Nokea
A patient with a new diagnosis of amyotrophic lateral sclerosis (ALS) is overwhelmed by his diagnosis and the known complications of the disease. How can the patient best make known his wishes for care as his disease progresses?
- A. Prepare an advance directive.
- B. Designate a most responsible physician (MRP) early in the course of the disease.
- C. Collaborate with representatives from the Amyotrophic Lateral Sclerosis Association.
- D. Ensure that witnesses are present when he provides instruction.
Correct Answer: A
Rationale: An advance directive legally documents care wishes for ALS progression. Other options lack legal binding or specificity.
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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.
A nurse is planning discharge education for a patient who underwent a cervical diskectomy. What strategies would the nurse assess that would aid in planning discharge teaching?
- A. Care of the cervical collar
- B. Technique for performing neck ROM exercises
- C. Home assessment of ABGs
- D. Techniques for restoring nerve function
Correct Answer: A
Rationale: Cervical collar care is essential for post-diskectomy recovery to maintain alignment. ROM exercises, ABG assessment, and nerve restoration are not appropriate.
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.
A patient, brought to the clinic by his wife and son, is diagnosed with Huntington disease. When providing anticipatory guidance, the nurse should address the future possibility of what effect of Huntington disease?
- A. Metastasis
- B. Risk for stroke
- C. Emotional and personality changes
- D. Pathologic bone fractures
Correct Answer: C
Rationale: Huntington's disease causes significant emotional and personality changes due to neurologic degeneration. It is not malignant, nor does it increase stroke or fracture risk.
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.