A nurse is reinforcing teaching about activities of daily living with a client who had a stroke. Which of the following statements should the nurse include?

"Rest in supine position for 30 minutes after a meal."

"Dress the affected side first

"Use the arm on your affected side to brush your hair."

"Use a straw when you drink liquids."

Answer and Explanation

The Correct Answer is B

Rationale:

A. "Rest in supine position for 30 minutes after a meal.": Lying flat after a meal increases the risk of aspiration particularly in stroke clients who may have impaired swallowing. A more upright position should be encouraged during and after meals to reduce this risk.

B. "Dress the affected side first.": Dressing the affected side first promotes independence and makes the task easier by minimizing the need for fine motor coordination on the impaired side. It also reduces frustration and helps establish a safe, consistent dressing routine.

C. "Use the arm on your affected side to brush your hair.": Stroke often leads to muscle weakness or paralysis on one side, making it difficult or unsafe to perform tasks with the affected limb. Initially, clients should use their stronger arm while the affected side is supported and rehabilitated gradually.

D. "Use a straw when you drink liquids.": Using a straw can increase the risk of aspiration in clients with post-stroke dysphagia by promoting rapid fluid intake. It is generally contraindicated until a swallowing assessment confirms that it is safe.

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Correct Answer is D

Explanation

Rationale:

A. Erythema toxicum: This is a common and benign rash seen in newborns. It is not infectious, poses no public health risk, and does not require mandatory reporting.

B. Bacterial vaginosis: Although it is a vaginal infection, bacterial vaginosis is not classified as a reportable condition. It does not pose the same level of public health concern as sexually transmitted infections like gonorrhea.

C. Molluscum contagiosum: Molluscum contagiosum is a viral skin infection that is generally self-limiting and not considered a reportable disease. It does not require public health intervention in most cases.

D. Gonorrhea: Gonorrhea is a nationally notifiable disease in many countries, including the United States, due to its infectious nature and potential for serious complications. Public health reporting is required to track, treat, and prevent its spread.

A. Severe immunodeficiency B. Asymptomatic HIV C. Mild febrile illness D. Egg allergy

Correct Answer is A

Explanation

Rationale:

A. Severe immunodeficiency: The MMR vaccine is a live attenuated vaccine and is contraindicated in clients with severe immunodeficiency, such as those undergoing chemotherapy or with advanced HIV/AIDS. These individuals cannot mount an appropriate immune response, placing them at risk for vaccine-related complications.

B. Asymptomatic HIV: Clients with asymptomatic HIV and adequate CD4 counts may safely receive the MMR vaccine. It is not contraindicated unless the client is significantly immunocompromised.

C. Mild febrile illness: Mild illnesses, such as low-grade fever or upper respiratory infections, do not contraindicate vaccine administration. The MMR vaccine can still be safely given, as minor illness does not significantly alter vaccine response or increase risks.

D. Egg allergy: Although the MMR vaccine is cultured in chick embryo fibroblasts, it does not contain significant egg protein, and studies have shown it can be safely administered to individuals with egg allergies. An egg allergy is not a valid reason to withhold the vaccine.

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