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How can the nurse best help the client deal with personal fears at this time?
- A. Encourage the client to verbalize feelings.
- B. Provide a detailed explanation of the disease progression.
- C. Tell the client about physical assessment findings.
- D. Explain that the disease may become periodically acute.
Correct Answer: A
Rationale: Encouraging verbalization of feelings helps the client process fears and promotes emotional coping during an MS exacerbation.
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The client has glossopharyngeal nerve (cranial nerve IX) paralysis secondary to a stroke. Which referral would be most appropriate for this client?
- A. Hospice nurse.
- B. Speech therapist.
- C. Physical therapist.
- D. Occupational therapist.
Correct Answer: B
Rationale: Glossopharyngeal nerve paralysis affects swallowing and speech. A speech therapist (B) is most appropriate to address these deficits. Hospice (A) is for end-of-life care, physical therapy (C) focuses on mobility, and occupational therapy (D) addresses daily activities.
The public health nurse is giving a lecture on potential outbreaks of infectious meningitis. Which population is most at risk for an outbreak?
- A. Clients recently discharged from the hospital.
- B. Residents of a college dormitory.
- C. Individuals who visit a third world country.
- D. Employees in a high-rise office building.
Correct Answer: B
Rationale: College dormitory residents (B) are at high risk for meningococcal meningitis due to close living conditions and shared spaces. Hospital discharges (A), travel (C), or office workers (D) are less specific risks.
The client diagnosed with a brain abscess has become lethargic and difficult to arouse. Which intervention should the nurse implement first?
- A. Implement seizure precautions.
- B. Assess the client's neurological status.
- C. Close the drapes and darken the room.
- D. Prepare to administer an IV steroid.
Correct Answer: B
Rationale: Lethargy and difficulty arousing suggest neurological deterioration. Assessing neurological status (B) is the first step to determine the cause and guide interventions. Seizure precautions (A), darkening the room (C), and steroids (D) follow assessment.
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.
When the nurse describes the myelogram procedure to the client, which statement is most accurate?
- A. Part of the test involves a lumbar puncture.'
- B. You will be asked to change positions frequently.'
- C. Dye is instilled into a vein in your arm.'
- D. Light anesthesia is administered during the test.'
Correct Answer: A
Rationale: A myelogram involves a lumbar puncture to inject contrast dye into the spinal canal for imaging.