Nokea
A client asks the nurse what causes Parkinson's disease. The nurse's correct reply would be that Parkinson's disease is thought to be due to:
- A. a deficiency of dopamine in the brain.
- B. a demyelinating process affecting the central nervous system.
- C. atrophy of the basal ganglia.
- D. insufficient uptake of acetylcholine in the body.
Correct Answer: A
Rationale: Parkinson's disease is caused by a deficiency of dopamine in the brain, leading to motor symptoms.
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Which assessment technique should the nurse implement when assessing the client's cranial nerves for vibration?
- A. Move the big toe up and down and ask in which direction the vibration is felt.
- B. Place a tuning fork on the big toe and ask if the vibrations are felt.
- C. Tap the client's cheek with the finger and determine if vibrations are felt.
- D. Touch the arm with two sharp objects and ask if one (1) vibration or two (2) is felt.
Correct Answer: B
Rationale: Placing a tuning fork on the big toe assesses vibration sense (via dorsal column pathways), not cranial nerves directly, but is the correct technique. Other options assess different sensations.
The client is postoperative retinal detachment surgery, and gas tamponade was used to flatten the retina. Which intervention should the nurse implement first?
- A. Teach the signs of increased intraocular pressure.
- B. Position the client as prescribed by the surgeon.
- C. Assess the eye for signs/symptoms of complications.
- D. Explain the importance of follow-up visits.
Correct Answer: B
Rationale: Positioning as prescribed (e.g., face-down) is critical to maintain gas tamponade efficacy and retinal reattachment. Teaching, assessment, and follow-up are secondary.
The nurse is reviewing the new nurse's discharge instructions for the client following outpatient cataract surgery. Which statement should the nurse remove from the discharge instructions?
- A. Avoid lifting, pushing, or pulling objects heavier than 15 pounds.
- B. Clean the eye with a clean tissue; wipe from inner to outer eye.
- C. Cough and deep breathe every 2 to 3 hours while you are awake.
- D. Avoid lying on the side of the affected eye the night after surgery.
Correct Answer: C
Rationale: The client should not cough because this will increase the pressure within the eye and risk for complications. Lifting heavy objects increases pressure on the surgical eye. The surgical eye should be cleaned with a clean tissue from the inner to outer canthus to prevent obstruction of the ducts with drainage. Lying on the side of the surgical eye can increase pressure on the surgical eye.
The male client diagnosed with type 2 diabetes mellitus tells the nurse he has begun to see yellow spots. Which interventions should the nurse implement? List in order of priority.
- A. Notify the health-care provider.
- B. Check the client’s hemoglobin A1c.
- C. Assess the client’s vision using the Amsler grid.
- D. Teach the client about controlling blood glucose levels.
- E. Determine where the spots appear to be in the client’s field of vision.
Correct Answer: A,E,C,B,D
Rationale: 1) Notify HCP (urgent for possible diabetic retinopathy); 2) Determine spot location (assess severity); 3) Amsler grid (evaluate central vision); 4) Check HbA1c (assess control); 5) Teach glucose control (long-term management).
An adult is being treated with phenytoin (Dilantin) for a seizure disorder. Five days after starting the medication, he tells the nurse that his urine is reddish-brown in color. What action should the nurse take?
- A. Inform him that this is a common side effect of phenytoin (Dilantin) therapy
- B. Test the urine for occult blood
- C. Report it to the physician because it could indicate a clotting deficiency
- D. Send a urine specimen to the lab
Correct Answer: A
Rationale: Phenytoin commonly causes reddish-brown urine, a benign side effect, so informing the client is appropriate. Testing or reporting is unnecessary unless other symptoms suggest a problem.