The nurse is assessing a client experiencing motor loss as the result of a left-sided stroke. Which of the following clinical manifestations related to motor loss would the nurse document?

Impulsive behavior and hostility toward family

Hemiparesis of the client's left arm and apraxia

Homonymous hemianopia on the left side and diplopia

Paralysis of the right side of the body and ataxia

Answer and Explanation

The Correct Answer is D

A.   These are behavioral changes that may occur after a stroke, but they are not directly related to motor loss.
B.   Hemiparesis is weakness on one side of the body, but in this case, the client is experiencing motor loss on the right side. Apraxia is the inability to perform purposeful movements, which can also occur after a stroke, but it is not a direct manifestation of motor loss.
C.   Homonymous hemianopia is the loss of vision in half of the visual field on the same side as the stroke. Diplopia is double vision. While these are both common symptoms of stroke, they are not related to motor loss.
D.   A left-sided stroke typically results in motor loss on the right side of the body. This is because the left side of the brain controls the right side of the body. Additionally, ataxia, which is a lack of coordination, is a common symptom of stroke.

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Correct Answer is C

Explanation

A. This intervention can be appropriate since a very low platelet count increases the risk of bleeding, including gastrointestinal bleeding. However, this action alone does not directly address the immediate risks associated with the low platelet count.
B. While hydration is important for overall health, this intervention does not specifically address the risks associated with a low platelet count. Additionally, excessive fluid intake may not be appropriate for all patients, especially if there are underlying kidney issues or fluid restrictions.
C. Clients with AML and low platelet counts are at increased risk for infections and may develop febrile neutropenia. Monitoring temperature every four hours can help detect early signs of infection, allowing for timely intervention.
D. While maintaining oral hygiene is important, especially in patients undergoing chemotherapy, this intervention may not be the most critical action based on the acute concern of a very low platelet count. However, it is important to note that patients with low platelet counts may also experience bleeding from the gums, making gentle oral care essential.

A. Flank mass and hematuria B. Dark tarry stool and mental status change C. Shortness of breath and chest pain D. Urinary frequency and hypotension

Correct Answer is A

Explanation

A. Renal cancer can often present with a palpable flank mass due to tumor growth. Hematuria (blood in the urine) is also a common finding in patients with kidney tumors and can result from bleeding within the renal system. Flank pain, especially in the context of renal cancer, often accompanies these findings.
B. Dark, tarry stools (melena) suggest gastrointestinal bleeding, which is not directly associated with renal cancer. Mental status changes could indicate various issues, such as metabolic imbalances or anemia, but they are not specific findings for renal cancer.
C. While patients with advanced cancer may experience shortness of breath due to metastasis to the lungs or other complications, chest pain is not a direct finding associated with renal cancer. These symptoms could indicate other issues, such as cardiac or pulmonary problems.
D. While urinary frequency can occur due to various urinary tract issues, it is not a classic symptom of renal cancer. Hypotension is also not a typical finding associated with renal cancer unless there is significant blood loss or other complications.

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Blood Cell	Normal Ranges
Red blood cells (mature, circulating)	Male: 451-6.01 million/mm3 Female: 4.01-5.51 million/mm3
Hemoglobin	Adult (15-64 yr) Male 14-17.3 g/dL Female 11.7-155 g/dL
Hematocrit	42%-52% in males 36% -48% in females
Reticulocytes	0.5% -2.5% of total RBC count
White blood cells (total)	4.5-11.1 10/mm3
Neutrophils	59% Bands 3% Segs-56%
Eosinophils	2.7%
Basophils	0.5%
Lymphocytes	34%
Monocytes	4%


Platelets	150,000-450,000/mm3

The nurse is assessing a client experiencing motor loss as the result of a left-sided stroke. Which of the following clinical manifestations related to motor loss would the nurse document?

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Correct Answer is C

Explanation

A nurse is assessing a client diagnosed with renal cancer. The client is complaining of flank pain. Which additional assessment finding should the nurse expect?

Correct Answer is A

Explanation

The nurse is assessing a client experiencing motor loss as the result of a left-sided stroke. Which of the following clinical manifestations related to motor loss would the nurse document?

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