Nokea
The client asks the nurse, 'What causes Creutzfeldt-Jakob disease?' Which statement would be the nurse's best response?
- A. The person must have been exposed to an infected prion.'
- B. It is mad cow disease, and eating contaminated meat is the cause.'
- C. This disease is caused by a virus that is in stagnant water.'
- D. A fungal spore from the lungs infects the brain tissue.'
Correct Answer: A
Rationale: Creutzfeldt-Jakob disease is caused by prions (A), infectious proteins. Mad cow (B) is a variant but not the sole cause, and viral (C) or fungal (D) causes are incorrect.
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The nurse is caring for the client who had a stroke affecting the right hemisphere of the brain. The nurse should assess for which problem initially?
- A. Right hemiparesis
- B. Expressive aphasia
- C. Poor impulse control
- D. Tetraplegia
Correct Answer: C
Rationale: A stroke affecting the right hemisphere may produce left, not right hemiparesis. Motor fibers in the brain cross over in the medulla before entering the spinal column. This client may or may not have aphasia because the center for language is located on the left side of the brain in 75% to 80% of the population; this client had a stroke involving the right hemisphere. Even though the client may have expressive aphasia, it is more important to assess for poor impulse control due to the risk for injury. The client with a stroke affecting the right side of the brain often exhibits impulsive behavior and is unaware of the neurological deficits. Poor impulse control increases the client’s risk for injury. Tetraplegia (quadriplegia) is associated with an SCI; tetraplegia usually does not occur from a stroke.
Which statement by a client with Alzheimer's disease indicates a need for further safety teaching?
- A. I'll use a nightlight in my bedroom.'
- B. I can cook meals on the stove alone.'
- C. I'll keep my medications in a locked box.'
- D. I'll wear a medical alert bracelet.'
Correct Answer: B
Rationale: Cooking alone on the stove poses a fire risk for clients with Alzheimer's due to memory and judgment impairments.
Which finding is considered to be one of the warning signs of developing Alzheimer's disease?
- A. Difficulty performing familiar tasks.
- B. Problems with orientation to date, time, and place.
- C. Having problems focusing on a task.
- D. Atherosclerotic changes in the vessels.
Correct Answer: A
Rationale: Difficulty performing familiar tasks (A) is an early Alzheimer’s sign due to cognitive decline. Orientation issues (B) occur later, focus problems (C) are nonspecific, and atherosclerosis (D) is unrelated.
Which collaborative intervention should the nurse implement when caring for the client with West Nile virus?
- A. Complete neurovascular examinations every eight (8) hours.
- B. Maintain accurate intake and output at the end of each shift.
- C. Assess the client’s symptoms to determine if there is improvement.
- D. Administer intravenous fluids while assessing for overload.
Correct Answer: D
Rationale: IV fluids (D) support hydration in West Nile virus while monitoring for overload prevents complications. Neurovascular exams (A) are less relevant, intake/output (B) is routine, and symptom assessment (C) is nursing-driven.
The chief executive officer (CEO) of a large manufacturing plant presents to the occupational health clinic with chronic rhinitis and requesting medication. On inspection, the nurse notices holes in the septum that separates the nasal passages. The nurse also notes dilated pupils and tachycardia. The facility has a 'No Drug' policy. Which intervention should the nurse implement?
- A. Prepare to complete a drug screen urine test.
- B. Discuss the client’s use of illegal drugs.
- C. Notify the client’s supervisor about the situation.
- D. Give the client an antihistamine and say nothing.
Correct Answer: A
Rationale: Nasal septal perforation, dilated pupils, and tachycardia suggest cocaine use. A drug screen (A) objectively confirms substance use while maintaining confidentiality. Discussing drug use (B) is premature, notifying the supervisor (C) breaches confidentiality, and ignoring findings (D) is unethical.