Nokea
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.
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An older adult has encouraged her husband to visit their primary care provider, stating that she is concerned that he may have Parkinsons disease. Which of the wifes descriptions of her husbands health and function is most suggestive of Parkinsons disease?
- A. Lately he seems to move far more slowly than he ever has in the past.
- B. He often complains that his joints are terribly stiff when he wakes up in the morning.
- C. Hes forgotten the names of some people that weve known for years.
- D. Hes losing weight even though he has a ravenous appetite.
Correct Answer: A
Rationale: Bradykinesia is a hallmark of Parkinson's disease. Joint stiffness, memory loss, or weight loss with increased appetite are not typical symptoms.
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 nurse is assessing a patient with an acoustic neuroma who has been recently admitted to an oncology unit. What symptoms is the nurse likely to find during the initial assessment?
- A. Loss of hearing, tinnitus, and vertigo
- B. Loss of vision, change in mental status, and hyperthermia
- C. Loss of hearing, increased sodium retention, and hypertension
- D. Loss of vision, headache, and tachycardia
Correct Answer: A
Rationale: Acoustic neuroma, a tumor of the eighth cranial nerve, affects hearing and balance, causing hearing loss, tinnitus, and vertigo. Vision loss, sodium retention, or tachycardia are not typical symptoms.
A patient with a brain tumor has begun to exhibit signs of cachexia. What subsequent assessment should the nurse prioritize?
- A. Assessment of peripheral nervous function
- B. Assessment of cranial nerve function
- C. Assessment of nutritional status
- D. Assessment of respiratory status
Correct Answer: C
Rationale: Cachexia involves weight loss and muscle atrophy, necessitating nutritional assessment to address deficits. Other assessments are less directly related.
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.