A nurse is caring for a client who recently had a stroke. Which alteration in neurologic function should the nurse expect?
Facial drooping
Frequent diarrhea
Steady gait
Vocal clarity
The Correct Answer is A
A. Facial drooping is a common symptom following a stroke, particularly if it affects areas of the brain responsible for facial movement.
B. Frequent diarrhea is not typically associated with stroke and may be related to other factors.
C. A steady gait is unlikely following a stroke, especially if the stroke has affected motor control or balance.
D. Vocal clarity can be affected after a stroke, but facial drooping is a more immediate and recognizable alteration in neurologic function.
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Correct Answer is D
Explanation
A. Petechiae are small, pinpoint hemorrhages and are considered objective data that can be observed and documented by the nurse.
B. Blood pressure is a vital sign and objective data that can be measured using a sphygmomanometer.
C. Cyanosis is a physical sign indicating low oxygenation in the blood and is objective data that can be observed.
D. Nausea is a subjective symptom reported by the client, reflecting their internal experience and cannot be measured or observed directly.
Correct Answer is B
Explanation
A. A pulse oximeter is used to measure oxygen saturation and is not relevant to cochlear dysfunction.
B. A hearing aid is appropriate for someone with cochlear dysfunction as it can help amplify sound and improve hearing, indicating the client is adapting to the hearing loss.
C. Eyeglasses are used for vision problems and do not relate to the function of the cochlear division of the vestibulocochlear nerve.
D. A bath thermometer is used to measure water temperature and is not relevant to auditory issues.