Nokea
A laminectomy and spinal fusion are performed on a patient with a herniated lumbar intervertebral disc. During the postoperative period, which finding is of most concern to the nurse?
- A. Paralytic ileus
- B. Urinary incontinence
- C. Greater pain at the graft site than at the lumbar incision site
- D. Leg and arm movement and sensation unchanged from preoperative status
Correct Answer: B
Rationale: Urinary incontinence may indicate nerve damage.
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Which intervention should the nurse delegate to the licensed practical nurse (LPN) when caring for a patient following an acute stroke?
- A. Assess the patient's neurologic status.
- B. Assess the patient's gag reflex before beginning feeding.
- C. Administer ordered antihypertensives and platelet inhibitors.
- D. Teach the patient's caregivers strategies to minimize unilateral neglect.
Correct Answer: C
Rationale: Administering medications is typically within the scope of practice for LPNs
MRS. Post is concerned about the effect of her diagnosis of systemic lupus erythematosus on childbearing. In discharge planning with Mrs. Post, you should
- A. instruct her to use an intrauterine device for birth control
- B. tell her pregnancy may cause an exacerbation of symptoms
- C. tell her that her symptoms will not change because of pregnancy
- D. instruct her to use birth control pills
Correct Answer: B
Rationale: Pregnancy can trigger lupus flares, requiring careful monitoring.
KL is a 34-year-old male admitted to the hospital (large trauma center) after suffering a traumatic brain injury (TBI) secondary to a serious motor vehicle accident. He was in excellent health prior to the accident. HT: 6'2" WT: 190 pounds (86 kg) What level of energy intake per day is the most appropriate for KL?
- A. 1,800 kcal
- B. 2,100 kcal
- C. 2,400 kcal
- D. 2,700 kcal
Correct Answer: C
Rationale: For a patient with traumatic brain injury (TBI), an energy intake of approximately 2,400 kcal/day is often appropriate to meet increased metabolic demands while avoiding overfeeding, which can exacerbate complications like hyperglycemia or respiratory issues.
To assess the patient's deep tendon reflexes, the nurse should:
- A. Use a reflex hammer to test responses in the biceps, triceps, and patellar tendons.
- B. Measure the patient's temperature.
- C. Inspect the patient's gait.
- D. Check the patient's level of consciousness.
Correct Answer: A
Rationale: Deep tendon reflexes are tested using a reflex hammer to elicit responses in specific tendons. Temperature, gait, and level of consciousness are unrelated to reflex testing.
Vasodilators produced by the endothelium include:
- A. endothelium-derived relaxing factor (EDRF)
- B. nitric oxide (NO)
- C. prostacyclin (PGL2)
- D. all above
Correct Answer: D
Rationale: The endothelium produces vasodilators such as EDRF (which includes NO) and prostacyclin (PGL2). These substances help regulate vascular tone and blood flow.