, causing focal deficits, not referred pain patterns.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Using a trapeze builds upper body strength, aiding transfers and mobility post-amputation. Scientifically, this promotes independence by enhancing muscle power for prosthetic use, aligning with rehabilitation goals to restore function and reduce reliance on others early in recovery.
Choice B reason: Abduction with a pillow prevents adduction contractures but doesn’t directly enhance mobility. It’s passive, not active, support. Scientifically, while useful, it lacks the progressive impact of strength training, making it secondary to fostering independence in amputation care.
Choice C reason: Avoiding prone position is outdated; prone lying prevents hip flexion contractures, aiding mobility. Scientifically, this caution hinders rehabilitation, as stretching the hip flexors supports prosthetic alignment and walking, contradicting progression toward independence.
Choice D reason: Loose dressings don’t promote mobility; tight, controlled dressings reduce edema for prosthetic fitting. Scientifically, this delays healing and strength-building, as proper wound management, not loose coverage, supports physical progression in amputation recovery.
Correct Answer is B
Explanation
Choice A reason: Pointing toes eases stocking application, reducing drag on skin. Scientifically, this aligns with proper technique, enhancing venous return without resistance, so no intervention is needed, as it supports effective antiembolic function per guidelines.
Choice B reason: Creases on the front risk pressure sores or impaired circulation, countering antiembolic goals. Scientifically, smooth application prevents venous stasis, requiring intervention, as this error compromises blood flow and skin integrity in at-risk clients.
Choice C reason: Turning stockings inside out aids application, a standard technique for even fit. Scientifically, this ensures proper compression gradient, supporting venous return, so no intervention is warranted, as it’s correct per procedural evidence.
Choice D reason: Applying before getting out of bed maximizes compression benefits, reducing clot risk. Scientifically, this aligns with prophylaxis timing, as gravity aids swelling post-ambulation, making it appropriate and not requiring nurse intervention.
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