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A male patient with a metastatic brain tumor is having a generalized seizure and begins vomiting. What should the nurse do first?
- A. Perform oral suctioning.
- B. Page the physician.
- C. Insert a tongue depressor into the patients mouth.
- D. Turn the patient on his side.
Correct Answer: D
Rationale: Turning the patient on their side prevents aspiration of vomit during a seizure. Tongue depressors are contraindicated, and suctioning or paging the physician are secondary actions.
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A patient who has been experiencing numerous episodes of unexplained headaches and vomiting has subsequently been referred for testing to rule out a brain tumor. What characteristic of the patients vomiting is most consistent with a brain tumor?
- A. The patients vomiting is accompanied by epistaxis.
- B. The patients vomiting does not relieve his nausea.
- C. The patients vomiting is unrelated to food intake.
- D. The patients emesis is blood-tinged.
Correct Answer: C
Rationale: Brain tumor-related vomiting is typically unrelated to food intake due to increased ICP. Epistaxis, blood-tinged emesis, or nausea relief are not characteristic.
The nurse is caring for a patient with Huntington disease who has been admitted to the hospital for treatment of malnutrition. What independent nursing action should be implemented in the patients plan of care?
- A. Firmly redirect the patients head when feeding.
- B. Administer phenothiazines after each meal as ordered.
- C. Encourage the patient to keep his or her feeding area clean.
- D. Apply deep, gentle pressure around the patients mouth to aid swallowing.
Correct Answer: D
Rationale: Deep, gentle pressure aids swallowing in Huntington's patients with choreiform movements. Redirecting the head or focusing on cleanliness is inappropriate, and phenothiazines are given before meals.
The nurse in an extended care facility is planning the daily activities of a patient with postpolio syndrome. The nurse recognizes the patient will best benefit from physical therapy when it is scheduled at what time?
- A. Immediately after meals
- B. In the morning
- C. Before bedtime
- D. In the early evening
Correct Answer: B
Rationale: Morning physical therapy maximizes benefit in postpolio syndrome, as fatigue worsens later in the day.
A 37-year-old man is brought to the clinic by his wife because he is experiencing loss of motor function and sensation. The physician suspects the patient has a spinal cord tumor and hospitalizes him for diagnostic testing. In light of the need to diagnose spinal cord compression from a tumor, the nurse will most likely prepare the patient for what test?
- A. Anterior-posterior x-ray
- B. Ultrasound
- C. Lumbar puncture
- D. MRI
Correct Answer: D
Rationale: MRI is the most sensitive test for detecting spinal cord compression from tumors. X-rays, ultrasound, and lumbar puncture are less effective for this diagnosis.
A patient with Huntington disease has just been admitted to a long-term care facility. The charge nurse is creating a care plan for this patient. Nutritional management for a patient with Huntington disease should be informed by what principle?
- A. The patient is likely to have an increased appetite.
- B. The patient is likely to require enzyme supplements.
- C. The patient will likely require a clear liquid diet.
- D. The patient will benefit from a low-protein diet.
Correct Answer: A
Rationale: Huntington's disease causes increased appetite due to involuntary movements, requiring high-calorie diets. Enzyme supplements, clear liquids, or low-protein diets are not indicated.