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The client is admitted with a diagnosis of trigeminal neuralgia. Which assessment data would the nurse expect to find in this client?
- A. Joint pain of the neck and jaw.
- B. Unconscious grinding of the teeth during sleep.
- C. Sudden severe unilateral facial pain.
- D. Progressive loss of calcium in the nasal septum.
Correct Answer: C
Rationale: Trigeminal neuralgia causes sudden, severe, unilateral facial pain (C) due to irritation of the trigeminal nerve. Joint pain (A) is unrelated, teeth grinding (B) is bruxism, and calcium loss (D) is not a feature.
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The resident in a long-term care facility fell during the previous shift and has a laceration in the occipital area that has been closed with steristrips. Which signs/symptoms would warrant transferring the resident to the emergency department?
- A. A 4-cm area of bright red drainage on the dressing.
- B. A weak pulse, shallow respirations, and cool pale skin.
- C. Pupils that are equal, react to light, and accommodate.
- D. Complaints of a headache that resolves with medication.
Correct Answer: B
Rationale: Signs of shock (weak pulse, shallow respirations, cool pale skin, B) suggest internal bleeding or serious injury post-fall, warranting ED transfer. Minor drainage (A) is expected, normal pupils (C) are reassuring, and a resolving headache (D) is not urgent.
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.
Which is a common cognitive problem associated with Parkinson’s disease?
- A. Emotional lability.
- B. Depression.
- C. Memory deficits.
- D. Paranoia.
Correct Answer: B
Rationale: Depression (B) is a common cognitive/emotional problem in Parkinson’s due to dopamine dysregulation and chronic illness impact. Emotional lability (A) is less common, memory deficits (C) occur later, and paranoia (D) is not typical.
Which finding in a client post-stroke indicates a need for immediate intervention?
- A. Blood pressure of 180/100 mmHg
- B. Mild weakness in the right arm
- C. Difficulty finding words
- D. Fatigue after physical therapy
Correct Answer: A
Rationale: Severe hypertension post-stroke increases the risk of hemorrhage or further brain injury, requiring immediate intervention.
A family member brings the client to the emergency department reporting that the 78-year-old father has suddenly become very confused and thinks he is living in 1942, that he has to go to war, and that someone is trying to poison him. Which question should the nurse ask the family member?
- A. Has your father been diagnosed with dementia?'
- B. What medication has your father taken today?'
- C. What have you given him that makes him think it's poison?'
- D. Does your father like to watch old movies on television?'
Correct Answer: B
Rationale: Sudden confusion and delusions suggest delirium, often medication-related. Asking about medications (B) identifies potential causes. Dementia (A) causes gradual decline, blaming poison (C) is untherapeutic, and movies (D) are irrelevant.