A nurse working on a medical-surgical unit is developing a discharge plan for a client who has left-sided hemiplegia following a stroke. Which of the following actions is the nurse’s priority?
Consult with a case manager about insurance coverage.
Counsel caregivers about respite care options.
Refer the client to a local stroke support group.
Ensure that the client has a referral for physical therapy.
The Correct Answer is D
A. Financial planning is important but not the immediate safety priority.
B. Respite care supports caregivers but does not directly impact client safety or recovery.
C. Support groups assist with long-term coping, not early functional recovery.
D. Physical therapy is essential for a client with hemiplegia to prevent contractures, improve mobility, and promote independence. Early rehabilitation enhances recovery and prevents complications such as deep vein thrombosis and muscle atrophy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D","F"]
Explanation
A. Ice helps reduce pain and swelling by causing vasoconstriction and minimizing tissue inflammation. Application should be intermittent (20 minutes on, 20 minutes off) and wrapped to avoid direct skin contact. Early ice therapy supports circulation preservation and limits edema progression.
B. The child has not yet received a cast; teaching about cast care is premature. Priority actions now are to stabilize, relieve pain, and control swelling before immobilization.
C. While wound care is appropriate, this is not a priority compared to interventions preventing neurovascular impairment in the fractured arm.
D. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that helps reduce both pain and inflammation. Administering analgesics promptly improves comfort and facilitates cooperation with care. Pain control is essential for monitoring neurovascular changes, as uncontrolled pain can mask worsening symptoms.
E. Although preparation reduces anxiety, this step should occur after the client’s comfort and circulation are stabilized. The immediate focus should be on pain and swelling management.
F. Elevation promotes venous return and reduces edema, minimizing pressure on surrounding tissues. The limb should be elevated above heart level unless contraindicated. This helps prevent circulatory compromise and supports healing.
Correct Answer is D
Explanation
A. Cardiogenic shock can cause elevated PAWP, but the primary underlying issue in that condition is left ventricular failure, which leads to poor cardiac output.
B. Hypotension generally correlates with low preload and decreased PAWP, not an increase.
C. Hypovolemia results in low PAWP due to decreased circulating volume and venous return.
D. An elevated PAWP (normal: 4–12 mm Hg) indicates increased left atrial pressure, which is commonly seen in left ventricular failure. This occurs when the left ventricle cannot pump blood effectively, causing blood to back up into the lungs and increasing pulmonary venous pressure.
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