A nurse is caring for a client who is recovering from a stroke and has right-sided homonymous
hemianopsia. To help the client adapt to the hemianopsia, the nurse should take which of the following
actions?
"Remind the client to look consciously at both sides of their meal tray."
Clients who have right-sided homonymous hemianopsia have lost the right visual field of both eyes and
might only eat the food they are able to see on the left half of the meal tray. Therefore, the nurse
should remind the client to look at both sides of his meal tray to help compensate for the visual loss.
A nurse is caring for a client who has a history of status epilepticus and requires seizure precautions.
Which of the following actions should the nurse take?
"Establish IV access."
The nurse should plan to establish IV access with a large-bore catheter and administer 0.9% sodium
chloride if seizures are imminent. If the client is stable, the nurse should initiate a saline lock.
A nurse is caring for a client who has a spastic bladder following a spinal cord injury. Which of the
following actions should the nurse take to help stimulate micturition?
, "Stroke the client's inner thigh."
The nurse should stimulate micturition by stroking the client's inner thigh. Other techniques include
pinching the skin above the groin and providing digital anal stimulation.
A nurse is teaching a client who has osteoporosis and has a new prescription for alendronate. Which of
the following information should the nurse include in the teaching?
"Remain upright for 30 minutes after taking this medication."
To prevent esophagitis or esophageal ulcers, which can result from alendronate therapy, the client
should sit upright for 30 min after taking this medication.
A nurse is planning care for a client following a lumbar puncture. Which of the following actions should
the nurse plan to take?
"Ensure that the client lies flat for up to 12 hours."
The client should lie flat for up to 12 hr to prevent cerebrospinal fluid leakage from the puncture site,
which can cause a headache.
A nurse is teaching an assistive personnel (AP) about providing care to a client following a total hip
arthroplasty. Which of the following instructions should the nurse include?
"Place the abductor pillow between the client's legs when turning the client."
The nurse should inform the AP that a client who had a total hip arthroplasty should maintain the hip in
abduction following surgery to reduce the risk of dislocating the affected hip. The AP should place an
abductor pillow between the client's legs when turning the client to keep the hips in abduction.
A nurse is reviewing postoperative instructions with a client following cataract surgery. Which of the
following client statements indicates an understanding of the instructions?
"I should call my doctor if my vision gets worse."
The client should expect an improvement in vision after the surgery, so the nurse should instruct the
client to report negative changes in vision immediately.
hemianopsia. To help the client adapt to the hemianopsia, the nurse should take which of the following
actions?
"Remind the client to look consciously at both sides of their meal tray."
Clients who have right-sided homonymous hemianopsia have lost the right visual field of both eyes and
might only eat the food they are able to see on the left half of the meal tray. Therefore, the nurse
should remind the client to look at both sides of his meal tray to help compensate for the visual loss.
A nurse is caring for a client who has a history of status epilepticus and requires seizure precautions.
Which of the following actions should the nurse take?
"Establish IV access."
The nurse should plan to establish IV access with a large-bore catheter and administer 0.9% sodium
chloride if seizures are imminent. If the client is stable, the nurse should initiate a saline lock.
A nurse is caring for a client who has a spastic bladder following a spinal cord injury. Which of the
following actions should the nurse take to help stimulate micturition?
, "Stroke the client's inner thigh."
The nurse should stimulate micturition by stroking the client's inner thigh. Other techniques include
pinching the skin above the groin and providing digital anal stimulation.
A nurse is teaching a client who has osteoporosis and has a new prescription for alendronate. Which of
the following information should the nurse include in the teaching?
"Remain upright for 30 minutes after taking this medication."
To prevent esophagitis or esophageal ulcers, which can result from alendronate therapy, the client
should sit upright for 30 min after taking this medication.
A nurse is planning care for a client following a lumbar puncture. Which of the following actions should
the nurse plan to take?
"Ensure that the client lies flat for up to 12 hours."
The client should lie flat for up to 12 hr to prevent cerebrospinal fluid leakage from the puncture site,
which can cause a headache.
A nurse is teaching an assistive personnel (AP) about providing care to a client following a total hip
arthroplasty. Which of the following instructions should the nurse include?
"Place the abductor pillow between the client's legs when turning the client."
The nurse should inform the AP that a client who had a total hip arthroplasty should maintain the hip in
abduction following surgery to reduce the risk of dislocating the affected hip. The AP should place an
abductor pillow between the client's legs when turning the client to keep the hips in abduction.
A nurse is reviewing postoperative instructions with a client following cataract surgery. Which of the
following client statements indicates an understanding of the instructions?
"I should call my doctor if my vision gets worse."
The client should expect an improvement in vision after the surgery, so the nurse should instruct the
client to report negative changes in vision immediately.
