A nurse is caring for a client who has had a stroke involving the right hemisphere. Which of the following alterations in function should the nurse expect?

Choice A rationale The right hemisphere of the brain is primarily responsible for visual-spatial orientation and the recognition of faces and places. A stroke in this region often leads to prosopagnosia, or the inability to recognize familiar faces, including family members. This occurs because the right hemisphere processes the holistic configuration of facial features. Damage here disrupts the client's ability to integrate visual information with stored memories of personal identities, causing significant social and emotional distress. Choice B rationale Difficulty reading, or alexia, is more commonly associated with left hemisphere damage, as the left side of the brain typically houses the primary centers for language processing, including syntax and word recognition. While the right hemisphere contributes to understanding the tone and context of written material, the mechanical act of reading and decoding symbols is a dominant left-brain function. Therefore, a right-sided stroke is less likely to cause fundamental reading deficits compared to a left-sided injury. Choice C rationale Hemiparesis occurs on the side of the body opposite to the brain lesion due to the decussation of motor fibers in the medulla. A right hemisphere stroke would result in left-sided hemiparesis or hemiplegia. Right hemiparesis is a hallmark sign of a left hemisphere stroke, where the motor cortex controlling the right side of the body is damaged. Assessing motor strength and symmetry is crucial, but the deficit must align with the neuroanatomical location of the stroke. Choice D rationale Aphasia, which involves the impairment of language production or comprehension, is typically a result of damage to the left hemisphere, where Broca's and Wernicke's areas are located in most individuals. While right-sided lesions can affect the prosody, melody, and emotional nuance of speech, they do not usually cause the structural language loss defined as aphasia. The nurse should expect communication to be more impacted by impulsivity or spatial neglect rather than traditional language deficits.