Nokea
In the care plan for Mr. Thompson, a 78-year-old man with Parkinson's disease, Nurse Edwards is identifying tasks that can be safely delegated to a nursing assistant (NA). Considering the responsibilities and scope of practice for a nursing assistant, which of the following tasks is most appropriate for Nurse Edwards to delegate?
- A. Checking for orthostatic changes in pulse and blood pressure.
- B. Monitoring for improvement in tremor after levodopa (L-dopa) is given.
- C. Adjusting the dosage of levodopa (L-dopa) based on the patient's response.
- D. Monitoring for abnormal involuntary jerky movements of extremities.
Correct Answer: A
Rationale: Checking for orthostatic changes is within the scope of practice for a nursing assistant and is important for monitoring the side effects of PD medications.
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Which of the following signs and symptoms of increased ICP after head trauma would appear first?
- A. Bradycardia
- B. Large amounts of very dilute urine
- C. Restlessness and confusion
- D. Widened pulse pressure
Correct Answer: C
Rationale: Restlessness and confusion are often the earliest signs of increased ICP. These symptoms occur due to impaired cerebral perfusion and hypoxia. As ICP rises, it compresses brain tissue and blood vessels, leading to altered mental status. Bradycardia, widened pulse pressure, and changes in urine output are later signs of increased ICP and indicate more severe neurological compromise.
The nurse suspects that a patient will be diagnosed as being in a comatose state based upon the Glasgow Coma Scale score. What score does the patient need to have to be identified as comatose?
- A. 7
- B. 9
- C. 11
- D. 13
Correct Answer: A
Rationale: A GCS score of 7 or less indicates a comatose state, while a score of 15 indicates full alertness. Scores of 9, 11, and 13 suggest varying degrees of neurological impairment but not coma. Recognizing a comatose state is critical for patient management.
The patient has had RA for some time but has not had success with previous medications. Although there is an increased risk for tuberculosis, which monoclonal antibody is used with methotrexate to best treat symptoms?
- A. Parenteral gold
- B. Certolizumab (Cimzia)
- C. Tocilizumab (Actemra)
- D. Hydroxychloroquine (Paquenil)
Correct Answer: C
Rationale: Tocilizumab targets IL-6 receptors.
While shopping, Marnie Smith, RN, sees a man on the floor in the shopping center having tonic-clonic movements. Her first action is to
- A. place her pen between his teeth and over his tongue
- B. restrain the movements of the extremities
- C. place a sweater under his head
- D. turn the patient into the prone position
Correct Answer: C
Rationale: Protecting the head and ensuring safety is the priority during a seizure.
A graduate nurse is taking a test on neurological conditions. Which of the following nursing interventions is used as a gastrointestinal preventative measure for the client with intracranial pressure?
- A. Insertion of an NG tube
- B. Administration of a histamine antagonist (Pepcid)
- C. Sips of clear fluid
- D. Insertion of a rectal tube
Correct Answer: B
Rationale: Histamine antagonists help prevent stress ulcers in clients with intracranial pressure.