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NUR |/ 211 |/Neuro |/Practice |/Questions |/WITH |/CORRECT
|/ANSWERS
- |/Michael |/is |/a |/ 24 |/year |/old |/man |/who |/presents |/with |/a |/ 6 |/hour |/history |/of |/sudden |/onset |/of |/inability |/to |/raise |/his |/eyebrow |/or |/smile |/on |/the |/right |/side. |/He |/also |/reports |/decreased |/lacrimation |/in |/the |/right |/eye |/and |/difficulty |/closing |/the |/right |/eyelid. |/The |/rest |/of |/his |/health |/history |/and |/physical |/exam |/is |/otherwise |/unremarkable. |/This |/likely |/represents |/paralysis |/of |/cranial |/nerve |/(CN): a. III. b. VIII. c. IV. d. VII.: |/Answer:|/d |/(KNOW |/HOW |/TO |/ASSESS |/ALL |/CRANIAL |/NERVES)
- |/The |/nurse |/is |/evaluates |/the |/client |/who |/is |/being |/treated |/for |/DKA. |/Which |/finding |/indicates |/that |/the |/client |/is |/responding |/to |/the |/treatment |/plan? a. Eyes |/sunken |/and |/skin |/flushed b. Skin |/moist |/with |/rapid |/elastic |/recoil c. Serum |/potassium |/level |/is |/3.3 |/mEq/L d. ABG |/results |/are |/pH |/7.25, |/Paco2 |/30, |/HCO3 |/17: |/Answer:|/b |/- |/these |/are |/signs |/that |/the |/patient |/is |/well |/hydrated A |/- |/incorrect |/- |/s/sx |/of |/dehydration C |/- |/incorrect |/- |/hypokalemia D |/- |/incorrect |/- |/you |/might |/see |/these |/ABG |/results |/in |/the |/DKA |/patient |/when |/they |/first |/present |/to |/the |/hospital
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- |/The |/nurse |/is |/assess |/the |/client |/who |/has |/Type |/II |/Diabetes. |/Which |/findings |/indicate |/to |/the |/nurse |/that |/the |/client |/is |/experiencing |/HHNS? |/Select |/all |/that |/apply a. Serum |/osmolality |/ 364 |/mOsm/kg b. Blood |/glucose |/level |/ 160 |/mg/dL c. Very |/dry |/mucous |/membranes d. Blood |/pressure |/of |/90/42 |/mm |/Hg e. Urine |/output |/ 500 |/mL |/past |/ 8 |/hours: |/Answer:|/a, |/c |/& |/d a. Serum |/osmolality |/of |/ 364 |/is |/elevated. |/The |/extremely |/high |/blood |/glucose |/levels |/in |/HHNS |/increase |/serum |/osmolality. b. Blood |/glucose |/levels |/for |/HHNS |/are |/usually |/over |/ 600 |/mg/dL c. Persistent |/hyperglycemia |/in |/HHNS |/causes |/osmotic |/diuresis, |/a |/loss |/of |/water |/and |/electrolytes |/and |/extreme |/dehydration. |/Very |/dry |/mucous |/membranes |/are |/a |/sign |/of |/dehydration. d. Hypotension |/from |/the |/loss |/of |/water |/and |/electrolytes |/in |/HHNS e. Urine |/output |/of |/ 500 |/mL |/in |/ 8 |/hours |/is |/normal. |/Clients |/with |/HHNS |/experience |/polyuria.
