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A patient, diagnosed with cancer of the lung, has just been told he has metastases to the brain. What change in health status would the nurse attribute to the patients metastatic brain disease?
- A. Chronic pain
- B. Respiratory distress
- C. Fixed pupils
- D. Personality changes
Correct Answer: D
Rationale: Brain metastases cause neurologic symptoms like personality changes, not chronic pain, respiratory distress, or fixed pupils, which are unrelated or less common.
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The nurse responds to the call light of a patient who has had a cervical diskectomy earlier in the day. The patient states that she is having severe pain that had a sudden onset. What is the nurses most appropriate action?
- A. Palpate the surgical site.
- B. Remove the dressing to assess the surgical site.
- C. Call the surgeon to report the patients pain.
- D. Administer a dose of an NSAID.
Correct Answer: C
Rationale: Sudden severe pain post-diskectomy may indicate graft extrusion, requiring immediate surgical notification. Palpation, dressing removal, or NSAIDs could delay critical intervention.
A patient has just returned to the unit from the PACU after surgery for a tumor within the spine. The patient complains of pain. When positioning the patient for comfort and to reduce injury to the surgical site, the nurse will position to patient in what position?
- A. In the high Fowlers position
- B. In a flat side-lying position
- C. In the Trendelenberg position
- D. In the reverse Trendelenberg position
Correct Answer: B
Rationale: Flat side-lying position minimizes pressure on the surgical site, reducing pain and complications. Other positions increase strain or risk.
A patient with Parkinsons disease is undergoing a swallowing assessment because she has recently developed adventitious lung sounds. The patients nutritional needs should be met by what method?
- A. Total parenteral nutrition (TPN)
- B. Provision of a low-residue diet
- C. Semisolid food with thick liquids
- D. Minced foods and a fluid restriction
Correct Answer: C
Rationale: Semisolid foods with thick liquids are easier to swallow, reducing aspiration risk. TPN, low-residue diets, or fluid restrictions are not indicated.
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.
A family member of a patient diagnosed with Huntington disease calls you at the clinic. She is requesting help from the Huntingtons Disease Society of America. What kind of help can this patient and family receive from this organization? Select all that apply.
- A. Information about this disease
- B. Referrals
- C. Public education
- D. Individual assessments
- E. Appraisals of research studies
Correct Answer: A,B,C
Rationale: The Huntington's Disease Society of America provides information, referrals, and public education. It does not offer individual assessments or research appraisals.