Nokea
Because carbamazepine (Tegretol) can cause liver dysfunction, the client's discharge plan should include instructions to report which symptom?
- A. Unusual bleeding
- B. Yellowing of the skin
- C. Cloudy urine
- D. Mottled skin
Correct Answer: B
Rationale: Yellowing of the skin (jaundice) indicates potential liver dysfunction, a known side effect of carbamazepine.
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When preparing the client for the upcoming positron emission tomography (PET) scan, the nurse instructs the client to avoid which substances the day before the test? Select all that apply.
- A. Caffeine
- B. Shampoo
- C. Diuretics
- D. Shellfish
- E. Alcohol
- F. Tobacco
Correct Answer: A,E,F
Rationale: Caffeine, alcohol, and tobacco can affect cerebral metabolism and blood flow, potentially altering PET scan results.
The nurse is assessing a client with a history of transient ischemic attacks (TIAs). Which finding is most concerning and should be reported immediately?
- A. Mild headache for 2 days
- B. Transient numbness in the left arm
- C. Slight dizziness when standing
- D. Occasional forgetfulness
Correct Answer: B
Rationale: Transient numbness in the left arm may indicate a TIA, which requires immediate reporting due to the risk of progression to a stroke.
Which intervention should the nurse take with the client recently diagnosed with amyotrophic lateral sclerosis (Lou Gehrig's disease)?
- A. Discuss a percutaneous gastrostomy tube.
- B. Explain how a fistula is accessed.
- C. Provide an advance directive.
- D. Refer to a physical therapist for leg braces.
Correct Answer: C
Rationale: ALS is progressive and terminal. Providing an advance directive (C) ensures the client’s wishes are respected early. Gastrostomy (A) is later, fistulas (B) are unrelated, and leg braces (D) are less urgent.
If the client had been unresponsive except to painful stimuli, which new assessment finding indicates that the client is improving?
- A. Pupils are fixed when stimulated with light.
- B. Pupils are unequal when stimulated with light.
- C. Client's Glasgow Coma Scale score is 12.
- D. Stroking the cheek with a swab causes swallowing.
Correct Answer: C
Rationale: A Glasgow Coma Scale score of 12 indicates improved responsiveness compared to being unresponsive except to painful stimuli, suggesting neurological improvement.
The nurse is caring for the older adult client with normal pressure hydrocephalus (NPH). Which treatment measure should the nurse anticipate?
- A. Carotid endarterectomy
- B. Ventriculoperitoneal shunt
- C. Insertion of a lumbar drain
- D. Anticonvulsant medications
Correct Answer: B
Rationale: A carotid endarterectomy involves removal of plaque from the carotid artery. NPH is treated with the placement of a permanent shunt in a lateral ventricle of the brain to the peritoneal cavity. The excess CSF drains into the peritoneal cavity. A lumbar drain can be used to remove CSF with disorders that increase CSF in the subarachnoid space in the lumbar area; this does not remain permanently. Anticonvulsant medications are used to treat seizures.