- |/The |/client |/develops |/SIADH |/secondary |/to |/a |/pituitary |/tumor. |/The |/client's |/assessment |/findings |/include |/thirst, |/weight |/gain, |/fatigue, |/and |/a |/serum |/sodium
4 |// |/vertebrae. |/Which |/findings |/support |/the |/nurse's |/conclusion |/that |/the |/client |/may |/be |/experiencing |/autonomic |/dysreflexia? |/Select |/all |/that |/apply a. Blurred |/vision b. BP |/198/ c. Heart |/rate |/ 150 |/bpm d. Extreme |/headache e. Sweaty |/face |/and |/arms: |/Answer:|/a, |/b, |/d, |/& |/e a. Blurred |/vision |/results |/from |/the |/HTN |/occurring |/with |/autonomic |/dysreflexia b. HTN |/is |/a |/symptom |/of |/autonomic |/dysreflexia |/from |/overstimulation |/of |/the |/SNS c. Bradycardia |/(not |/tachycardia) |/is |/a |/symptom |/of |/autonomic |/dysreflexia d. HA |/results |/from |/the |/HTN e. Sweating |/results |/from |/the |/sympathetic |/stimulation |/above |/the |/level |/of |/injury
- |/The |/nurse |/learns |/in |/report |/that |/the |/client |/admitted |/with |/a |/vertebral |/fracture |/has |/a |/halo |/external |/fixation |/device |/in |/place. |/Which |/intervention |/should |/the |/nurse |/plan? a. Ensure |/the |/traction |/weight |/hangs |/freely
5 |// b. Remove |/the |/vest |/from |/the |/device |/at |/bedtime c. Cleanse |/sites |/where |/the |/pins |/enter |/the |/skull d. Screw |/the |/pins |/in |/the |/skull |/daily |/to |/tighten: |/Answer:|/c |/There |/are |/no |/weights |/involved |/in |/a |/halo |/device The |/vest |/is |/never |/removed |/until |/the |/fracture |/has |/completely |/stabilized. |/The |/surgeon |/will |/tighten |/the |/pins |/as |/needed.
- |/The |/nurse |/is |/caring |/for |/the |/client |/experience |/Guillain-Barr' |/syndrome. |/It |/is |/most |/important |/for |/the |/nurse |/to |/monitor |/the |/client |/for |/which |/complication? a. Autonomic |/dysreflexia b. Septic |/emboli c. Cardiac |/dysrhythmias d. Respiratory |/failure: |/Answer:|/d
- |/The |/nurse |/is |/administering |/IV |/mannitol |/to |/decrease |/the |/client's |/ICP |/following |/a |/craniotomy. Which |/laboratory |/test |/result |/should |/the |/nurse |/monitor |/during |/the |/client's |/treatment |/with |/mannitol? a. Serum |/osmolarity b. WBCs c. Serum |/cholesterol d. Erythrocyte |/sedimentation |/rate |/(ESR): |/Answer:|/a Mannitol |/is |/an |/osmotic |/diuretic, |/serum |/osmolarity |/with |/be |/increased |/as |/fluid |/is |/pulled |/from |/the |/tissues, |/thus |/decreasing |/cerebral |/edema |/postoperatively.
7 |// that |/could |/occur |/with |/trauma, |/but |/there |/is |/no |/indication |/that |/the |/increased |/ICP |/is |/due |/to |/trauma.
- |/The |/client |/with |/myasthenia |/gravis |/has |/become |/increasingly |/weaker. |/The |/physician |/prepares |/to |/identify |/whether |/the |/client |/is |/reacting |/to |/an |/overdose |/of |/the |/medication |/(cholinergic |/crisis) |/or |/an |/increasing |/severity |/of |/the |/disease |/(myasthenic |/crisis). |/An |/injection |/of |/edrophonium |/(Tensilon) |/is |/administered. |/Which |/of |/the |/following |/would |/indicate |/that |/the |/client |/is |/in |/cholinergic |/crisis? a. No |/change |/in |/condition b. Complaints |/of |/muscle |/spasms c. An |/improvement |/of |/the |/weakness d. A |/temporary |/worsening |/of |/the |/condition: |/Answer:|/d An |/injection |/of |/edrophonium |/injection |/makes |/the |/client |/in |/cholinergic |/crisis |/temporar- |/ily |/feel |/worse. |/An |/improvement |/in |/the |/weakness |/indicates |/myasthenia |/crisis.
