A nurse is reviewing the medical record of a client who had a left-sided stroke.

Which of the following findings should the nurse expect?

Blood pressure

Temperature

Neurologic status

Laboratory results

Answer and Explanation

The Correct Answer is C

Clients with a left-sided stroke will have neurological deficits on the right side of the body, including paralysis or weakness. Impaired speech, language, and cognition are also possible. Blood pressure, temperature, and laboratory results may be affected by the stroke, but they are not specific to a left-sided stroke.

Option A, "Blood pressure," is incorrect because it may be affected by the stroke, but it is not specific to a left-sided stroke.

Option B, "Temperature," is incorrect because it may be affected by the stroke, but it is not specific to a left-sided stroke.

Option D, "Laboratory results," is incorrect because they may be affected by the stroke, but they are not specific to a left-sided stroke.

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Correct Answer is D

Explanation

The nurse should recommend the pneumococcal vaccine to the client, as this is recommended for all adults over the age of 65 to prevent pneumococcal disease. Choice A is incorrect because the tuberculosis vaccine is not routinely given to adults in the United States. Choice B is incorrect because the HPV vaccine is recommended primarily for young adults to prevent HPV-related cancers. Choice C is incorrect because the MMR vaccine is recommended for children, and most adults have already received it. Choice A is not correct because the tuberculosis vaccine is not routinely given to adults in the United States.

A. Ask the client's healthcare surrogate for permission to withhold nourishment. B. Request a prescription for IV fluids. C. Explain the importance of oral hydration to the client. D. Provide regular oral care for the client with a moist swab.

Correct Answer is D

Explanation

The correct answer is choice D. Provide regular oral care for the client with a moist swab. When a client with a terminal illness and in the active phase of dying refuses further hydration and nourishment, the nurse should provide comfort measures such as regular oral care to prevent discomfort. The nurse should not force the client to eat or drink or request a prescription for IV fluids. The healthcare surrogate cannot be asked for permission to withhold nourishment as the client has the right to refuse nourishment.

Option A - The client has the right to refuse nourishment, and healthcare surrogate permission is not required.

Option B - Requesting a prescription for IV fluids is not an appropriate intervention as the client has the right to refuse nourishment.

Option C - Explaining the importance of oral hydration to the client is not an appropriate intervention as the client has the right to refuse nourishment.

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A nurse is reviewing the medical record of a client who had a left-sided stroke. Which of the following findings should the nurse expect?

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A nurse is reviewing the medical record of a client who had a left-sided stroke.

Which of the following findings should the nurse expect?