Nokea
An MRI scan of a 33-year-old female client with new-onset seizures has revealed a lesion on her frontal lobe. Which of the following signs and symptoms would most likely be a direct result of this lesion?
- A. Changes in sensation or movement in the client's limbs
- B. Fluctuations in blood pressure
- C. Changes in speech and reasoning
- D. Increased intracranial pressure
Correct Answer: C
Rationale: The correct answer is C: Changes in speech and reasoning. The frontal lobe is responsible for higher cognitive functions, including speech and reasoning. A lesion in this area can lead to difficulties in speech production, language comprehension, and reasoning abilities. Choices A, B, and D are incorrect. Changes in sensation or movement in the client's limbs are more associated with lesions in the motor or sensory cortices of the brain, not the frontal lobe. Fluctuations in blood pressure are often related to autonomic nervous system dysfunction, which is controlled by other brain regions. Increased intracranial pressure is typically seen in conditions like brain tumors or head trauma, not directly related to a frontal lobe lesion.
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What aspect of hormonal contraceptives places a woman at the greatest risk for the development of blood clots?
- A. Hormonal contraceptives increase serum triglyceride and cholesterol levels.
- B. Hormonal contraceptives increase platelet levels.
- C. Hormonal contraceptives increase blood levels of clotting factors.
- D. Hormonal contraceptives cause injury to blood vessel linings.
Correct Answer: C
Rationale: The correct answer is C. Hormonal contraceptives increase blood levels of clotting factors, particularly factors II, VII, IX, and X. This elevation in clotting factors can predispose individuals to thromboembolic events, including blood clots. Choices A, B, and D are incorrect because hormonal contraceptives do not have a significant effect on serum triglycerides and cholesterol, platelet levels, or causing direct injury to blood vessel linings as the primary mechanism for clot formation.
A patient with a history of breast cancer is being prescribed tamoxifen (Nolvadex). What should the nurse include in the patient education?
- A. Tamoxifen may increase the risk of venous thromboembolism.
- B. Tamoxifen may decrease the risk of osteoporosis.
- C. Tamoxifen may cause hot flashes and other menopausal symptoms.
- D. Tamoxifen may cause weight gain and fluid retention.
Correct Answer: A
Rationale: The correct answer is A. Tamoxifen increases the risk of venous thromboembolism. Patients should be educated about signs and symptoms of blood clots, such as swelling, pain, or redness in the legs. Choices B, C, and D are incorrect because tamoxifen is not associated with decreasing the risk of osteoporosis, causing hot flashes and menopausal symptoms, or causing weight gain and fluid retention.
The patient should be taught that an improvement in symptoms will likely be noticed within
- A. 48 hours.
- B. a week to 10 days.
- C. 2 to 3 weeks.
- D. 4 to 6 weeks.
Correct Answer: C
Rationale: When taking isoniazid and rifampin for active tuberculosis, patients should be taught that an improvement in symptoms will likely be noticed within 2 to 3 weeks. Choice A (48 hours) is too soon to expect significant improvement in symptoms. Choice B (a week to 10 days) is also too early for noticeable improvement with this medication regimen. Choice D (4 to 6 weeks) is too far out to expect a noticeable improvement in symptoms.
A 45-year-old client is admitted with new-onset status epilepticus. What is the priority nursing intervention?
- A. Administer IV fluids and monitor electrolytes.
- B. Administer antiepileptic medications as prescribed.
- C. Ensure a patent airway and prepare for possible intubation.
- D. Monitor the client for signs of hypotension.
Correct Answer: C
Rationale: The correct answer is C. In a client with new-onset status epilepticus, the priority nursing intervention is to ensure a patent airway and prepare for possible intubation. This is crucial to prevent hypoxia and further complications. Administering IV fluids and monitoring electrolytes (choice A) can be important but ensuring airway patency takes precedence. Administering antiepileptic medications (choice B) is essential but only after securing the airway. Monitoring for hypotension (choice D) is also important but not the priority when managing status epilepticus.
A male patient is receiving testosterone therapy for hypogonadism. What serious adverse effect should the nurse monitor for during this therapy?
- A. Increased risk of liver dysfunction
- B. Increased risk of prostate cancer
- C. Increased risk of bone fractures
- D. Increased risk of breast cancer
Correct Answer: A
Rationale: The correct answer is A: Increased risk of liver dysfunction. Testosterone therapy can lead to liver dysfunction, including cholestatic jaundice and hepatitis. This adverse effect necessitates monitoring of liver function tests during testosterone therapy. Choice B, increased risk of prostate cancer, is incorrect because testosterone therapy does not cause prostate cancer but is contraindicated in patients with known or suspected prostate cancer. Choice C, increased risk of bone fractures, is incorrect as testosterone therapy is actually associated with an increase in bone mineral density, reducing the risk of fractures. Choice D, increased risk of breast cancer, is incorrect because testosterone therapy in males does not increase the risk of breast cancer.