A nurse is caring for a client who has an endotracheal tube and is receiving mechanical ventilation. Which of the following actions should the nurse take to reduce the risk of ventilator associated pneumonia?

Choice A reason: A stroke involving the right cerebral hemisphere can affect the cognitive and emotional functions of the brain, such as judgment, impulse control, and emotional regulation³. This can lead to risky or inappropriate behaviors, such as acting impulsively or disregarding social norms. Therefore, the nurse should monitor the client for poor impulse control and provide appropriate interventions, such as education, cueing, feedback, and environmental modifications.
Choice B reason: A stroke involving the right cerebral hemisphere can affect the visual functions of the brain, such as depth perception, spatial orientation, and visual recognition³. However, the deficits are usually in the left visual field, not the right, because the right side of the brain controls the left side of the body and the environment. Therefore, the nurse should monitor the client for deficits in the left visual field, not the right.
Choice C reason: A stroke involving the right cerebral hemisphere can affect the abstract reasoning functions of the brain, such as understanding metaphors, humor, or sarcasm. However, the ability to discriminate words and letters is more related to the language functions of the brain, which are mainly controlled by the left cerebral hemisphere. Therefore, the nurse should monitor the client for language deficits, such as aphasia or dysarthria, if the stroke involves the left cerebral hemisphere, not the right.
Choice D reason: A stroke involving the right cerebral hemisphere can affect the motor functions of the brain, such as movement, coordination, and balance³. However, the motor retardation, which is a slowing down of physical and mental activity, is more related to the mood functions of the brain, which are mainly controlled by the frontal lobe of the brain. Therefore, the nurse should monitor the client for motor retardation if the stroke involves the frontal lobe, not the right cerebral hemisphere.

Choice A reason: Rinse the mouth after administration. This answer is correct because rinsing the mouth after using inhaled beclomethasone can help prevent oral candidiasis, a fungal infection that can cause soreness, white patches, and bleeding in the mouth.

Choice B reason: Check the pulse after medication administration. This answer is incorrect because checking the pulse after using inhaled beclomethasone is not necessary, as this medication does not affect the heart rate or blood pressure. Inhaled beclomethasone is a corticosteroid that reduces inflammation and swelling in the airways.

Choice C reason: Limit caffeine intake. This answer is incorrect because limiting caffeine intake is not related to the use of inhaled beclomethasone, but rather to the management of asthma symptoms. Caffeine can act as a bronchodilator and improve lung function, but it can also cause nervousness, insomnia, and palpitations in some people.

Choice D reason: Take the medication with meals. This answer is incorrect because taking the medication with meals is not relevant to the use of inhaled beclomethasone, as this medication is not taken orally but by inhalation. Inhaled beclomethasone is delivered directly to the lungs, where it exerts its anti-inflammatory effect.