Nokea
Proper body alignment of the hemiplegic patient with the use of a footboard, trochanter rolls, and pillows will minimize the development of
- A. plantar extension
- B. shoulder abduction
- C. internal hip rotation
- D. external hip rotation
Correct Answer: A
Rationale: Footboards prevent plantar extension deformities.
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You are providing care for a patient with an acute hemorrhagic stroke. The patient's husband has been reading a lot about strokes and asks why his wife did not receive alteplase. What is your best response?
- A. Your wife was not admitted within the time frame that alteplase is usually given.
- B. This drug is used primarily for patients who experience an acute heart attack.
- C. Alteplase dissolves clots and may cause more bleeding into your wife's brain.
- D. Your wife had gallbladder surgery just 6 months ago and this prevents the use of alteplase.
Correct Answer: C
Rationale: Alteplase increases the risk of bleeding, making it contraindicated in hemorrhagic stroke.
In the development of the nervous system, which is the correct order of events?
- A. First, cells must be specified to be neurons, second, these neurons must make connections with their targets, third, the neurons must migrate to their final position, and fourth, the neurons refine their synaptic connections.
- B. First, cells must be specified to be neurons, second, the neurons must migrate to their final position, third, these neurons must make connections with their targets, and fourth, the neurons refine their synaptic connections.
- C. First, cells must migrate to their final position, second, these cells must be specified to be neurons, third, the neurons must make connections with their targets, and fourth, the neurons refine their synaptic connections.
- D. First, the prospective neurons must make connections with their targets, second, the neurons refine their synaptic connections, third, the neurons must migrate to their final position, and fourth, the cells are specified to become neurons.
Correct Answer: B
Rationale: The correct sequence of nervous system development involves: (1) specification of cells as neurons, (2) migration of neurons to their final positions, (3) formation of connections with targets, and (4) refinement of synaptic connections. This order ensures proper neural circuit formation and function. Specification occurs first, followed by migration, which positions neurons correctly. Axon outgrowth and target connection occur next, and finally, synaptic pruning and refinement optimize neural communication.
A laminectomy and spinal fusion are performed on a patient with a herniated lumbar intervertebral disc. During the postoperative period, which finding is of most concern to the nurse?
- A. Paralytic ileus
- B. Urinary incontinence
- C. Greater pain at the graft site than at the lumbar incision site
- D. Leg and arm movement and sensation unchanged from preoperative status
Correct Answer: B
Rationale: Urinary incontinence may indicate nerve damage.
What should be included in the management of a patient with delirium?
- A. The use of restraints to protect the patient from injury
- B. The use of short-acting benzodiazepines to sedate the patient
- C. Identification and treatment of underlying causes when possible
- D. Administration of high doses of an antipsychotic drug such as haloperidol (Haldol)
Correct Answer: C
Rationale: Identifying and treating underlying causes is key in managing delirium.
MRS. Post is concerned about the effect of her diagnosis of systemic lupus erythematosus on childbearing. In discharge planning with Mrs. Post, you should
- A. instruct her to use an intrauterine device for birth control
- B. tell her pregnancy may cause an exacerbation of symptoms
- C. tell her that her symptoms will not change because of pregnancy
- D. instruct her to use birth control pills
Correct Answer: B
Rationale: Pregnancy can trigger lupus flares, requiring careful monitoring.