Nokea
A client with multiple sclerosis is prescribed diazepam (Valium). What assessment finding indicates that the medication is effective for the client?
- A. Muscle spasticity is reduced
- B. Blood glucose level is within normal limits
- C. The client states that muscles are weak
- D. Ophthalmologic examination shows no evidence of cataracts
Correct Answer: A
Rationale: Diazepam is a muscle relaxant used to reduce spasticity in MS. Its effectiveness is measured by the reduction in muscle stiffness and spasms.
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During the patient's process of grieving for the losses resulting from spinal cord injury, what should the nurse do?
- A. Help the patient to understand that working through the grief will be a lifelong process
- B. Assist the patient to move through all stages of the mourning process to acceptance
- C. Let the patient know that anger directed at the staff or the family is not a positive coping mechanism
- D. Facilitate the grieving process so that it is completed by the time the patient is discharged from rehabilitation
Correct Answer: A
Rationale: Grieving is a long-term process requiring ongoing support.
Certain metabolic diseases can affect the nervous system. For instance, people with diabetes can develop a nervous system problem called diabetic neuropathy. What are the symptoms of diabetic neuropathy?
- A. Constipation or diarrhea
- B. Rapid heart beat
- C. Pain in feet
- D. All of the above
Correct Answer: D
Rationale: Diabetic neuropathy can cause a wide range of symptoms, including gastrointestinal issues like constipation or diarrhea, cardiovascular symptoms like rapid heart rate, and sensory symptoms like pain in the feet. This condition results from nerve damage due to high blood sugar levels. Recognizing these symptoms is essential for managing diabetes-related complications.
A 22-year-old female patient recovering from a craniotomy begins crying and asking for her mother who is sleeping in the visitors' lounge. The patient's Glasgow Coma Scale (GCS) of 15 and pupils are equal and reactive. What nursing action would be most appropriate at this time?
- A. Ask the mother to come and stay with the patient.
- B. Administer an as-needed sedative to calm the patient.
- C. Notify the neurosurgeon that the patient is upset and crying.
- D. Reassure the patient, and sit with her until she falls back asleep.
Correct Answer: A
Rationale: The patient is stable with a GCS of 15 and normal pupillary response, indicating no immediate neurological concern. Emotional distress after surgery is common, and having a family member present can provide comfort. Sedation or notifying the surgeon is unnecessary unless there are signs of neurological deterioration.
A 35 year-old reporter presents to your office for evaluation of back pain and weakness in his left leg. He was play-wrestling with his nephew and hurt his back 2 weeks ago. He states that he has noticed tingling in his left leg as well. He has not noticed incontinence of bowel or bladder function. You perform a physical examination and confirm that he is dragging his left foot when he walks and that his Achilles reflex is diminished. The diagnosis is a herniated disc. Which nerve root are you testing with the Achilles reflex?
- A. C5, C6
- B. L2, L3, L4
- C. S1, S2
- D. L4, L5
Correct Answer: C
Rationale: The Achilles reflex tests the S1 and S2 nerve roots. A diminished Achilles reflex may indicate a herniated disc compressing these nerve roots. C5, C6, L2, L3, L4, and L4, L5 are tested by other reflexes, such as the biceps, patellar, and brachioradialis reflexes.
Referred pain from pancreatitis is at what level?
- A. T7/8
- B. L1/2
- C. T3/4
- D. T12/L1
Correct Answer: A
Rationale: Referred pain from pancreatitis is typically felt at the T7-T8 dermatome, which corresponds to the epigastric region. This is due to shared spinal cord segments between the pancreas and the abdominal wall.