- |/The |/client |/with |/Guillain-Barre' |/syndrome |/is |/scheduled |/to |/receive |/plasma- |/pheresis |/treatments. |/The |/client's |/spouse |/asks |/the |/nurse |/about |/the |/purpose |/of |/plasmapheresis |/treatments. |/Which |/explanation |/is |/correct? a. "Plasmapheresis |/removes |/excess |/fluid |/from |/the |/bloodstream." b. "plasmapheresis |/will |/increase |/the |/protein |/levels |/in |/the |/blood." c. "Plasmapheresis |/removes |/circulating |/antibodies |/from |/the |/blood." d. "Plasmapheresis |/infuses |/lipoproteins |/to |/restore |/the |/myelin |/sheath.": |/Answer |/C
8 |// Plasmapheresis |/is |/a |/procedure |/in |/which |/harmful |/antibodies |/are |/removed |/from |/the |/blood. |/During |/the |/procedure, |/blood |/is |/removed |/from |/the |/client, |/the |/plasma |/is |/separated, |/and |/blood |/cells |/without |/the |/plasma |/are |/returned |/to |/the |/client.
- |/The |/nurse |/is |/assessing |/the |/client |/following |/a |/closed |/head |/injury. |/When |/applying |/nailbed |/pressure, |/the |/client's |/body |/suddenly |/stiffens, |/the |/eyes |/roll |/upward |/and |/there |/is |/an |/increase |/in |/salivation |/and |/loss |/of |/swallowing |/reflex. |/Which |/observation |/should |/the |/nurse |/document? a. Decerebrate |/posturing |/observed b. Decorticate |/posturing |/observed c. Positive |/Kernig's |/sign |/observed d. Seizure |/activity |/observed: |/Answer |/D Body |/stiffening, |/eyes |/rolled |/upward, |/increase |/in |/salivation, |/and |/a |/loss |/of |/swallowing |/reflex |/are |/signs |/consistent |/with |/the |/tonic |/phase |/of |/a |/tonic-clonic |/seizure. |/This |/phase |/is |/followed |/by |/the |/clonic |/phase |/with |/violent |/muscle |/contractions.
- |/The |/client |/is |/in |/status |/epilepticus. |/Which |/interventions, |/if |/prescribed |/should |/be |/included |/in |/this |/client's |/immediate |/treatment? |/Select |/all |/that |/apply a. Administer |/dexamethasone |/intravenously. b. Give |/oxygen |/and |/prepare |/for |/endotracheal |/intubation
10 |// |/mize |/the |/risk |/of |/recurrence? a. Strict |/adherence |/to |/a |/bowel |/retraining |/program b. Keeping |/the |/linen |/wrinkle-free |/under |/the |/client c. Preventing |/unnecessary |/pressure |/on |/the |/lower |/extremities d. Limiting |/bladder |/catheterization |/to |/once |/every |/ 12 |/hours: |/Answer:|/d The |/most |/common |/causes |/of |/autonomic |/dysreflexia |/are |/bowel |/and |/bladder |/disten- |/tion. |/Catheterization |/should |/be |/performed |/every |/4-6 |/hours. |/All |/the |/other |/interventions |/are |/appropriate.
- |/The |/nurse |/is |/teaching |/the |/client |/with |/myasthenia |/gravis |/about |/the |/prevention |/of |/myasthenic |/and |/cholinergic |/crises. |/The |/nurse |/tells |/the |/client |/that |/this |/is |/most |/effectively |/done |/by: a. Eating |/large, |/well |/balanced |/meals b. Doing |/muscle-strengthening |/exercises c. Doing |/all |/their |/chores |/in |/the |/early |/morning |/while |/less |/fatigued d. Taking |/medications |/on |/time |/to |/maintain |/therapeutic |/blood |/levels: |/Answer: |/d |/Clients |/with |/MG |/are |/taught |/to |/space |/out |/activities |/and |/meals |/throughout |/the |/day |/and
11 |// should |/eat |/small |/meals |/to |/avoid |/overeating. |/Muscle |/strengthening |/exercises |/are |/not |/helpful. |/Taking |/medications |/correctly |/is |/the |/most |/important |/thing |/to |/avoid |/crises.
