A nurse is caring for a client who had a right-sided stroke and is exhibiting homonymous hemianopsia when eating. Which of the following actions should the nurse take?
Provide a nonskid mat to reduce plate movement.
Encourage the use of wide grip utensils.
Remind that the client look for food on the left side of the tray.
Encourage the client to use her right hand when feeding herself.
The Correct Answer is C
A. A nonskid mat might be helpful for plate stability, but it does not address the visual deficit related to homonymous hemianopsia.
B. Wide grip utensils are useful for motor difficulties, but the primary issue here is a visual field deficit, not motor impairment.
C. Homonymous hemianopsia results in loss of vision in the same half of the visual field in both eyes. Encouraging the client to turn her head or look for food on the affected side (left side of the tray) can help compensate for the visual loss.
D. While using the right hand may be important after a right-sided stroke, the more pressing issue here is addressing the visual field deficit, not hand preference.
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Correct Answer is A
Explanation
A. Computerized tomography angiography (CTA) is commonly used to visualize blood vessels and identify any blockages or abnormalities in blood flow that may have contributed to a TIA.
B. While a complete blood count (CBC) may be ordered as part of the general assessment, it is not specific for diagnosing TIA and does not provide information on cerebrovascular issues.
C. A transesophageal echocardiogram (TEE) is used to assess cardiac function and may be indicated in some stroke cases, but it is not the primary diagnostic test for TIA.
D. Prothrombin time (PT) assesses clotting function but is not specific for diagnosing TIA; it may be ordered for other reasons but is not a primary diagnostic tool in this context.
Correct Answer is B
Explanation
A. The ascending tracts transmit sensory information to the brain, but they do not process the information; that function is performed in the brain itself.
B. This statement accurately reflects the function of the descending tracts, which carry motor signals from the CNS to the muscles, facilitating voluntary movement.
C. Sensory receptors are located in various tissues throughout the body, including the skin and muscles, but not exclusively in the muscles.
D. Motor neurons are located in the spinal cord and peripheral nervous system, not in the dermal layer of the skin, where sensory receptors reside.