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A nurse is teaching about safe positioning with the caregiver of a client who has right-sided hemiplegia following a stroke. Which of the following statements by the caregiver indicates an understanding of the teaching?

A.

"I will ensure their neck is flexed backwards when they're lying on their stomach."

B.

"I will support their feet with a rolled pillow when they are lying on their back."

C.

"I will rest their heels on the mattress when they are sitting up in bed."

D.

"I will use a thick pillow under their head to support the neck."

Answer and Explanation

The Correct Answer is B

B. Supporting the feet with a rolled pillow helps prevent foot drop (a common issue in hemiplegia). It maintains the ankle in a neutral position, preventing contractures.
A. When lying on the stomach (prone position), the neck should be neutral (neither flexed nor extended). Flexing the neck backward can strain the cervical spine and compromise airway alignment.
C.    For a client with right-sided hemiplegia, the affected leg (right leg) should be supported to prevent foot drop.
D.    A thick pillow under the head can cause neck hyperextension.
The head should be supported with a small, firm pillow to maintain a neutral neck position.
 


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Related Questions

Correct Answer is C

Explanation

C. Morphine is a central nervous system depressant that can help decrease anxiety and relieve dyspnea in clients with acute heart failure. Therefore, a decrease in anxiety would indicate that the medication has been effective in achieving its intended outcome.
A. Emesis, or vomiting, is not an expected outcome of morphine administration in the context of acute heart failure.
B. While morphine can help alleviate dyspnea, an increased respiratory rate may indicate respiratory distress rather than effective symptom relief.
D. Morphine does not directly affect urinary output, and a decrease in urinary output may indicate other issues such as renal dysfunction or fluid overload.

Correct Answer is B

Explanation

B. Ondansetron is a commonly used medication for preventing nausea and vomiting induced by chemotherapy. It belongs to a class of drugs called serotonin receptor antagonists, which work by blocking serotonin receptors in the brain and gastrointestinal tract, thereby reducing the sensation of nausea and the urge to vomit. Ondansetron is often administered prior to chemotherapy to help prevent these side effects.
A. Diphenhydramine works by blocking histamine receptors in the brain that trigger nausea and vomiting. However, it is not commonly used as a first-line antiemetic for chemotherapy-induced nausea and vomiting.
C. Sertraline is a selective serotonin reuptake inhibitor (SSRI) antidepressant and is not used specifically for preventing chemotherapy-induced nausea and vomiting.
D. Methylprednisolone is a corticosteroid medication that has anti-inflammatory and immunosuppressant effects.

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