- |/The |/nurse |/has |/instructed |/the |/family |/of |/a |/client |/with |/brain |/attack |/(stroke) |/who |/has |/homonymous |/hemianopsia |/about |/measure |/to |/help |/the |/client |/overcome |/the |/deficit. |/The |/nurse |/determines |/that |/the |/family |/understands |/the |/measures |/to |/use |/if |/they |/state |/they |/will: a. Place |/objects |/in |/the |/client's |/impaired |/field |/of |/visioin. b. Discourage |/the |/client |/from |/wearing |/eyeglasses c. Approach |/the |/client |/from |/the |/impaired |/field d. Remind |/the |/client |/to |/turn |/the |/head |/to |/scan |/the |/lost |/visual |/field.: |/Answer: |/d |/Homonymous |/hemianopsia |/is |/loss |/of |/half |/of |/the |/visual |/field. |/The |/client |/should |/wear |/eyeglasses |/if |/they |/have |/them. |/The |/client|/should |/be |/approached |/from |/the |/unimpaired |/side.
- |/The |/client |/is |/admitted |/to |/the |/hospital |/with |/a |/diagnosis |/of |/Guillain-Barre' |/syndrome. |/The |/nurse |/inquires |/during |/the |/nursing |/admission |/interview |/if |/the |/client |/has |/a |/history |/of: a. Seizures |/or |/trauma |/to |/the |/brain b. Meningitis |/during |/the |/last |/ 5 |/years c. Back |/injury |/or |/trauma |/to |/the |/spinal |/cord d. Respiratory |/or |/gastrointestinal |/infection |/during |/the |/past |/month: |/Answer: |/d |/Guillain-Barre' |/is |/a |/clinical |/syndrome |/of |/unknown |/origin |/that |/involves
13 |// as |/a |/complication |/of |/the |/surgery |/if |/the |/client |/exhibits: a. A |/negative |/Kernig |/sign b. Absence |/of |/nuchal |/rigidity c. A |/positive |/Brudzinski |/sign d. A |/Glasgow |/coma |/scale |/score |/of |/15: |/Answer:|/C Signs |/of |/meningitis |/include |/a |/positive |/Kernig |/sign, |/presence |/of |/nuchal |/rigidity |/and |/a |/positive |/Brudzinski |/sign. |/A |/GSC |/of |/ 15 |/is |/a |/perfect |/score.
- |/The |/nurse |/is |/preparing |/to |/discharge |/a |/client |/with |/a |/halo |/device. |/The |/nurse |/determines |/that |/the |/client |/needs |/further |/instruction |/if |/the |/client |/states |/that |/he |/or |/she |/will: a. Use |/a |/straw |/to |/drink b. Drive |/only |/during |/the |/daytime c. Use |/caution |/because |/the |/device |/alters |/balance d. Wash |/the |/skin |/daily |/under |/the |/lamb's |/wool |/liner |/of |/the |/vest: |/Answer: |/b |/Client |/with |/a |/halo |/device |/can't |/turn |/their |/head |/and |/are |/unsafe |/to |/drive. |/All |/the |/other |/statements |/are |/true.
- |/The |/nurse |/is |/caring |/for |/a |/client |/who |/takes |/phenytoin |/(Dilantin) |/for |/seizures. |/During |/the |/assessment, |/the |/nurse |/notes |/the |/client |/also |/takes |/birth |/control |/pills. |/Which |/teaching |/should |/the |/nurse |/include? a. It |/is |/not |/important |/to |/take |/this |/medication |/as |/prescribed b. If |/you |/are |/having |/stomach |/upset |/you |/may |/stop |/taking |/your |/medicine c. There |/is |/a |/potential |/for |/decreased |/effectiveness |/of |/birth |/control |/pills |/with |/phenytoin
14 |// d. There |/is |/an |/increased |/risk |/of |/thrombophlebitis |/while |/taking |/phenytoin: |/An- |/swer: |/c Dilantin |/should |/be |/taken |/as |/prescribed |/on |/a |/scheduled |/dose. |/The |/client |/should |/not |/stop |/taking |/the |/medication |/without |/the |/approval |/of |/the |/HCP. |/There |/is |/a |/risk |/of |/increased |/bleeding |/with |/Dilantin |/due |/to |/blood |/dyscrasias.
