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A patient has just been diagnosed with Parkinsons disease and the nurse is planning the patients subsequent care for the home setting. What nursing diagnosis should the nurse address when educating the patients family?
- A. Risk for infection
- B. Impaired spontaneous ventilation
- C. Unilateral neglect
- D. Risk for injury
Correct Answer: D
Rationale: Parkinson's disease increases fall risk due to dyskinesia and bradykinesia, making 'risk for injury' a priority. Infection, ventilation, or neglect are not typical concerns.
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A patient diagnosed with a pituitary adenoma has arrived on the neurologic unit. When planning the patients care, the nurse should be aware that the effects of the tumor will primarily depend on what variable?
- A. Whether the tumor utilizes aerobic or anaerobic respiration
- B. The specific hormones secreted by the tumor
- C. The patients pre-existing health status
- D. Whether the tumor is primary or the result of metastasis
Correct Answer: B
Rationale: Pituitary adenoma effects depend on the hormones it secretes, impacting bodily functions. Respiration type, health status, or tumor origin are less determinative.
A patient with suspected Parkinsons disease is initially being assessed by the nurse. When is the best time to assess for the presence of a tremor?
- A. When the patient is resting
- B. When the patient is ambulating
- C. When the patient is preparing his or her meal tray to eat
- D. When the patient is participating in occupational therapy
Correct Answer: A
Rationale: Parkinson's resting tremor is most evident when extremities are motionless, disappearing with purposeful movement. Assessment during rest is optimal.
The nurse is caring for a patient newly diagnosed with a primary brain tumor. The patient asks the nurse where his tumor came from. What would be the nurses best response?
- A. Your tumor originated from somewhere outside the CNS.
- B. Your tumor likely started out in one of your glands.
- C. Your tumor originated from cells within your brain itself.
- D. Your tumor is from nerve tissue somewhere in your body.
Correct Answer: C
Rationale: Primary brain tumors arise from brain cells, unlike secondary tumors from outside the CNS. Glandular or nerve tissue origins are less specific.
A patient with amyotrophic lateral sclerosis (ALS) is being visited by the home health nurse who is creating a care plan. What nursing diagnosis is most likely for a patient with this condition?
- A. Chronic confusion
- B. Impaired urinary elimination
- C. Impaired verbal communication
- D. Bowel incontinence
Correct Answer: C
Rationale: ALS causes progressive speech impairment, making impaired verbal communication a primary concern. Cognitive function, bladder, and bowel control are typically preserved.
A patient newly diagnosed with a cervical disk herniation is receiving health education from the clinic nurse. What conservative management measures should the nurse teach the patient to implement?
- A. Perform active ROM exercises three times daily.
- B. Sleep on a firm mattress.
- C. Apply cool compresses to the back of the neck daily.
- D. Wear the cervical collar for at least 2 hours at a time.
Correct Answer: B
Rationale: Sleeping on a firm mattress promotes proper spinal alignment and pain relief. Active ROM, cool compresses, and limited collar use are not standard conservative measures.