Nokea
Metoprolol, a β-adrenergic blocker that inhibits sympathetic nervous system activity, is prescribed for a patient. Which of the following assessments should the nurse monitor?
- A. Dry mouth
- B. Constipation
- C. Slowed pulse
- D. Urinary retention
Correct Answer: C
Rationale: Inhibition of the fight or flight response leads to decreased heart rate. Dry mouth, constipation, and urinary retention are associated with peripheral nervous system blockade.
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The following prescriptions are received for an unconscious patient admitted to the emergency department (ED) with a head injury as result of an automobile accident. Which of the following prescriptions should the nurse question?
- A. Obtain radiographs of the skull and spine.
- B. Prepare the patient for lumbar puncture.
- C. Send for computed tomography (CT) scan.
- D. Perform neurologic checks every 15 minutes.
Correct Answer: B
Rationale: After a head injury, the patient may be experiencing intracranial bleeding and increased intracranial pressure, which could lead to herniation of the brain with lumbar puncture. The other orders are appropriate.
The charge nurse is observing a novice staff nurse who is assessing a patient with a possible spinal cord lesion for sensation. Which of the following action indicates a need for further teaching about neurological assessment?
- A. The novice nurse asks the patient, 'Does this feel sharp?'
- B. The novice nurse tests for light touch before testing for pain.
- C. The novice nurse has the patient close the eyes during testing.
- D. The novice nurse uses an irregular pattern to test for intact touch.
Correct Answer: A
Rationale: When performing a sensory assessment, the nurse should not provide verbal clues. The other actions by the new nurse are appropriate.
After reviewing a patient's cerebrospinal fluid (CSF) analysis, which of the following results is most important for the nurse to communicate to the health care provider?
- A. Specific gravity 1.007
- B. Protein 6.5 g/L
- C. White blood cell (WBC) count 5 x 10^6/L
- D. Glucose 2.5 mmol/L
Correct Answer: B
Rationale: The protein level is high. The specific gravity, WBCs, and glucose values are normal.
When caring for a patient who has had cerebral angiography, which of the following nursing actions should be included in the plan of care?
- A. Ask about headache and photophobia.
- B. Keep patient NPO until gag reflex returns.
- C. Check pulse and blood pressure frequently.
- D. Assess orientation to person, place, and time.
Correct Answer: C
Rationale: Since a catheter is inserted into an artery (such as the femoral artery) during cerebral angiography, the nurse should assess for bleeding after this procedure. The other nursing assessments are not necessary after angiography.
The nurse is admitting a patient with a brain stem infarction. Which of the following assessments is priority?
- A. Reflex reaction time
- B. Pupil reaction to light
- C. Level of consciousness
- D. Respiratory rate and rhythm
Correct Answer: D
Rationale: Vital centres that control respiration are located in the medulla, and these are the priority assessments because changes in respiratory function may be life threatening. The other information also will be collected by the nurse, but it is not as urgent.