The |/ED |/nurse |/is |/caring |/for |/a |/client |/who |/has |/been |/brought |/in |/by |/ambulance |/after |/sustaining|/a |/fall |/at |/home.|/What |/physical |/assessment |/finding |/is |/suggestive |/of |/a |/basilar |/skull |/fracture? |/Select |/all |/that |/apply A) Epistaxis B) Periorbital |/edema
16 |//
A |/client |/with |/spinal |/cord |/injury |/has |/a |/nursing |/diagnosis |/of |/altered |/mobility |/and |/the |/nurse |/recognizes |/the |/increased |/risk |/of |/deep |/vein |/thrombosis |/(DVT). |/Which |/of |/the |/following |/would |/be |/included |/as |/an |/appropriate |/nursing |/intervention |/to |/prevent |/a |/DVT |/from |/occurring? A) Placing |/the |/client |/on |/a |/fluid |/restriction |/as |/prescribed B) Applying |/thigh-high |/elastic |/stockings C) Administering |/an |/antifibrinolytic |/agent
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D)
Assisting |/the |/client |/with |/passive |/range-of-motion |/(PROM) |/exercises: |/B) |/Applying |/thigh-high |/elastic |/stockings
A |/client |/who |/has |/sustained |/a |/nondepressed |/skull |/fracture |/is |/admitted |/to |/the |/acute |/medical |/unit. |/Nursing |/care |/should |/include |/which |/of |/the |/following? A) Preparation |/for |/emergency |/craniotomy B) Watchful |/waiting |/and |/close |/monitoring C) Administration |/of |/inotropic |/drugs D) Fluid |/resuscitation: |/B) Watchful |/waiting |/and |/close |/monitoring
A |/client |/who |/suffered |/a |/spinal |/cord |/injury |/is |/experiencing |/an |/exaggerated |/autonomic |/response. |/What |/aspect |/of |/the |/client's |/current |/health |/status |/is |/most |/likely |/to |/have |/precipitated |/this |/event? A)
19 |//
Following |/a |/spinal |/cord |/injury |/a |/client |/is |/placed |/in |/halo |/traction. |/While |/perform- |/ing |/pin |/site |/care, |/the |/nurse |/notes |/that |/one |/of |/the |/traction |/pins |/has |/become |/detached. |/The |/nurse |/would |/be |/correct |/in |/implementing |/what |/priority |/nursing |/action? A) Complete |/the |/pin |/site |/care |/to |/decrease |/risk |/of |/infection B) Notify |/the |/neurosurgeon |/of |/the |/occurrence C) Stabilize |/the |/head |/in |/a |/lateral |/position D) Reattach |/the |/pin |/to |/prevent |/further |/head |/trauma: |/B) |/Notify |/the |/neurosurgeon |/of |/the |/occurrence
A |/ 13 |/year |/old |/was |/brought |/to |/the |/ED |/after |/being |/hit |/in |/the |/head |/by |/a |/baseball |/and |/is |/subsequently |/diagnosed |/with |/a |/concussion. |/What |/assessment |/finding |/would |/rule |/out |/discharging |/the |/client? A) The |/client |/reports |/a |/headache.
20 |//
B)
The |/client |/reports |/pain |/at |/the |/site |/where |/the |/ball |/hits |/his |/head. C) The |/client |/is |/visibly |/fatigued. D) The |/client's |/speech |/is |/slightly |/slurred.: |/D) |/The |/client's |/speech |/is |/slightly |/slurred.
An |/82-year-old |/man |/is |/admitted |/for |/observation |/after |/a |/fall. |/Due |/to |/his |/age, |/the |/nurse |/knows |/that |/the |/client |/is |/at |/increased |/risk |/for |/what |/complication |/of |/his |/injury?
