nurse is caring for a client who has an acute respiratory failure (ARF). The nurse should monitor the client for which of the following manifestations of this condition? (Select all that apply.)

Choice A reason: A stroke involving the right cerebral hemisphere can affect the cognitive and emotional functions of the brain, such as judgment, impulse control, and emotional regulation³. This can lead to risky or inappropriate behaviors, such as acting impulsively or disregarding social norms. Therefore, the nurse should monitor the client for poor impulse control and provide appropriate interventions, such as education, cueing, feedback, and environmental modifications.
Choice B reason: A stroke involving the right cerebral hemisphere can affect the visual functions of the brain, such as depth perception, spatial orientation, and visual recognition³. However, the deficits are usually in the left visual field, not the right, because the right side of the brain controls the left side of the body and the environment. Therefore, the nurse should monitor the client for deficits in the left visual field, not the right.
Choice C reason: A stroke involving the right cerebral hemisphere can affect the abstract reasoning functions of the brain, such as understanding metaphors, humor, or sarcasm. However, the ability to discriminate words and letters is more related to the language functions of the brain, which are mainly controlled by the left cerebral hemisphere. Therefore, the nurse should monitor the client for language deficits, such as aphasia or dysarthria, if the stroke involves the left cerebral hemisphere, not the right.
Choice D reason: A stroke involving the right cerebral hemisphere can affect the motor functions of the brain, such as movement, coordination, and balance³. However, the motor retardation, which is a slowing down of physical and mental activity, is more related to the mood functions of the brain, which are mainly controlled by the frontal lobe of the brain. Therefore, the nurse should monitor the client for motor retardation if the stroke involves the frontal lobe, not the right cerebral hemisphere.

Choice A reason: Budesonide via dry powder inhaler is not a suitable medication for an acute asthma exacerbation. Budesonide is an inhaled corticosteroid that helps to reduce inflammation and prevent asthma attacks. It is taken daily as a maintenance therapy and does not work quickly enough to relieve the symptoms of an acute asthma exacerbation.

Choice B reason: Cromolyn via metered dose inhaler is not an effective medication for an acute asthma exacerbation. Cromolyn is a mast cell stabilizer that helps to prevent the release of inflammatory mediators that cause asthma symptoms. It is taken daily as a preventive therapy and does not work quickly enough to relieve the symptoms of an acute asthma exacerbation.

Choice C reason: Albuterol via jet nebulizer is a recommended medication for an acute asthma exacerbation. Albuterol is a short acting beta 2 agonist that helps to relax the smooth muscles of the airways and improve breathing. It is taken as needed as a rescue therapy and works quickly to relieve the symptoms of an acute asthma exacerbation.

Choice D reason: Montelukast orally is not a preferred medication for an acute asthma exacerbation. Montelukast is a leukotriene modifier that helps to reduce inflammation and prevent asthma attacks and exercise induced bronchoconstriction. It is taken once a day as an adjunctive therapy and does not work quickly enough to relieve the symptoms of an acute asthma exacerbation.