A patient who is diagnosed with a stroke is requesting a glass of water. Which action is appropriate for the nurse to take?

Give the patient a glass of water.

Check the patient's dysphagia screen

Consult speech pathology.

Teach that stroke patients are nothing by mouth (NPO)

Answer and Explanation

The Correct Answer is B

A. Give the patient a glass of water.: Giving the patient water without assessing their swallowing ability can be dangerous due to the risk of aspiration.
B. Check the patient's dysphagia screen.: Assessing for dysphagia is crucial because stroke patients often have impaired swallowing, which increases the risk of aspiration and choking.
C. Consult speech pathology.: Consulting a speech pathologist is important for a comprehensive swallowing assessment, but it is not the immediate action when a patient requests water.
D. Teach that stroke patients are nothing by mouth (NPO).: Not all stroke patients are NPO. This decision is based on the patient's ability to swallow safely, determined by a dysphagia screen.

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Correct Answer is D

Explanation

A. Instruct the patient to wear constrictive clothing: This is incorrect. Constrictive clothing can impede blood flow and worsen venous stasis.
B. Encourage frequent ambulation: This is correct. Ambulation promotes circulation, helps prevent blood stasis, and encourages the healing of ulcers.
C. Encourage the patient to keep legs in a dependent position: This is incorrect. Keeping the legs in a dependent position can increase venous pressure and exacerbate edema, which is counterproductive for managing venous stasis ulcers.
D. Apply compression stockings: This is correct. Compression stockings help to improve venous return, reduce edema, and promote ulcer healing by preventing blood from pooling in the legs.

A. "Smoking cessation is important because nicotine is a vasoconstrictor." B. "Adequate fluid intake is important to maintain blood pressure." C. Those most affected are middle-aged women after menopause." D. "A low-fat diet is required to reduce atherosclerosis in large arteries."

Correct Answer is A

Explanation

A. "Smoking cessation is important because nicotine is a vasoconstrictor.": Buerger disease is strongly associated with tobacco use, and nicotine causes vasoconstriction, which exacerbates the condition. Smoking cessation is crucial in managing and preventing progression.
B. "Adequate fluid intake is important to maintain blood pressure.": While staying hydrated is generally important, it is not specifically related to the management of Buerger disease, which is more focused on vascular health and smoking cessation.
C. "Those most affected are middle-aged women after menopause.": Buerger disease predominantly affects young male smokers, not middle-aged women.
D. "A low-fat diet is required to reduce atherosclerosis in large arteries.": Buerger disease involves inflammation and thrombosis in small and medium-sized arteries and veins, not atherosclerosis in large arteries. Therefore, a low-fat diet, while beneficial for general cardiovascular health, is not specifically targeted for Buerger disease.

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A patient who is diagnosed with a stroke is requesting a glass of water. Which action is appropriate for the nurse to take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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