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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.
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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 25-year-old female patient with brain metastases is considering her life expectancy after her most recent meeting with her oncologist. Based on the fact that the patient is not receiving treatment for her brain metastases, what is the nurses most appropriate action?
- A. Promoting the patients functional status and ADLs
- B. Ensuring that the patient receives adequate palliative care
- C. Ensuring that the family does not tell the patient that her condition is terminal
- D. Promoting adherence to the prescribed medication regimen
Correct Answer: B
Rationale: Untreated brain metastases lead to a rapid decline, making palliative care the priority to manage symptoms and improve quality of life. Promoting function or withholding information is less appropriate.
A gerontologic nurse is advocating for diagnostic testing of an 81-year-old patient who is experiencing personality changes. The nurse is aware of what factor that is known to affect the diagnosis and treatment of brain tumors in older adults?
- A. The effects of brain tumors are often attributed to the cognitive effects of aging.
- B. Brain tumors in older adults do not normally produce focal effects.
- C. Older adults typically have numerous benign brain tumors by the eighth decade of life.
- D. Brain tumors cannot normally be treated in patient over age 75.
Correct Answer: A
Rationale: Brain tumor symptoms in older adults are often misattributed to aging, delaying diagnosis. Tumors produce focal effects, are not typically benign, and treatment is not age-restricted.
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 has been admitted to the neurologic ICU with a diagnosis of a brain tumor. The patient is scheduled to have a tumor resection/removal in the morning. Which of the following assessment parameters should the nurse include in the initial assessment?
- A. Gag reflex
- B. Deep tendon reflexes
- C. Abdominal girth
- D. Hearing acuity
Correct Answer: A
Rationale: Assessing gag reflex is critical preoperatively to prevent aspiration during surgery. Other assessments are less relevant to immediate surgical risks.