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For what purpose would the nurse use the Mini-Mental State Examination to evaluate a patient with cognitive impairment?
- A. It is a good tool to determine the etiology of dementia.
- B. It is a good tool to evaluate mood and thought processes.
- C. It can help to document the degree of cognitive impairment in delirium and dementia.
- D. It is useful for initial evaluation of mental status but additional tools are needed to evaluate changes in cognition over time.
Correct Answer: C
Rationale: The MMSE documents cognitive impairment in delirium and dementia
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When assessing a patient's level of consciousness, the nurse should:
- A. Evaluate the patient's response to verbal and physical stimuli.
- B. Measure the patient's blood pressure.
- C. Inspect the patient's skin color.
- D. Assess the patient's respiratory rate.
Correct Answer: A
Rationale: Evaluating a patient's response to verbal and physical stimuli is essential for assessing their level of consciousness. Blood pressure, skin color, and respiratory rate are important but do not directly measure consciousness.
The patient works on a computer 8 hours each day. What kind of repetitive strain injury would be expected in this patient?
- A. Meniscus injury
- B. Rotator cuff injury
- C. Radial-ulnar fracture
- D. Carpal tunnel syndrome
Correct Answer: D
Rationale: Carpal tunnel syndrome is a common repetitive strain injury associated with prolonged computer use.
A 40-year-old client presents with a complaint of morning stiffness in her hands, and painful joints of about 3 months duration. On physical examination, you note deviation of the fingers of both hands toward the ulnar side, and swelling and thickening of the proximal interphalangeal joints. You refer the client to a physician for diagnosis and treatment of what you expect to be
- A. osteoarthritis
- B. degenerative joint disease
- C. rheumatoid arthritis
- D. gouty arthritis
Correct Answer: C
Rationale: Symptoms such as morning stiffness, joint swelling, and ulnar deviation are characteristic of rheumatoid arthritis.
You are caring for a patient who has just had open carpal tunnel release surgery. The surgeon has requested that the patient's hand and arm remain elevated above the level of the heart after the surgery. This is to
- A. Reduce lymphatic drainage.
- B. Reduce postoperative swelling.
- C. Restrict hand movements.
- D. Decrease possibility of nosocomial infection.
Correct Answer: B
Rationale: Elevation reduces swelling by improving venous and lymphatic return.
In initial stage of Parkinson disease the most typical involuntary movement is the following:
- A. chorea
- B. atetosis
- C. tremor
- D. dystonia
Correct Answer: C
Rationale: Tremor is the correct answer because it is one of the earliest and most characteristic symptoms of Parkinson's disease. The tremor is typically a resting tremor, which decreases with voluntary movement and is often described as ‘pill-rolling' due to its appearance. It results from the degeneration of dopaminergic neurons in the substantia nigra.